Lack in Funding Could Be Contributing to Increase in Texas Nursing Home Violations

Nursing home violations across the country are decreasing, but Texas is going in the opposite direction.

By Michael MarksSeptember 8, 2016 10:59 am

Conditions in nursing homes are improving nationwide. A new report says code violations at U.S. facilities dropped by 8 percent from 2010 to 2014 – the most recent data available.

But in Texas, the numbers are moving in the opposite direction. Over that same period, nursing home violations in the state’s 1,200 facilities increased by 20 percent.

Robert Garrett, with the Dallas Morning News, says the study links the uptick in violations to the lack of funding. Certain advocates, like AARP, says that Texas also has weak regulations and enforcement of those regulations.

One AARP representative told Garrett that in the 2015 fiscal year, the state Department of Aging and Disability Services – which regulates nursing homes – took enforcement action against nursing homes only 44 times, even though inspectors cited 17,647 deficiencies.

State inspectors spend anywhere from three to five days at a facility about once a year, Garrett says. The inspectors are employed by the state, which contracts with the federal government to pay for the inspections.

“Some of these advocates think that we can’t possibly have a very tough inspection regime,” Garrett says.

Instead of the usual reticence to discuss inspections, the Texas Health Care Association – which commissioned the report – has showcased the rising numbers in a plea for more money.

“These are the people who are forgotten, largely,” Garrett says. “These are the elderly who have spent all their assets – if they even had any – and it doesn’t take that many years in a nursing home to consume all your assets. They are basically the poor elderly.”

The study pointed to 20 years of inadequate state Medicaid funding for nursing homes, Garrett says. Medicaid is the main funding source for nursing homes, with 70 percent of all residents enrolled in the program. According to another study by the American Health Care Association, Garrett reports that Texas Medicaid paid an average of $142 per patient per day, which fell about $13 short of the cost it takes to cover care.

“The nursing homes definitely have been making the case,” Garrett says. “They’ve had their tin cup out for session after session.”

But experts are saying the projected general fund budget for the 2017 legislative session won’t be as padded as state Comptroller Glenn Hegar suggested.

“[Nursing homes are] sailing into a strong headwind,” he says, “because they’re going to be competing with things that are nearer and dearer to the Republican leaders’ hearts – such as border security and tax cuts.”

Post by Beth Cortez-Neavel.