New TX Nursing Home Survey: Medicaid and Medicare Cuts Threaten Direct Care Staff Layoffs, Deferred Tech Investment, Possible Facility Closures

Mar 11, 2013, 11:41 ET from Texas Health Care Association




Legislature Urged to Focus More on Adequacy of Texas Seniors' State Medicaid Rates, Not Just Issues Surrounding 'Medicaid Expansion'


AUSTIN, Texas, March 11, 2013 /PRNewswire-USNewswire/ --  A newly completed survey of Texas nursing homes finds the series of state and federal funding cuts to seniors' skilled nursing facility (SNF) care is creating a dangerous strain on facilities' ability to care for growing numbers of older, more medically complex patients.

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. The questions and results are as follows:

"As a result of the continuing budget chaos in Washington regarding Medicare coupled with ongoing state Medicaid underfunding, have you:


  • Made any staff changes?  
    • 65.9% report yes
  • Reduced staff hours, wages and/or benefits? 
    • 72.5% report yes
  • Cancelled or postponed facility improvements?  
    • 60.0% report yes


"Looking ahead, what actions may you be forced to consider in 2013?


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


In releasing the new survey detailing how Medicaid and Medicare cuts are negatively affecting the economic stability of Texas nursing homes, and the growing threat to lawmakers' most vulnerable constituents, Tim Graves, President of THCA, said the debate over so-called "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," stated Graves. "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 ($372 million in GR funding) just to meet today's cost of caring for the nearly 60,000 Medicaid-dependent elderly and disabled Texans living in nursing homes.

Methodology Notes

The THCA survey represents an objective evaluation of current and prospective actions Texas' skilled nursing facilities may take to cope with the growing pressure on all aspects of operations. 100 facilities from every geographic part of the state offered responses. This comprises approximately 1/10th of all facilities statewide. Rural facilities comprise approximately 51% of the sample; Suburban and urban facilities comprise approximately 49%.

Small facilities (25-50 beds) comprised 8% of the respondents; medium-sized facilities (50-100 beds) comprised 30% of respondents; larger facilities (100-150 beds) comprised 36%% of respondents; still larger facilities (150+ beds) comprised 26% of respondents. While the universe of respondents may not be a statistically representative sample of all Texas long term and post acute care facilities, Graves says the results are instructive to policymakers, the media and the public at large as to how funding cuts impair facilities' economic stability and put elderly patients' care at risk.

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 non-profit and for-profit skilled nursing facilities (SNFs), specialized rehabilitation facilities 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 more than 190 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.

SOURCE Texas Health Care Association