Texas SNF survey: Funding cuts portend staff layoffs, deferred tech investment, facility closures

A new survey of Texas nursing homes finds the series of state and federal funding cuts to seniors’ skilled nursing facility care is creating a dangerous strain on facilities’ ability to care for growing numbers of older, more medically complex residents.

Following the $58 million state Medicaid cut in 2011 and a series of federal Medicare cuts since 2009—the latest being a $51 million cut associated with the federal sequester—Texas nursing homes are reporting the cumulative funding squeeze is having a significantly negative impact on facility operations, and are a growing threat to patient care.

Among the findings:

• 65.9 percent of respondents reported staff changes;
• 72.5 percent of respondents have reduced staff hours, wages and/or benefits;
• 60 percent of respondents have cancelled or postponed facility improvements.

When asked what actions they may be forced to consider in 2013, respondents reported:

• 84.3  percent of facilities may have to freeze wages;
• 81.8 percent may have to defer facility expansions or renovations;
• 78.4 percent may have to defer investment in new technology and therapy equipment;
• 75 percent may have to defer, reduce or change staff benefits;
• 31.1 percent may have to lay off direct care staff;
• 18.4 percent may be forced to consider actually closing their facility.

In releasing the survey, Tim Graves, president of the Texas Health Care Association (THCA), said the debate over Medicaid expansion has obscured badly needed discussion and action to protect Texas seniors' access to quality nursing home care.

"The so-called 'Medicaid expansion' discussion in Austin is coming at the expense of a closer legislative look at how Texas nursing home patients are increasingly put at risk by the state's own lack of Medicaid funding adequacy," said Graves, in a statement. "So far, the Texas Legislature has not come close to adequately addressing seniors' state Medicaid funding requirements, and far more focus is warranted. Local seniors are at risk, and the Legislature needs to act."

Graves noted the Health and Human Services Commission (HHSC) estimates Medicaid spending in the 2014-2015 biennium will require an additional $925 million  just to meet today's cost of caring for the nearly 60,000 Medicaid-dependent elderly and disabled Texans living in nursing homes.

Patricia Sheehan

Patricia Sheehan was Editor in Chief of I Advance Senior Care / Long Term Living from 2010-2013. She is now manager, communications at Nestlé USA.