Low Medicaid Reimbursement Rate Affecting Long Term Care in Texas

recent survey conducted by the Texas Coalition for Long Term Care Business (CLTCB) found that 61.4% of companies with nursing homes as customers have seen a decrease in purchasing from those nursing homes in the past year.

Why Is This Happening?

Nursing homes and other long term care facilities in Texas are currently suffering due to the fact that Texas has the 49th lowest reimbursement rate for Medicaid. The reimbursement rate represents the percentage of total cost that the state government is being compensated for program expenditures by the federal government.

Under the Affordable Care Act, Medicaid reimbursement rates were set to increase to at least 100% of Medicare reimbursement rates on January 1, 2013. However, the payments have been delayed for 5 months and the new rates have still not yet been effected.

Consequences of Low Reimbursement Rate

The status of the Medicaid reimbursement rate in Texas means fewer doctors are accepting patients paying with Medicaid. This isn’t because the doctors don’t want to treat them; rather, it is because the doctors and hospitals are actually losing money when they treat patients whose primary form of payment is Medicaid.

When reimbursement rates are low and medical facilities continue to experience a rise in costs, it is simply not feasible to continue business as usual. Operations must be changed to fit the high costs and low reimbursement rates. Usually, in order to avoid dramatically reducing quality of care, the first thing to be cut from the budget is staff.

Financial Woes Becoming A Reality

“A recent statewide survey indicated 72% of nursing homes have already had to reduce staff or freeze benefits,” according to Buddy Parker, a member of CLTCB and representative of First Choice Medical Supply in Garland, Texas.

If the Medicaid reimbursement rate remains low, Long Term Care living facilities in Texas will have to continue slashing costs in order to keep up with the rising prices.

Hilltop Haven, a non-profit nursing home just outside Dallas, Texas, was already forced to shut down in March, due to their inability to “find a sustainable financial model”. Ninety percent of Hilltop Haven’s residents were on Medicaid.

Your Best Option

If you are a Texan and you haven’t considered Long Term Care Insurance, now is the time. A government study estimates that 7 in 10 Americans over the age of 65 will need Long Term Care at some point.

Despite a common misconception, Medicare does NOT cover Long Term Care. In order to qualify for the government subsidized Long Term Care from Medicaid, you must exhaust all of your financial assets. As the recent news in Texas proves, Medicaid may not even be a reliable source of quality care anymore. More facilities are turning towards privately insured business models and cutting the number of Medicaid-eligible patients they accept.

If you live in Texas and have questions about Long Term Care Insurance or are interested in a policy, visit the Texas Long-Term Care Partnership website here.

Dallas Nursing Home Spends Weekend Without Power

A nursing home in Dallas was forced to spend the past weekend without power.

Golden Acres Nursing Home

Golden Acres Living and Rehabilitation Center experienced a power outage last Friday and despite attempts to have the power turned on, no such thing happened until Monday afternoon. The facility has more than 200 residents at the moment.

In the mean time, the nursing home used backup generators throughout the weekend to help keep their vulnerable residents comfortable, but on Monday morning, they experienced a total blackout.

Repeated Attempts

A representative from Oncor, the utility company, said that they were unaware that the facility was a nursing home, otherwise it would have been higher on their priority list. Some say that isn’t the case, though, as they called the company repeatedly and specifically told them it was a nursing home.

Linda Roberts, daughter of a resident, told a local news station that her repeated pleas to the power company went unanswered for three days.

“It has been a very bad situation, especially this morning,” said Roberts. “Yesterday was bad enough, but today, when there is no lights, no heat, no power at all, it is very dangerous.”

Vulnerable Residents

Executive director of the home said that blankets, coats, and hats were used to keep the residents warm, but nonetheless, it posed a danger to residents. He also said that he was calling and texting the company to his best avail. Power was restored on Monday afternoon.

Residents are already extremely vulnerable during the winter, but a situation like this only serves to further worsen their vulnerability and could potentially cause health problems for those who are especially frail or sensitive to changes like extreme temperatures.

To read the full news report and see a video interview from Fox Dallas-Forth Worth, click here.

In Wake of National Nursing Home Week, Understanding How to Choose a Long Term Care Facility Is As Important As Ever

In light of National Nursing Home Week, which was celebrated May 11-17 this year, it seems prudent to discuss some current issues facing nursing homes across the state of Texas. Texas has had its fair share of negative light shone on nursing homes across the state, but two violent attacks in Houston’s long-term care facilities recently brought the subject back into the spotlight again.

Do Your Research on Nursing Homes

The brutal occurrences, which left two men dead and one critically injured, bring up yet again the issues of nursing home oversight, staffing levels, and the crucial importance of researching a nursing home before enrolling as a resident. When it comes to finding a good nursing home, looks can often be deceiving. Just because a facility looks nice on the outside, or maybe even on the inside, too, doesn’t mean there aren’t problems lurking below the surface. Unfortunately, some families find this out the hard way.

No matter how much research you do, it can be difficult to detect problems in nursing homes, but there are a few things you can do to help increase the chances that the facility you choose isn’t one of the bad apples. Whether it’s a lack of staff personnel or poor administrative oversight, some nursing homes face problems that can often pass down negative consequences to residents. Before you decide on a certain facility, make sure you take the time to look into various aspects of the facility to help you better understand the staff, administration, and quality of care provided.

Problems Facing Texas

Just last year, a nationwide Nursing Home Report Card was published and Texas ranked 51st, the absolute worst ranking possible. This ranking was based on a number of different measures including facility deficiencies, staff levels, and verified ombudsmen complaints. The report card, produced by a non-profit organization in Florida, highlights the extreme problems facing nursing homes across the state of Texas. The Lone Star state received a grade of F and was the only state to receive failing grades in 6 of the 8 measures.

According to the report, just over 94% of nursing home facilities in Texas have deficiencies and a little more than 16% were cited as having severe deficiencies. Texas also had the lowest percentage of nursing homes with an above-average direct care staff rating, with just 19.68% of nursing homes qualifying under that measure. Because nursing home quality has been shown to be poor across the entire state of Texas, it is especially important for Texans to understand the best ways to research nursing homes and compare different ones to find the best available.

How to Compare Long-Term Care Facilities

One way to gain some insider knowledge about the state of different nursing homes is to speak with your local long-term care ombudsman. Ombudsmen are individuals who volunteer to help investigate complaints surrounding nursing homes and work with local organizations to help rectify the problems. They provide free services to family members and individuals interested in long-term care. You can get in touch with your local ombudsman by contacting your local Area Agency on Aging, of which there are 28 in Texas.

Another way to compare nursing homes is to utilize the Nursing Home Compare online tool provided by the Center for Medicare and Medicaid Services. US News and Health Report also publishes an annual nursing homes ranking list compiled using data from the CMS website and other sources. You can view this year’s ranking list of nursing homes here and navigate through the ones specifically in Texas.

Besides doing research online, in-person research is another crucial tool to helping you get a better grasp of what is happening in nursing homes across Texas or in your area. If you are able, visit the nursing home yourself and walk around all the different areas of the facility. It’s best to visit nursing homes a number of times on different days. For example, you might want to make two visits during the week, one in the morning or afternoon and one at night. It is wise to do the same thing again on the weekend to get a good feel of how the facility operates and whether or not it is a good fit for what you are looking for.

When it comes to long term care, there are extremely important things at stake, including the safety, health, and wellbeing of either you or your loved one. Before committing to a specific nursing home, do your best to research, visit, and compare nursing homes so you can find the best one.

Scathing New Report Reveals Texas Nursing Homes Lack Enforcement and Oversight and Recommends Closing Austin Facility

Texas nursing homes are not being monitored enough and facilities with violations are not being properly penalized, according to a new report released by the Texas Department of Aging and Disability Services.

DADS Report

The Sunset Advisory Commission released the report earlier this month detailing issues found within the 13 state supported living centers in Texas and putting forth a number of recommendations for legislators. The report followed investigative coverage conducted by KVUE that revealed a rise in the prevalence of abuse in nursing homes across the state.

The DADS report notes a number of problems within the Texas state-supported living centers and includes detailed explanations of the problems and suggestions to help fix them. One of the main problems highlighted in the report is the fact that the nursing homes that have been found to have serious violations have suffered very little, if any, consequences as a result. Not only are the centers “problematic”, but they are also “costly” to the state, according to the authorities who compiled the report, which includes state senators and representatives.

Costs to Texas Taxpayers 

To house just 3,650 people in the 13 centers involves the employment of more than 13,900 individuals and a cost of more than $661.9 million annually to the state. Texas is one of the few states that still runs a large state-supported living center system, the report notes, and the costs to taxpayers are “growing unsustainably”. One facility in particular came under fire in the report.

Despite “questionable quality of care” at the living centers, the nursing homes have remained open and serving residents, some of whom may be suffering due to the potentially lacking care quality. Because the state can no longer afford to continue supporting all 13 living centers, as concluded by the commission members, they recommended closing the Austin state supported living center by the year 2017 and several others by 2022.

Quality Care Matters

There is no way for DADS to effectively ensure adequate care is being provided at these facilities, which presents a problem for both the state and the residents. The commission report recommends higher penalties against nursing homes that commit violations in order to bolster the quality of care provided and ensure the same mistakes are not repeated intentionally due to a lack of fear of consequence.

When it comes to choosing a long term care facility, it can be difficult to know which nursing homes will provide the quality care most people are looking for, but this new report helps Texas residents be more aware of the various problems facing these state supported systems. It’s important to remember that the report just includes recommendations, not final decisions, and a review of the report is currently being processed to determine which steps, if any, to take to further rectify the problems outlined in the report.

To see the full DADS report, click here. To get a better idea of how to choose a long term care facility, read our latest article on the state of nursing homes in Texas and the different ways to compare and research long term care facilities.

Texas Drops in Senior Health Ranking

Texas seniors face a myriad of health problems and are stuck with some of the worst nursing home quality in the nation, according to a recent report.

Texas Falls in Ranking

The United Health Foundation released their annual Senior Health Report that ranks each state based on the health and healthcare of seniors in that state. This year, Texas ranked 41st on the list, dropping 2 spots from their ranking of 39 last year in 2013. Though the United States pays more per capita for health care than any other country in the world, it seems the quality of care in our health care system is struggling to stay on par with the cost.

Despite the fact that Texas is often hailed as an ideal retirement spot for seniors, this report shines light on some of the drawbacks of the state’s senior health care system and helps expose some of the troubles those seniors are experiencing.

The Foundation used a number of various measures to determine each state’s ranking on the list including community support, home health care, obesity, poverty, cognition, food insecurity, depression. Texas fell even further to the bottom of the list this year and there are a few measures that stand out as noteworthy.

Lack of Senior Community

When it comes to community, Texan seniors don’t have much of one at all. According to the report, Texas ranks 49th in senior community and 48th in community support. This statistic may come as a surprise because of the number of seniors in Texas, but despite the growing demographic, the support system seems to be nearly nonexistent.

Texas came in at number 21 for diabetes management and 27 for depression, which isn’t the greatest ranking but isn’t near the bottom, either. Seniors with a chronic condition that requires pain management aren’t in a good spot, though. The Lone Star State ranked 42nd in pain management of all the 50 states. On top of that, the state also ranked 42nd in multiple chronic conditions, meaning there is a great deal of seniors who are suffering from more than one chronic disease, be it heart disease, diabetes, dementia, stroke, or cancer.

As the prevalence of dementia increases across the nation, Texas remains at the bottom of the list in terms of cognition, ranking 41st. In terms of overall senior health, the health status of seniors in Texas was ranked as 31st in the nation.

Long Term Care in Texas

It isn’t all about individual health, though. Long term care settings also have a huge impact on the collective senior health and how seniors can navigate their health care system. Unfortunately, Texas ranks 29th in nursing home quality, meaning they have almost the worst quality of nursing homes in the whole country.

On the other hand, though, Texas ranks at the top of the list in terms of home health care, at number 5. So while the quality of skilled nursing facilities is extraordinarily poor, the quality of home health care, a common and often preferred alternative, is quite high.

One big change that occurred within the last year in Texas is the prevalence of smokers. Smoking increased a shocking 10% in the past year alone. The state ranks 34th for smoking. Another more positive change is an increased use in hospice care and a drop in the number of seniors dying in the hospital, which means better care is being paid to these individuals who are int heir last days. Rather than die in a hospital, they pass in a more comfortable setting that is meant for end of life care. While this may seem inconsequential to some, this is actually extraordinarily important to a lot of seniors.

Challenges Facing Lone Star Seniors

The state of Texas faces a number of big challenges: there is a high percentage of seniors struggling in poverty, the quality of nursing home care is low, and the prevalence of food insecurity is high. But the availability of home health care workers is good, which is a positive sign for seniors in the state. As the number of seniors continues to grow across the nation, senior health care is moving to the forefront of priorities. Long term care is becoming a talked about topic as people begin to recognize the importance of planning for a long life and ensuring they aren’t forced into a poor quality nursing home.

Texans have a number of options to help plan for long term care and for those with assets to protect, Long Term Care Insurance is a wise one. A policy can help provide you with either home care or nursing home care and help you avoid spending yourself into poverty. Find out more about Long Term Care Insurance here or fill out this form to request a free quote today.

To read the full Senior Health Report, click here or read our take on last year’s report here.

Texas Ranks at Bottom for Long Term Care Quality

Texas comes in at the bottom when it comes to long term and nursing home care in the United States, according to a recent report released by AARP.

Long Term Care Scorecard

With an increase in both the cost of long term care and the demand for it, some states are struggling to keep an effective long term care system in place. An increase in patients and a declining availability of caregivers has led to greater financial burden on the states and some are doing a better job than others at providing care for the growing demographic. The recent report evaluated the progress of long term services and supports in each state. Texas ranked 30th overall out of 51.

The report, titled “Raising Expectations 2014: A State Scorecard on Long-Term Services and Supports for Older Adults, People with Physical Disabilities, and Family Caregivers”, looks at various influencers of the long term services and support systems within the 50 states. It found that the availability, cost, and quality of care vary greatly depending on where you are in the country. The analysis includes 26 measurable indicators grouped into 5 main categories, which include affordability and access, choice of setting and provider, quality of life and care, support for family caregivers, and effective transitions.

System Measures

Texas ranked at the very bottom of the scorecard for both quality of life and care and transitions; the Lone Star state ranked 49th and 47th, respectively. On the better side, Texas ranked 10th for affordability and access of long term care services.

Included in those measurable factors is the number of people with long term care coverage through private insurance. In Texas, 38 of every 1,000 adults aged 40 and older have long term care coverage. Washington DC has the highest rate of insured with 130 per 1,000 adults owning a private Long Term Care Insurance policy. In terms of the cost, quality, and direction of care, there were both improvements and setbacks. Consider these statistics about Texas’s long term care system:

–       The median nursing home cost as a % of median household income for 65+ was reported to be 181% in 2013, down from 205% in 2010.

–       The nursing home staff turnover rate is the third worst in the country. In 2010, the rate was reported to be 72%, up from 46.2% in 2008.

–       The percentage of nursing home residents with low care need decreased from 16.4% in 2007 to 14.3% in 2010, indicating the system’s transitions are more effective.

–       The percentage of Medicaid and other state funds going towards home and community based services for the elderly and disabled has increased to 53.5% in 2011 from 50% in 2009.

–       The percentage of disabled adults usually or always getting needed support was up to 68.9% in 2010, from 66% in 2009.

Plan for Care

The AARP report was released shortly before the Texas Sunset Advisory Commission meets to assess potential changes for the Department of Aging and Disability Services. The Commission published a report last month detailing violations including weak enforcement of nursing home violations and failure to close inadequate facilities.

Long term care is an important topic that deserves some research on your part, both on the cost of care in your area, the best facilities for care, and the various ways to shield your savings from the cost. Texas has quickly become a retirement hot spot, but making plans for your long term care can help ensure those years are spent without worrying about spending through your nest egg.

You can learn more about the cost of long term care in Texas and how to prepare for the bill. Planning for long term care is an important part of securing your financial future. Request a free quote comparison of the top companies today.

Long Term Care in Texas Costs How Much?

Living a long life isn’t an uncommon desire; in fact, it’s quite common to hear someone say they want to live to 100 years old (or even older!). With a long life come certain changes, though. Long term care is one of them. If you are planning to live a long life, you must also be prepared for the high financial risk that long term care poses.

Genworth Financial recently published their 2014 Cost of Care Survey, which details just how expensive long term care is across the country, including Texas, and helps consumers plan for that cost.

Long Term Care in Texas

Long term care refers to services received in a variety of settings like a nursing home, assisted living facility, adult day care, and even at home from a home health aide. As life spans in the United States continue to rise and the cost of health care goes up with it, planning for the cost of long term care makes a great deal of sense when it comes to retirement planning.

Planning your retirement won’t do any good if you are suddenly injured or diagnosed with an illness that requires expensive care for an extended period of time. Fortunately, here in Texas, long term care is cheaper than the national average, but chances are the price tags will still shock you.

Cost Across Care Settings

The median annual cost of a home health aide in Texas is $41,184. Home health aides are nurses or health professionals that provide long term care in the comfort of your home. When asked, most people express that they would prefer this type of care over facility care. This number has seen a 1% growth rate over the past 5 years and is about $4,000 lower than the national median cost.

Adult day care facilities, which are public centers where adults can be dropped off for the day, typically during business hours, have a median annual cost of $8,970 in Texas. The cost of adult day care services in Texas has increased 3% in the past 5 years, but is still about half of the national median cost.

Assisted living facilities, another commonly preferred care setting, have seen a 5% growth rate in the past 5 years in Texas. Assisted living facilities provide long term care but in a more independent setting than a nursing home. They are often similar to apartment complexes, but have medical personnel on staff in case of any emergencies. The median annual cost of a single room in an assisted living facility in Texas is $42,270, which is less than $300 higher than the national median cost.

Nursing homes are usually the least preferred care setting but the most necessary for those with severe health problems. They are also the most expensive form of long term care. A private room in a nursing home in Texas will cost you an average of $65,700. This number is significantly lower than the national median cost of $87,600. Similarly, the cost of a semi-private room in Texas will cost an average of $50,735, compared to the national average of $77,380.

Less than Average

All in all, long term care in Texas is usually less expensive than the national average, but it varies from city to city and facility to facility. The important thing to remember about the high cost of long term care is most people can’t cover the cost on their own. Because health insurance and Medicare won’t cover it, either, it’s crucial to implement a plan to prepare for the potential cost. Long Term Care Insurance is a great way to do just that.

Long Term Care Insurance helps you plan for the cost of long term care without having to save up hundreds of thousands of dollars in assets. Instead, you transfer the financial risk to the insurance company and just pay regular premiums, which pale in comparison to the full cost of care. Buying Long Term Care Insurance shouldn’t be a last minute decision, though, so be sure to do your research and buy as early as possible to get the best rates.

View the full Cost of Care Survey here or request a free Long Term Care Insurance quote today.