For Texas operators, a proposal that might not be as appealing as it sounds

John O'Connor
John O'Connor

At first blush, providers in other states might feel a bit envious about a proposal being floated in Texas.

A special commission has recommended that the organization responsible for nursing home oversight — the Department of Aging and Disability Services — be terminated. As in abolished, annulled, canceled, dissolved, eliminated, halted, killed and put out of its misery. Ding-dong, the Wicked Witch would be dead.

It's probably safe to assume providers in most other states wouldn't mind snapping off a piece of that action. And for obvious reasons. What provider wouldn't mind an end to annual nursing home inspections, the constant parade of new department rules and the various other gifts that state oversight agencies bring to the party?

Under current regulations, each nursing home/facility is supposed to receive at least one unannounced inspection during a nine- to 15-month cycle. When these surveys occur, all aspects of care and services are fair game. Nursing homes might not necessarily view these inspections as a necessary evil. But it's not like providers would bemoan their disappearance.

Now before you petition to have your state annexed to Texas, remember this: The proposal might not be quite as good as it seems. For the same commission that is seeking to close the aging and disabilities services department has added this poison pill: The agency's work would be put under the jurisdiction of the state's Health and Human Services Commission. In other words, all that would really change is the name of the cop walking the beat.

It's also worth noting what drove the push to disband DADs: a general sense that it was not monitoring mishaps at nursing homes closely enough. Numerous recent media reports have singled out state regulators for failing to report incidents of abuse and mistreatment. The group seeking change doesn't just want a new cop walking the beat; it wants a cop that doesn't “coddle” nursing homes.

Nor is the commission's attitude unique in Texas. State Senator Charles Schwertner (R-Georgetown) recently proposed a “three-strikes” rule that would force the state to close nursing homes found to have the highest-level violations of federal quality standards on three separate days over 24 months. You can probably imagine how happy Texas operators are about this possible development.

It remains to be seen whether the oversight adjustment will take place. But as antipathy toward operators continues to escalate, the recommendation would appear to have a decent chance. And as for providers in other states that would like to see their current oversight agency abolished, the message from Texas seems to be fairly clear: Be careful what you ask for.

John O'Connor is McKnight's Editorial Director.

Daily Editors' Notes

McKnight's Daily Editors' Notes features commentary on the latest in long-term care news and issues. Entries are written by Editorial Director John O'Connor, Editor James M. Berklan, Senior Editor Elizabeth Newman and Staff Writer Emily Mongan.

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