Experts warn of nurse shortage in state

HARLINGEN — The nursing home industry in Texas is calling attention to the high turnover rate of nurses, saying the problem could begin to affect overall levels of medical care.

A study by the Texas Health Care Association, a nonprofit trade group representing nursing homes, says the annual turnover rate for certified nursing assistants is 97 percent.

The churn rate for registered nurses and licensed vocational nurses is almost as high, coming in at 90 percent, according to a THCA study released this year.

Kevin Warren, president and CEO of Austin-based THCA, said one of the primary issues is the state’s low Medicaid reimbursement rate of $143.48 per day. Only South Dakota provides a lower payment at $133.74.

“When you look across the state, roughly two-thirds of the residents that reside in nursing facilities in the state, their care is paid for through Medicaid,” he said. “And we see that today’s Medicaid rate in skilled nursing is roughly about $27 a day less than what the cost of care is to deliver.”

There are about three dozen long-term care facilities located in the Rio Grande Valley. Statewide, there are about 1,200 such facilities and they are caring for 90,000 residents.

Warren said the low Texas Medicaid reimbursement means a long-term care facility is only paid about $6 per hour per patient for care, which hampers a nursing home company’s ability to compensate and retain nurses.

As the state’s economy improves, he said, long-term care facilities face increasing competition for trained nurses from other medical and even non-medical fields.

“As the workforce and labor markets continue to improve elsewhere, it can make it difficult for employers to compete in the labor market,” Warren said. “They have to increase wages to compete; they have to increase benefits, because they just don’t have the financial resources in order to support those increases.”

To restore some stability to the nursing situation in Texas, Warren said the state Medicaid reimbursement rate must rise, local schools must be encouraged to provide training for students in long-term care and young people must be shown the potential for a career in what promises to be a growing industry.

“I personally have had experience working alongside people and working with people who as individuals started off their careers as certified nursing assistants and then worked their way into nursing school and became a med aide, and worked their way through nursing school and became a director of nursing,” Warren said.

“Really, when you talk to providers they will tell you that if there’s the will, the commitment and drive, the sky is the limit,” he added.

The economic benefit of long-term care facilities provide to the state amount to more than $500 million in state and local taxes and $14.6 billion in total economic activity, according to the THCA.

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