The Goals of the NFRA

Provide a quality incentive to improve nursing facility care in Texas

Institute a payment system that fully funds the true cost of care today and tomorrow

Allow increased investment in recruitment and retention of caregivers

Preserve dignity and quality of life to ALL Texas nursing facility residents

Preserve access to skilled nursing facilities in Texas for Medicaid patients

What is the NFRA?

The NFRA is a provider-based solution to the problem of chronic underfunding of long term care in Texas. The NFRA would enable long term care providers to contribute funding that would be used by the state to draw down additional federal Medicaid dollars to improve the quality of care in Texas nursing homes. The NFRA would not increase the state general revenue spending.

How does it work?

Nursing home providers would pay a reinvestment allowance based on nursing home revenues. The funds collected would be used by the state to obtain additional federal Medicaid matching funds. This additional funding would be returned back to nursing facilities in Texas through a rate increase, closing the gap between the costs for taking care of Medicaid residents and the reimbursement rate. Providers would also have the opportunity to earn additional funding through quality incentive payments.

How will this improve long term care in Texas?

The NFRA will enable nursing facility owners and operators to raise wages, improve training and invest in capital improvements and equipment to meet the needs of the residents in their communities and improve the quality of long term care for all Texans.

Is this a tax on nursing home residents?

No. The NFRA is a provider-based investment in improving quality. The bill specifically states, “a facility may not list the reinvestment allowance as a separate charge on a resident’s billing statement or otherwise directly or indirectly attempt to charge the reinvestment allowance to a resident”. Funding from this program would also be prohibited for use to expand Medicaid.

Why does it sunset?

Providing sunset provisions for the NFRA would ensure members of the Legislature are satisfied with the improved quality of care delivered in Texas skilled nursing facilities with the additional investment.

What will it cost the taxpayers?

The NFRA will have zero impact on the state’s general revenue fund. Funds from this program would also be prohibited from being passed onto the consumer. The NFRA will allow Texas to capture hundreds of millions in additional Medicaid funding Texans now lose out on.

Will Texas be the first to attempt this approach to increase funding for long term care?

No. Other states have used this innovative approach to improve long term care.

Will the Legislature have oversight of how these funds are used?

Yes, an annual report must be filed with state leadership that details, among several items, whether the program is helping to improve quality in nursing homes.