Before COVID-19, Texas nursing homes reported the worst staffing shortages in the nation. Texas projected we will be 60,000 nurses short by 2030, and that demand in nursing homes would double between 2015 and 2030.

On top of the supply shortage, the highest vacancy and turnover rates of any practice area for registered nurses and certified nurse aides are in nursing homes. In 2019, the CNA turnover rate in nursing homes was 67%. To say long-term care facilities had been experiencing staffing challenges is an understatement.

Now, add the impact this brutal virus has had on our field. Nursing homes have been at the center of this pandemic storm for a year, and residents and staff have been hit hardest. Since the start of the pandemic in Texas, over 8,600 nursing home residents and 85 employees have lost their lives. 

A recent national report showed nursing homes lost 153,000 jobs over the course of 2020, almost 10% of the workforce. Even as vaccines arrive, bringing with them great hope, those on the frontline are burned out and leaving the field. For a year they’ve endured physical and mental trauma risking their lives to care for our loved ones. We’ve reached a breaking point. 

The Texas House and Senate budget committees are meeting now, and the state has a large role to play in nursing home care — paying for over 62% of services through Medicaid and regulating the sector. This is the heart of the problem. 

Nursing homes face financial constraints at the behest of federally and state-set reimbursement rates, which limit their ability to recruit and retain staff. CNAs provide critical support by assisting residents with eating, bathing, toileting and moving. Yet, they earn about $13 per hour. RNs are drawn to other settings like hospitals where they are valued in the public eye, earn higher pay and are not hindered by a challenging regulatory system.       

In the wake of COVID-19, the need to take action has never been more urgent. Several states have already prioritized nursing homes by making direct investments in infrastructure and care. Gov. Greg Abbott ® and the Texas Legislature must take steps to revive nursing homes and strengthen the workforce so our most vulnerable have access to high-quality care by: 

  • Allocating Medicaid funding to nursing homes and directing those dollars to increase staff wages and benefits;
  • Supporting SB 146 and HB 2062 to create a student loan repayment assistance program for nurses that choose a career in nursing homes;  
  • Awarding COVID-19 hero pay to lower-wage frontline staff in long-term care settings using available Texas CARES Act funds; and
  • Creating a Nursing Home Workforce & Quality Task Force to develop long-term staffing strategies and nursing home care model reforms to promote resident well-being, health and safety.

Non-profit providers are committed to caring for older Texans, but without additional support and the resources necessary to care for those we serve, the current environment isn’t sustainable.

Lori Porter, CEO of the national association for CNAs, recently said it best. “We can talk about this problem for another 40 years, but unless we start valuing older adults and those who care for them, nothing of consequence will change. And then what will we do when the next disaster strikes? We do not need more talk. We need commitments and declarations — now.”

With the legislature in session, the time has come for Texas to answer the call.

George Linial is president & CEO of LeadingAge Texas, the statewide association for non-profit nursing homes and aging services providers.