Texas Nursing Home Staffing Rates Disappoint ---- AARP Texas Calls For New Approach To Improve Care

AUSTIN, Texas – Staffing shortages and staff turnover rates in Texas nursing homes continue to exceed national averages on several measures, prompting the need for action in the next legislative session to ease the ongoing crisis in care of older and vulnerable Texans.

In reviewing federal nursing home staffing-level data from the third quarter of 2021, AARP Texas finds concerning levels of care, including:

• Registered Nurse Staffing: Texas nursing homes average just 25 minutes of registered nurse staffing per resident per day. That’s 40 percent fewer minutes of RN care compared to the national average of 42 minutes.
  
• Weekend RN Care: Registered nurse care on the weekends also is lower in Texas than the national average. Texas nursing homes report 19 minutes of RN care on the weekends, a third less time of care than the national average of 29 minutes.
   
• Registered Nurse Staff Turnover: The national rate of RN staff turnover is 50 percent. In Texas, the turnover rate is 60.6 percent, according to the most recent data (Q3 2021) reported by the Centers for Medicare and Medicaid Services.
  

Registered nurses are the most senior medically trained professionals required to be in a facility on a daily basis. Certified nurse aides (CNAs), meanwhile, perform the majority of non-medical nursing home care, such as bathing, dressing, toileting.

• Certified Nurse Aide Staffing: On average, Texas nursing homes report providing 110 minutes of care by CNAs. The national average is 131 minutes.
  
• Licensed Vocational Nurse and Licensed Practical Nurse Staffing: When it comes to Licensed Vocational Nurse and Licensed Practical Nurse staffing, Texas exceeds the national average. LVNs and LPNS in Texas provide, on average, 10 minutes more care (63 minutes per resident per day) compared to the national average of 53 minutes.
  

Nursing homes receive billions of taxpayers’ dollars every year to care for chronically ill frail elders and others. But in Texas, there’s no guarantee that the money is spent on direct care for the residents.

AARP Texas is proposing that Texas specify how much nursing homes spend on residents’ direct care and impose limits on what they can spend elsewhere, such as administrative expenses, executive salaries and advertising, or even how much they pocket as profit.

AARP Texas Director Tina Tran said AARP will ask legislators in the 2023 legislative session for action to ensure that nursing home residents won’t be shortchanged on care.

“Quality of care and safety for Texans in nursing homes is of grave importance,” said AARP Texas Director Tina Tran. “If facility operators focus the spending of taxpayers’ dollars on staffing and actual services, it should make a positive difference in the quality of care in Texas nursing homes, which today is sorely disappointing.”

Medicaid, funded under a state and federal government partnership, provides health insurance to low-income people and typically pays for about 60 percent of the nursing home care nationwide, usually for long-stay residents with chronic health issues. Medicare pays for some limited nursing home care following a hospital stay but does not provide for ongoing custodial care in a facility. Nursing home residents who do not qualify for their care to be paid for by Medicaid or Medicare, pay out of pocket or through long-term care insurance.


CONTACT: Mark Hollis mhollis@aarp.org or 512.480.2429