Having gone without a Medicaid increase for a decade, nursing homes in Texas are bracing for a financial hit when a small-but-vital pandemic subsidy ends Thursday.
Skilled nursing facilities in the Lone Star State have been receiving an additional $19.63 per patient per day since April 2020. The federal government has been winding down higher Federal Medical Assistance Percentages awarded to providers throughout the pandemic; Texas had committed to supporting a higher subsidy through the end of the public health emergency.
With that occurring May 11, that state’s long-term care advocates are warning that nursing homes still need financial help.
A spokeswoman for LeadingAge Texas said the group is asking legislators to appropriate $40 million in bridge funding to keep the current reimbursement rates through Aug. 31, the end of the state’s fiscal year.
“While the PHE expires on May 11th, the impacts of the pandemic, inflation and a dire workforce shortage remain,” Alyse Meyer, vice president of Advocacy of LeadingAge Texas said in an email to McKnight’s Long-Term Care News Monday. “Nursing homes serving Medicaid recipients have relied on this add-on for three years and they need consistent funding to avoid disruptions in care, maintain staffing levels, and ensure access to high quality-care in the communities they serve.”
The loss of the subsidy could put a hole in many nursing homes’ precarious budgets. The average facility could lose between $40,000 and $50,000 per month, Kevin Warren, president of the Texas Health Care Association, told the San Antonio Report.
Meyer said that the cost of care is underfunded by an average of $123 per patient per day.
Lawmakers are wrangling through budget negotiations, which could increase funding for nursing homes by $400 million and also provide $32 million for nursing and repayment programs over the long-term. Texas’ Medicaid rates have not increased since 2013.
“The biggest question mark on the states that we’re in is Texas. I think everybody’s got a comfort level now that the Texas legislature will make permanent the $19.62 that was part of the FMAP add-on and some additional amount above that,” Rick Matros, CEO of Sabra Health Care REIT, said during an earnings call last week. “Texas has the option of extending that $19.62 until the full rate increase goes into effect in September, but we just don’t know yet if they’re going to do that. I think the worst case scenario for Texas is that they have a 4-month hole.”
The short-term mess that could erupt if bridge funding is not approved could doom smaller and nonprofit facilities, at least one system head said. Patrick Crump, CEO of Morningside Ministries, also told the San Antonio publication that losing the $19.63 per patient per day subsidy could result in an overall loss of about $250,000 to $300,000 at Morningside Manor.
