Workforce crisis impacting quality of long term care in Texas

April 2, 2018

Contact: Jim Suydam, 512-417-5382

Workforce crisis impacting quality of long term care in Texas

Low Medicaid reimbursements contribute to costly turnover among caregivers

(AUSTIN, Texas) — A workforce crisis is rocking the long term care industry in Texas, dragging down quality ratings and endangering the lives of the most vulnerable seniors in the state.

The Texas Health Care Association today released a report detailing how significant challenges with recruitment and retention of direct care staffing, resulting from demanding work requirements and low Medicaid reimbursement rates in Texas making it difficult to compete in the labor market. These factors, and others, are leaving long term care facility operators scrambling to fill shifts while working on improving the quality of care.

Texas nursing homes are challenged with one of the lowest nursing home Medicaid reimbursement rates in the nation. With approximately two-thirds of the over 90,000 thousand Texas nursing home residents having care paid for by Medicaid, nursing homes don’t have the ability to shift costs to other payers or have access to other major sources of revenue. The result is a negative impact on recruitment and retention of direct care staff. And in a booming economy like Texas, alternative employment opportunities result in significant turnover rates as seen in Texas in recent years.

A survey conducted by the Texas Center for Nursing Workforce Studies (TCNWS) showed only 8 percent of the nursing home respondents believed to have an adequate supply of nursing personnel. TCNWS labeled the hiring of more RNs for nursing homes as an “imperative.”
High turnover rates lead negatively impacts direct care hours and can lead to negative outcomes. The resulting impact on quality of care as inexperienced staff constantly replace experienced caregivers. Nursing home providers are forced to spend millions each year in overtime wages and agency staffing to fill empty shifts.

According to CMS Nursing Home Compare, Texas has one of the lowest overall staff ratings for nursing homes. A further analysis of state’s average staffing ratings reveals a correlation with a state’s overall quality rating, under the CMS 5 star rating system.

“This data simply proves what anyone involved in long term care already knows — staffing is the key to delivering the kind of long term care you would want for your own family,” said Kevin Warren, President and CEO of the Texas Health Care Association. “The more consistent and dedicated the staff is, the more they understand and are able to effectively respond to each individual’s care needs. Having the necessary resources to compete in a highly competitive workforce that is already in short supply is critical to meet the needs of all individuals relying on the nursing home community in Texas.”

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About THCA
Founded in 1950, the Texas Health Care Association (THCA) is the largest long term care association in Texas. THCA’s membership is comprised of several hundred licensed nonprofit and for-profit skilled nursing facilities (SNFs), and assisted living facilities in Texas. These facilities provide comprehensive, around-the-clock nursing care for chronically ill or short-term residents of all ages, along with rehabilitative and specialized medical programs. THCA also represents long term care businesses that provide products and services to the state’s approximately 2,850 nursing homes and assisted living facilities. To learn more, visit or connect with THCA on Facebook, Twitter and YouTube.