Kevin Warren, Texas Health Care Association

Lawmakers this holiday weekend gave Texas skilled nursing providers a long-awaited reason to celebrate: the first increase to the state’s Medicaid base rate in 10 years and supplemental funding to help providers stay afloat until that new rate kicks in in September.

The House and Senate approved both the supplemental funding that extends a COVID-era add-on through Aug. 31 and a $900 million general Medicaid rate increase as part of the overall state budget that starts Sept. 1. Both measures now await the governor’s signature, nursing home leaders in the state told McKnight’s Long-Term Care News this weekend.

“Texas nursing homes can breathe a sigh of relief as this legislative session ends,” Alyse Meyer, vice president of advocacy for LeadingAge Texas said in an email. “This funding will help address some of the challenges nursing homes have voiced for over a decade, but particularly since the pandemic.

“Nursing home advocates delivered a clear and consistent message. Older Texans and their families need reliable access to high-quality care. The ongoing impact of COVID-19, a dire workforce shortage and record-high inflation cannot be overcome without additional support.”

Meyers said hearing directly from providers and families in their communities — a grassroots effort nursing home advocates leaned into hard over the past year — helped Legislators better understand the challenges providers are facing.

“The long term-care profession in Texas worked collectively this session to educate lawmakers about the ongoing challenges in long-term care facilities across Texas, the need to invest in consistent access to care and the critical support these funds provide to prevent major disruptions in care for Texans,” added Kevin Warren (pictured), president and CEO of the Texas Health Care Association. 

Should Gov. Greg Abbott (R) sign off on the funding, providers will see instant results. Many had feared the loss of the $19.63 daily per-patient add-on, which served to continue federal matching funds that had been available during the pandemic. It expired with the end of the public health emergency earlier this month. The supplement will be a bridge for providers until they can benefit from the updated Medicaid rates for fiscal 2024.

Warren said the average percentage increase nursing homes will see with the base rate adjustment won’t be clear until the Texas Health and Human Services Commission holds a hearing in mid-July.

Of the $900M, about $100 million will be set aside until September 2024, Warren added. That funding will help stabilize revenue levels that could be impacted by the state Medicaid system’s conversion to a PDPM-like payment model.

Meyer noted that lawmakers also made “historic investments” to address the state’s nursing shortage. Senate Bill 25 aims to strengthen nursing programs by funding scholarships and student loan repayment.

“Nurses will be incentivized to work in healthcare settings experiencing the worst shortages like nursing homes — a proven policy we’ve long supported,” Meyer said.

Owners and operators had predicted this year could finally be the one for Texas to move on its Medicaid rates. Major national investors, including Ensign, have eagerly made acquisitions in the state to position themselves for coming improvements.

But the likely increase will be a lifesaver for the state’s many small, independent and rural providers too.

“Not-for-profit providers are thrilled to see nursing homes prioritized,” said Rodney Rueter, LeadingAge Texas Board member and CEO of Lutheran Sunset Ministries. “Our ministry is dedicated to serving seniors that rely on Medicaid for their care, but underfunding poses a real threat to our mission. These investments are a step in the right direction. It will allow us to begin to recognize and reward the incredible commitment of our staff and continue providing dignified and compassionate care to our rural community.”