New report: Workforce crisis impacting quality of long term care in Texas

The Texas Health Care Association has released a new report detailing how the nursing turnover rate and workforce availability in Texas nursing homes are at crisis levels. The report compiles recent statistics and academic studies to show that the workforce crisis is causing the industry to fall below national averages in survey, quality and staffing measures.

Compounding the problem is the state’s Medicaid reimbursement rate, which is one of the lowest rates in the nation. As a result, Texas has among the highest number of one-star-rated nursing homes among all states. Because of the low rate, nursing home operators are unable to make significant investments to upgrade facilities and offer competitive benefits and wages to entice high-quality direct care staff to stay in the industry. The turnover rates for RNs, licensed vocational nurses (LVNs) and certified nursing assistants (CNAs) are above 90 percent.

A survey conducted by the Texas Center for Nursing Workforce Studies (TCNWS) showed only 8 percent of the nursing home respondents believe there is an adequate supply of nursing personnel. TCNWS labeled the hiring of more RNs for nursing homes as an “imperative.”

Compounding the problem is a stressful and heavily regulated workplace. On any given day, up to 34 different local, state and federal agencies with authority over licensed nursing homes in Texas may visit a nursing facility. Within this environment, direct care staff are leaving the sector altogether. Nursing homes are unable to attract and retain a robust workforce, contributing to extremely high rates of nursing staff turnover that exacerbate deficiencies across nursing homes.

The workforce crisis can have a direct affect on quality of care, as new or inexperienced staff replace experienced caregivers. A lack of care continuity can lead to higher incidence of negative outcomes and adverse events. Without a significant shift in the state’s approach to supporting nursing homes, efforts to improve will fall short and quality of care for senior Texans will worsen.

THCA is currently working to address the workforce crisis with members of the Texas Legislature.