AUSTIN (KXAN) – Texas nursing homes have been slammed by coronavirus, which has killed 883 people and affected over half the state’s facilities, but federal records report these homes face another growing problem: staff shortages.
Federal data collected by the Centers for Medicare and Medicaid Services (CMS) shows a mounting number of nursing homes have reported staff shortages in every category the agency is tracking. Meanwhile, cases of coronavirus, also commonly called COVID-19, have surged in late June to record levels in the state.
CMS oversees nursing home regulation. The agency has been collecting coronavirus and facility data nationwide and began sharing it publicly in late May. The weekly data, released in three batches so far, provides numbers of COVID-19 cases and deaths, as well as information on whether a facility has staffing shortages.
A KXAN analysis of the CMS data shows more facilities have reported shortages each week among nursing staff, clinical staff, aides and other staff. The shortages reveal another facet of the complex challenges senior facilities face in keeping their residents, who are the most vulnerable to the virus, safe.
It’s a problem that predated coronavirus, but the pandemic has made it worse, said Kevin Warren, president and CEO of the Texas Health Care Association, which represents and supports long-term care providers.
“Nursing home staffing shortages and the staffing crisis existed long before COVID-19. The decades-long underfunding of Texas nursing homes in the Medicaid program, combined with a very difficult and labor-intensive profession, has made workforce challenges a significant issue. The virus has exacerbated the problem and has brought attention to this ongoing issue that has yet to be addressed,” Warren said in an email. “A previously existing shortage combined with prohibitions and restrictions on staff working in multiple locations and staff testing positive has placed added pressure on an already over-extended profession.”
Warren said many facilities have been able to hire more staff and nursing assistants through state waiver programs, but those “are not permanent solutions.”
“When the reimbursement for approximately 2/3 of the residents cared for in Texas nursing homes is approximately $35 per day less than it costs to actually provide the care, a facility doesn’t have the financial capability to compete in the labor market as necessary,” he added.
KXAN analyzed the three weeks of federal data released so far. In the first week of data released May 24, numerous facilities did not submit data, but have submitted data in subsequent weeks. To capture a conservative snapshot of staffing shortages, the graphs below represent only the 1,054 facilities that submitted data since the first reporting period. Texas has 1,224 nursing facilities in total. Those that did not submit data in the first reporting period have been removed; however, if all facilities are included the staffing shortages only rise more sharply.
The federal data provides the largest picture available of COVID-19 cases and deaths in nursing homes. However, it is an incomplete dataset. Federal officials have allowed nursing homes to leave out information that predates the data collection effort.
State health officials have refused to reveal facility-level coronavirus information, saying that releasing such records would violate health privacy laws. KXAN has independently confirmed over 20 facilities in Central Texas.
KXAN spoke with one nursing home employee, a nurse aid at a facility in the Rio Grande Valley, who echoed Warren’s concerns with staffing. The nurse aide asked not to be named in this report because she is currently employed and not authorized to speak publicly by her company.
She said her own nursing home is short-staffed.
“[The employees] don’t want to come in because everybody else is getting paid more. H-E-B is paying more than we are. Walmart is paying more than we are,” she said.
“It doesn’t surprise me at all,” she added, regarding staff shortages. “I’ve been doing this for 30 years, and it is sad. It is just sad.”
In Austin, Delia Satterwhite’s brother, Stephen Morales, died of coronavirus at a local nursing home. She has become outspoken about improving nursing home conditions and increasing testing for residents and staff. She will testify before a congressional hearing chaired by U.S. Rep. Lloyd Doggett on nursing home issues Thursday.
“If they are short-staffed now, I feel bad for the people that are living there because they don’t have nobody to care for them,” Satterwhite said.