New Analysis: At $12.73 Billion Annually, Texas Ranks 4th Nationally in Nursing Facility-Generated Economic Activity and Employment

Mar 01, 2011, 11:36 ET from Alliance for Quality Nursing Home Care

Proposed 33 Percent State Cuts to Medicaid-Funded Care Raises Stakes in 2011 DC Medicare Funding Debate

AUSTIN, Texas, March 1, 2011 /PRNewswire-USNewswire/ -- A new 50 state analysis detailing the significance of the U.S. skilled nursing sector to the strength of America's national and state economies finds Texas ranks fourth nationally in nursing facility generated economic activity ($12.73 billion annually) and employment (98,700). Total jobs activity resulting from nursing facility activity is 154,673. This makes the skilled nursing sector Texas' second largest health facility employer after hospitals.

With President Barack Obama having unveiled his proposed FY 2012 federal budget, and with proposed 33 percent cuts to Medicaid-funded nursing home care in HB1 and SB1, the new study spotlights how facilities are caught in an ongoing state-federal funding squeeze. Medicaid cuts combined with potential Medicare funding reductions in Washington would risk not only seniors' care, but also jobs stability and the fragile economic recovery now taking shape. The funding squeeze on Texas facilities is especially pertinent from a patient care perspective due to the fact a majority of facility patients rely upon Medicare and Medicaid.  

Moreover, the study emphasizes the critical importance of stable Medicare funding from Washington in propping-up the ailing Texas Medicaid program, which has become a touchstone of budgetary discussion in Austin, and state capitols nationwide. Alan G. Rosenbloom, President of the Washington-based Alliance for Quality Nursing Home Care, stated: "With enormous pressure on Governor Perry to balance his budget, this places a premium on ensuring the Texas congressional delegation and President Obama work to achieve stable Medicare funding for the skilled nursing sector in a final FY 2012 budget. Doing so will help protect Texas seniors' care, grow the Texas jobs base, and nurture the state's fragile economic recovery."

The new installment of the Alliance for Quality Nursing Home Care's "Care Context" series of health policy analyses, created with analytic support from Avalere Health, a non-partisan health advisory firm, details the fact that, nationally, the U.S. skilled nursing sector accounts for 1.7 million jobs, with a total impact of over $201 billion annually on U.S. economic activity. The new analysis finds the following 10 states have the highest number of nursing facility jobs; followed by the total jobs created by nursing facility activity, and the total economic impact on the state economy:


NF Jobs

Total NF-Generated Jobs

Total NF-Generated Econ Activity




$21.35 Billion




$17.86 Billion




$13.13 Billion




$12.73 Billion




$11.63 Billion




$11.76 Billion




$10.72 Billion




$7.83 Billion




$9.83 Billion




$3.37 Billion 

"When considering budgetary policy for FY 2012, we want to ensure the Texas congressional delegation appreciates the considerable positive impact of skilled nursing facilities on the state's economy, and that achieving Medicare funding stability in Washington has a significant positive impact on local economic activity and jobs," said Buddy Parker, a representative of First Choice Medical Supply in Garland, TX, and a member of the Texas Coalition for Long Term Care Business (CLTCB). "Medicare is more than a key national health program, it serves as a cornerstone of rural, suburban and urban economic vitality throughout Texas."

Emil Parker, Director at Avalere Health, the lead author of the analysis, said nursing facilities in Texas and across the nation are responding to the funding squeeze in a variety of ways, including submitting late payments to vendors and being forced to delay facility improvements and maintenance: "Given that the average age of nursing home facilities in the United States is 29 years, delays in maintenance may negatively affect residents' quality of life. In addition, if nursing facility physical plants cannot be maintained adequately and the sector's capacity declines as a result, some patients may have to spend more time in higher-cost acute care hospitals because of delays in transfers to nursing facilities," he said.

Nursing facilities are the dominant provider of Medicare post-acute care services, treating 50 percent of all Medicare beneficiaries who are discharged from hospitals to post-acute care. The majority of patients are short-stay Medicare patients who are discharged from the hospital to the nursing facility, and need restorative and recuperative care before returning to home and community. Over the past two years, the nursing facility sector – through both federal regulatory and budgetary actions – has already absorbed nearly $30 billion nationally in Medicare cuts over ten years.

To View Complete Study, and to Learn More About the Significance of the U.S. Nursing Home Sector to the U.S. Economy and its Dominant Role in Caring for Post-Acute Care, go to

SOURCE Alliance for Quality Nursing Home Care