Texas, Massachusetts Nursing Homes Face Financial Woes
Financial difficulties facing Texas nursing homes, evidenced by the state's takeover of 14 nursing homes last week, have spawned a package of House and Senate bills that seek to increase public funding and decrease government regulation of the state's more than 1,200 nursing facilities, the Austin American-Statesman reports (Bahadur, Austin American-Statesman, 4/8). About 25% of Texas nursing homes have filed for bankruptcy protection, 13 went out of business last year, and more than half are dealing with "some kind of financial difficulty." Two major factors -- the state's low Medicaid reimbursement to nursing homes (Texas ranks 45th in the country) and laws that regulate homes "more aggressively" than most other states -- have led the industry to "the edge of financial collapse." Texas Health Care Association President Tim Graves estimates the industry needs an additional $2 billion in Medicaid funding to keep pace with inflation and operating costs (Villafranca, Houston Chronicle, 4/7). Some of the nursing home bills pending this session include:
- SB 1593, sponsored by state HHS Committee Chair Sen. Mike Moncrief (D), would "address concerns that surveyors are too harsh and that the internal process for appealing their reports is unfair." The bill also seeks to improve the appeals process for deficiencies found through nursing home surveys by moving the appeals committee from the Department of Human Services to the HHS Commission. It would also establish "quality assurance monitors" to help nursing homes improve their conditions. The bill is scheduled for a Senate vote this week (Austin American-Statesman, 4/8).
- A bill sponsored by state Sen. Robert Duncan (R) seeks to cap punitive damages in liability lawsuits against nursing homes.
- An appropriations bill amendment attached by State Sen. Chris Harris (R) would erase nursing home surveys from state records after deficiencies have been corrected. Results from past state nursing home investigations are often used in lawsuits against nursing homes (Houston Chronicle, 4/7).
Massachusetts Homes Announce Closure
Massachusetts nursing homes also are facing financial difficulty, with three state nursing homes announcing closure last week, bringing the total number of Massachusetts nursing home closures since early 1999 to 53, the Boston Globe reports. Nursing home officials say high operating costs and inadequate government reimbursements have spurned the industry's "distress." According to Scott Plumb, executive vice president of the Massachusetts Extended Care Federation, which represents most of the state's facilities, Medicaid pays an average of $130 per day per patient, about $20 per patient per day below costs. The coincident closure of three nursing homes has "raised the specter" of a potential bed shortage in Massachusetts, the Globe reports. About 90% of the state's nursing home beds are occupied, and patient care may be compromised as "fewer homes shoulder larger burdens," according to the Governor's Health Care Task Force. A bill (SB 513) introduced by state Sen. Stephen Lynch seeks to increase Medicaid spending by $200 million, more than twice the amount in Gov. Paul Cellucci's (R) budget. Although the federation is supporting the bill, Plumb expressed doubts that it will pass. "[W]e don't sense the political will, in a state that just rolled income taxes back, to do that," Plumb said (Barnard, Boston Globe, 4/7).
