Texas Ranks a Dismal 49th

Posted on 06/19/2014 by | AARP Texas | Comments

New scorecard ranks Lone Star State in terms of long-term quality of care and quality of life

State watchdog to examine the future of agency that licenses nursing homes and long term services at June 24-25 hearing

AUSTIN, TX– Just days before the Texas Sunset Advisory Commission examines the future of the state agency that regulates long-term care services in Texas, a national report released today by AARP ranks Texas 49th in “Quality of Care and Quality of Life”, a measurement that directly impacts the safety and well-being of nursing home residents.

Texas LTSS scorecardThe full report — Raising Expectations 2014: A State Scorecard on Long-Term Services and Supports for Older Adults, People with Physical Disabilities, and Family Caregivers — is available at www.longtermscorecard.org. The new scorecard from AARP, Commonwealth Fund, and SCAN Foundation measures effects of state policy on ability to live independently: choice of setting, care quality, support for family caregivers and more.

Texas’ dismal quality ranking is based on performance on several indicators, including:

39th in percentage of high-risk nursing home residents with pressure sores (rate of 6.9% compared to national median of 5.9% and a best state rate of 3.0%);

50th in nursing home staffing turnover (rate of 72% compared to national median of 38.1% and a best state rate of 15.4%); and

50th in percentage of long-stay nursing home residents administered antipsychotic medications (rate of 27.6% compared to national median of 20.2% and a best state rate of 11.9%).

“When families make the difficult decision to place a loved one in a nursing home, they do it with every expectation that they will be well cared for and safe,” said Bob Jackson, AARP Texas director. “What this scorecard tells us is that for some Texas nursing homes, quality of care and safety are an issue. This is unacceptable for a proud state like Texas, not to mention dangerous.”

On a brighter note, Texas ranks 16th when it comes to offering consumers a choice in setting and provider, in large part because it has more than half of Medicaid and state-funded long-term services and supports devoted to care at home and in the community (ranking 7th on this indicator).

“Texas has effectively rebalanced the funding for long-term services and supports to reflect a consumer’s preference to receive care in the home and to be fiscally prudent since care at home costs the state less than half the cost of care in a nursing home,” Jackson said. “Now it’s time for the legislature and the governor to take the steps to ensure that those older Texans who need care in nursing homes get the care they need and remain safe.”

Starting on Tuesday and Wednesday, June 24-25, the Sunset Advisory Commission — a panel of five senators, five state representatives and two public members chaired by Senator Jane Nelson, R-Flower Mound and Vice Chair Representative Four Price, R-Amarillo — will hold hearings on several agencies to determine if the agencies or functions should be continued, abolished, or modified. Among the agencies being reviewed is the Department of Aging and Disability Services (DADS), which regulates nursing homes and other long-term care services and supports.

The sunset staff report found that “DADS issues few sanctions for violations, including many serious and repeat violations, leaving people receiving care in nursing homes and from other licensed providers in harm’s way.” The staff report noted that in fiscal year 2013, DADS identified 18,735 nursing home violations that resulted in a total of just 11 enforcement actions.

The agency inspects nursing facilities to ensure the health and safety of the residents, ranging from the condition of the physical building to the quality of care provided by staff. The most serious violations are those that place the resident in immediate jeopardy or cause actual harm to a resident.

A decision hearing will follow in August, at which time the Sunset Commission will vote on whether to accept, reject or modify the staff recommendations. The recommendations can be found at the Sunset Commission’s website — https://www.sunset.texas.gov.

“In several potential life-or-death type indicators, Texas has nowhere to go but up,” Jackson noted. “Fortunately, the Sunset Advisory Commission is poised to take steps to ensure those facilities with a track record of providing poor quality care are encouraged to improve or risk having a new administrator. But changes of this magnitude won’t happen without a conscious, bipartisan effort by the legislature and the governor.”

mr4249 5pts

In my human service days, I worked for a corporation that provided nursing home care in Texas and other states.  It was a very large corporation.  For the vast majority of the homes that I worked, Care was good or better.  We were well regulated.  The State and the Fed demanded and got a lot of documentation from us.  So much so that we spent a whole lot of time documenting.  Attending classes on how to document.  Having and providing staff in-services about the importance of documenting.  But...

Money, easily gotten through reimbursement with apparently little oversight by the state and the fed, attracted a different breed of vermin.  One that spent a whole lot time ensuring the money came in.  Paying the core of nursing home staffs (personal care attendants) minimum or less.  Not providing quality in-services to these critical staffs on a timely basis (they were busy taking care of your grandmother). And so on and so on....

This was in the mid 90's when I worked as a social work consultant for this corporation.  I'm only citing my own experience.  Over the years since then, I would read reports about deaths and utter disregard for the elders in some of these homes.  Apparently, this still goes on today in Texas.  But really, 49th?

Die at home if you can.  At least you will have someone familiar attending to your needs.  

Taking a jab at Sarah Palin, there are death panels.  They are called nursing homes in Texas.

Yea, i'm bitter.  Money is more important than children (education), adults (refusal to accept Medicaid $), women (total disregard of their choices) and our elders.  One day, soon I hope, that will change and people will matter more.


jc41189859 5pts

It doesn't surprise me. One of the richest states, Texas keeps company with poor states like Alabama and Mississippi with regard to expenditures for mental health, education, state based social programs for the poor, etc. Texas has always been at the bottom, with the bottom dwellers and feeders. Texas is a safe haven for corporate America, large insurance companies, hospital corporations, and protection for physicians from malpractice suits.Tort reform in Texas is the ATM for financing of all (national as well) Republican candidates in their quests for office. 

All of this is accomplished by a very tight reign being held by the Attorney General of Texas. That office is the brains behind the machine. The governor of Texas, Rick Perry, being indicted for overstepping the limits of his power of veto, is an example of the oppressive nature of the current trend in Texas politics. it is well known and documented that if people speak out against state officials who are currently in positions of authority in Austin, personal retaliation against them will be coming. Such tactics are those of extremists. 

Perry has publicly endorsed the idea that Texas should break away from the other states and become a republic. The offices of the federal government have been duplicated in Austin. (Dept of Homeland Security, etc.) Texas has begun to store its own gold. Keep posted. Key elections will take place in November.

pg7285 5pts

Not the least bit shocked at these numbers since Texas government has shown for decades it does not care about its seniors nor its children .... Perhaps its time to re-evaluate if the Republican and Teaparty needs to be ousted from Austin but from city government as well !