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For Immediate Release
February 25, 2015
Contact: Rebecca Reid
410-212-3843
THCA Testifies Three Strike Bill Will Have Unintended Consequences For All Texas Nursing Homes
State’s Largest Nursing Home Provider Association Says Three Strikes Could Potentially Close
High Performing Facilities and Jeopardize Access to Eldercare
(Austin, TX) – The Chair of the Texas Health Care Association (THCA) Board of Directors today testified before the Senate Health and Human Services Committee and cautioned lawmakers that proposed “Three Strikes” legislation, intended to target a small number of chronic underperforming nursing homes, will instead cast a wide net over Texas long term care facilities and potentially jeopardize access to local skilled nursing care.
“We understand the goal of the Three Strikes bill is to make certain the state’s regulatory agency executes its responsibility to ensure skilled nursing facilities provide quality care to the frail elderly in a safe and healthy environment,” said Ron Payne, Chair of the Board of Directors for THCA and CEO of Southwest LTC Management Services, LLC. “THCA member providers share that goal but believe the answers to achieving it lie in a different strategy and implementation of existing regulation.”
If passed, Senate Bill 304 would expand the authority of state agency personnel to determine whether a facility remains open. The results of those determinations could affect the quality of care for thousands of elderly in the state’s 1,200 nursing facilities. The current statutory framework provides the Department of Aging and Disability Services (DADS) appropriate authority, including the discretion to revoke a license where a facility violates a regulatory requirement in either a repeated or substantial manner. DADS is also authorized to suspend a facility’s license and order the facility closed where DADS finds the facility has violated a standard and the violation creates an immediate threat to the health and safety of a resident.
Also testifying before the Committee, Liam Frye, M.D., a board certified geriatrician and certified medical director of long term care facilities in the Austin area noted an already adversarial and highly subjective survey process. “There is tremendous variation, seemingly left to the whim of the individual surveyor, as to what constitutes a violation,” said Dr. Frye. “The policy of heavy fines and penalties does not seem to be working. Rather, there needs to be some way to put money back into the nursing homes and for the Department of Aging and Disability Services (DADS) to help and assist them.”
The THCA has recommended an alternative proposal to SB 304 entitled Protecting Resident Choice that, among other things, recommends increased transparency on the part of the provider by requiring notification to residents and family members when a facility receives certain violations on a state survey.
“Three Strikes removes the discretion of the regulatory agency to revoke a nursing home license and without examination of circumstances around the violations, mandates closure,” said Payne. “State regulation currently provides for the authority to close the doors of nursing homes that are repeat underperformers, to require correction plans from facilities earnestly addressing their care challenges, and to recognize facilities with consistently excellent survey results. Those are three different types of facilities, yet all would be impacted by SB 304.”
In a statewide, ongoing effort to enhance the level of care in Texas nursing homes, the Texas Health Care Association (THCA) recently announced the Commitment to Care, an initiative by nursing home providers to chart a strategic course to improve care quality for seniors, promote transparency and accountability among providers and collaborate with senior advocates on the goal of establishing Texas as a national leader in eldercare.
“Our members support the expansion of approaches that provide early detection and intervention for process failures or unsafe practices to improve quality, rather than an enforcement mechanism that would displace residents and staff, and result in broad reaching consequences for the residents, employees, and the communities served,” testified Payne. “That said, serious violations of health and safety standards in Texas facilities are never acceptable and we must be committed to do all we can to ensure they are prevented.”
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To learn more about Commitment to Care, please visit txhca.org/quality-care/commitment-to-care. For ongoing Twitter updates and information, follow @TXHCA and the #Commit2Care hashtag.
About THCA
Founded in 1950, the Texas Health Care Association (THCA) is the largest long-term care association in Texas. THCA’s membership is comprised of several hundred licensed non-profit and for-profit skilled nursing facilities (SNFs), specialized rehabilitation facilities and assisted living facilities in Texas. These facilities provide comprehensive, around-the-clock nursing care for chronically ill or short-term residents of all ages, along with rehabilitative and specialized medical programs. THCA also represents more than 190 long-term care businesses that provide products and services to the state’s approximately 2,850 nursing homes and assisted living facilities. To learn more, visit http://txhca.org/ or connect with THCA on Facebook, Twitter and YouTube.
New figures from the U.S. Census Bureau on Thursday showed Texas boasts five of the nation's eleven fastest-growing cities. The Lone Star State is booming. It's time to start planning for our future.
Little has changed since the days when people in the first states decided they'd had it with city life, left their homes and chalked the letters GTT on the door--'Gone to Texas.'
Except that now Texas sports some of the nation's biggest cities, and the migrants come from abroad, the West Coast and Midwest more than from the East. The state's cities and suburbs consistently rank among the fastest-growing in the country.
The trend paints a picture of the future of this state.
Primarily, Texas will become a mostly Hispanic state, just like it was in its earliest days, according to state demographer Lloyd Potter.
'In not too long most Texans will be of Hispanic descent,' he said.
It was just five years into the 21st Century when Anglo Texans lost their majority; Potter projects a state that is three fifths Hispanic by the century's midpoint.
There are several reasons why. For one, the Baby Boom generation will die off in coming decades, and it is represented almost entirely by whites. The Hispanic population, Potter said, is much younger with typically larger families, poised for solid growth.
Hispanics are also the largest group of incoming migrants, both foreign and domestic. In coming decades, Potter said, the Hispanic demographic will drive the majority of growth in Texas' population, which he expects will double to 50 million by 2050.
'You don't see too many other states that are projecting they are going to grow at that rate and that significantly,' he said. The states that routinely compete with Texas' growth rate are much smaller, like North Dakota, so a small addition to population constitutes a big percentage increase.
Things would always be easier if they just stayed the way they were. But growth means changes and changes mean work. More people put more stress on public infrastructure and services. The state will need more landfills and more roads, bigger schools and more police, a bigger power grid and water system plus more personnel in almost every state office.
Of course, more Texans mean more taxpayers contributing to public funds. And with the growing population, that money will likely be spent on a stressed infrastructure.
One of the biggest challenges will be widening the roads.
'It's fair to say that our transportation infrastructure isn't quite there,' Potter said.
State data shows that much of the growth has concentrated around a triangle traced between Houston, Dallas-Fort Worth and San Antonio, outlined by interstate highways 35, 45 and 10.
The I-35 corridor has seen a particular influx of population, from Laredo to San Antonio, Austin, Georgetown and DFW. In Houston, an influx of commuters from the suburbs clogs the city roads daily. Give it a few more decades without substantive action and the roads might end up even more inadequate.
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Large-scale roadway expansion is a mind-boggling endeavor. It takes years, creates traffic nightmares while it happens, and sometimes can't be feasibly imagined in places where urban development butts up to the edge of major highways.
Public transit throughout the urban triangle also seems a long way off. Current plans call for a bullet train linking Houston and Dallas and a commuter rail between Austin and San Antonio, but those projects alone won't put a substantial dent in highway traffic.
Another challenge will be expanding water infrastructure, including reservoirs and pipes, to meet the needs of thirsty folks when the rains abate, as they do every now and then.
The power grid is already pressed to run millions of air conditioners at peak summer heat, and that capacity will need to grow.
Increased power generation plus more cars on the roads means cities will have to rein in air quality, which is worsening now in some places.
Public schools will also have to get bigger as more students enroll, which will mean more spending by the state. Throngs of new mostly Hispanic students will need to be encouraged to graduate high school and go to college if the state hopes for a competitive workforce in the later century.
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There will be no excuse for state policymakers when a burgeoning population starts to shut down public infrastructure and calls rise up for emergency funding to solve the problem. The warning of surging growth has been around for years.
'There certainly is recognition that these are challenges from a policy perspective,' Potter said. 'But there also has to be the political will and the resources to invest in ensuring that agencies are able to implement their strategies.'
There may be slight respite. The most recent Census numbers, which affirm the rapid growth trend, extend until 2015, before low oil prices bore down in full force on the Texas economy. The 2016 numbers, due out next year, will likely slow the trend in migrants to Texas, Potter said. But the dip will likely be short lived.