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Texas Medicaid funding places residents at risk

Published on April 2nd, 2009

The Dallas Morning News had an article about the amount of money Texas provides to nursing home residents who are on Medicaid.  The article emphasizes that the amount of money is directly related to the quality of care and shows how Texas treats its most vulnerable citizens.

Texas’ Medicaid program only reimburses nursing homes an average of $112.79 per patient per day – less than 48 other states.  Texas remains 30 percent below the national average of $163.27 per day.  Patient advocates and industry experts say Texas’ 49th-place ranking means that nursing homes can’t pay employees competitive wages. That in turn leads to high staff turnover, which hurts residents’ care.  It is no surprise that 28 percent of Texas’ 1,100 nursing homes received the worst rating and only 10 percent scored the best when Medicare announced its new nursing home ratings late last year.

The reimbursements now don’t even cover nursing homes’ actual costs and would need to increase to at least $125 a day for facilities to break even.  Skilled nursing care costs tens of thousands of dollars a year, so many nursing home residents eventually exhaust their personal assets and qualify for Medicaid, the federal-state health care program for the poor.

Nursing homes have tried to hold the line on their labor costs, but that leads to high staff turnover. It’s difficult to compete with hospitals, which pay better, so nursing homes routinely lose registered nurses, licensed vocational nurses and nurses’ aides.  "The average annual turnover rate is 87 percent for certified nurses’ aides," said Pearl Merritt, who leads a center task force on long-term care. "It’s a challenge to maintain high-quality care in a revolving-door environment."

Nurses’ aides can work at a McDonald’s for more than what Texas nursing homes are willing to pay them.

 

 

Joe Pioletti
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