Leaders Urge Texas to Allocate $400M to Bolster SNF Staffing as 30% of Facilities Have Restricted Admissions

The Texas Health Care Association (THCA), in a joint proposal with aging services organization LeadingAge Texas, this week requested $400 million in funding to help providers staff buildings amid the skilled nursing workforce shortage.

That’s less than 3% of the total federal aid funding allocated to the state, THCA said in a letter to Texas Gov. Greg Abbott — the state received approximately $16.7 billion for pandemic purposes from the American Rescue Plan Act.

Federal dollars can’t come soon enough, with more than 30% of facilities in the state having to restrict admissions due to staffing shortages, according to a member survey conducted by the association; about 70% of surveyed members are unable to hire enough nurses.

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Fort Worth, Texas-based Focused Post Acute Care Partners has been operating with 60% of its workforce, and conservatively expects to lose 40% more to the federal vaccination mandate.

Of its 1,700-person workforce, the operator has yet to confirm vaccination status and vaccination intentions with 700 of its staff members.

If it turns out that all 40% of remaining staff leave, that would put in motion “draconian” measures to continue serving residents, Post Acute CEO Mark McKenzie told Skilled Nursing News.

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“First step is we’ll limit [admissions],” said McKenzie. “We have a plan that we have to take to our landlord, that would allow us to consolidate buildings.”

Post Acute facilities are close enough to each other geographically to consolidate residences if need be, McKenzie added.

McKenzie said the $400 million is designed to last the industry until the next regular legislative session — in January 2023.

Fund allocation is expected to be included on a special state legislative session agenda scheduled for Sept. 20, according to Gov. Abbott’s office.

“This is a much needed action to strengthen the long-term care profession for us, to be able to pay for the staff that are so critical in terms of caring for the patients they serve,” Kevin Warren, president and CEO of THCA, told Skilled Nursing News. “We’re looking to try to stabilize the workforce, and this market.”

Meanwhile, monthly costs for running long-term care facilities in the state has increased “two to three-fold” with no additional support beyond Provider Relief Fund dollars due to run out at the end of the year.

Medicaid reimbursement — pre-pandemic — is $32 less than what it costs to actually deliver care in a long-term setting, according to Warren. Factoring in agency staff and increased costs tied to COVID-19, that figure balloons to $50.

Texas Health and Human Services (THHS) approved a temporary rate increase of $19.63 per day for Medicaid residents, Warren said, but added that while resident costs remain, “federal appropriations do not.”

THCA’s plan would use funding to hire agency staff, and bolster recruiting and hiring efforts via sign-on bonuses and overtime pay, along with improving staff retention programs by providing frontline staff bonuses, hero pay and shift differential pay.

Funding would also employ an infection prevention specialist at each skilled nursing facility in Texas, support long-term care student loan repayment, and implement “bridge” programs to fast-track licensed vocational nurses (LVNs) to get their resident nurse (RN) credentials.

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