A Good Nursing Home May be Hard to Find in Texas

If you're currently seeking quality nursing home care for a parent, you may discover that finding a highly-rated nursing home near your home can be quite difficult in the state of Texas.

Many parts of Texas have very few options when it comes to highly-rated nursing home care. Sadly, the state of Texas has the highest percentage of nursing homes with one- and two-star ratings, with 51 percent of all facilities rated below average (or much below average) according to an analysis that was conducted by the Kaiser Family Foundation.

While the nursing home industry is critical of the variability of state inspections, nursing home abuse lawyers like us are concerned about Medicare’s reliance on self-supported data regarding quality care. Consumer groups do feel that the star system provides a good starting point, and most recommend avoiding those facilities that only have one or two stars. The problem is that even with this guideline, oftentimes there are no higher-rated nursing home facilities anywhere close to home.

This is a real problem which exists in many areas of Texas. For example, one family in Lockhart, Texas found that while there were ten nursing homes within a 25-mile radius of their home, only one scored better than two stars. The only nursing home that managed to get three stars was located approximately 20 miles away. There was not one facility within 25 miles that earned four or five stars, even though almost half of nursing homes earn those scores nationally. Unfortunately for many loved ones, a longer commute would mean less-frequent visitations.

Solving the problem.

The question that comes to mind now is why we are allowing these poorly rated facilities to continue to operate? Even though they have been scrutinized for decades, a large percentage of Texas assisted living facilities still maintain variable rates of quality.

Consumer advocates are of the opinion that several factors contribute to the low-quality of care in our nation’s nursing homes, such as:

• Insufficient staff
• Weak or inadequate rules on staffing (state and federal levels)
• Low pay that causes high turnover rates
• Ineffective and weak financial penalties
• State officials who fear displacement of residents and thus are reluctant to close problem facilities

It should be noted that in states where staffing standards are higher, quality scores are higher (according to a University of California researcher). While there are no state requirements concerning patient care, this researcher says that in an ideal situation, each patient should receive approximately four hours of direct care daily with some of that care delivered by registered nurses. Federal law mandates that a registered nurse must be on duty eight hours each day and that a vocational nurse must always be available. While some states have additional standards, Texas has no staffing ratios for nurses’ aides and other non-licensed staff members except in units that specialize in Alzheimer’s care. It's also important to note that non-profit facilities usually earn higher quality scores than for-profit facilities.

Working toward improvements and solutions.

Just this year, Texas lawmakers passed a "3 strikes" law to combat those nursing homes which consistently commit serious health and safety violations. This new law, which goes into effect September 1st, 2016, allows state officials to pull the license of any nursing home facility that receives three or more "serious health and safety violations" within two years. Another bill which recently passed in Texas closes a loophole that has allowed nursing homes to avoid fines if they simply fix the problems for which they were cited.

We hope that the passage of these two new laws will force nursing homes in Texas to step up to the plate and provide a better-quality care to these valued members of our society.