AUSTIN (KXAN) — Long-term Care Ombudsman Patty Ducayet worries about nursing home residents left waiting on staff for help getting out of bed or to a bath. She told lawmakers she also thinks about low activities budgets which leave few resources to entertain residents, broken facility transport vans sitting in parking lots, and poorly maintained HVAC systems that affect residents and staff during winter weather or on hot, summer days.

Tasked with representing and advocating for residents in nursing homes and assisted living facilities, Ducayet told lawmakers she and her staff see the “strain” caused by the lack of resources at some operations.

Ducayet testified before the Texas House Human Services Committee on Tuesday, as the lawmakers considered ways to improve the lives and safety of people living and working in long-term care facilities. The committee largely focused on workforce challenges and staff retention issues facing the industry.

KXAN previously reported on a study that found around a 15% reduction in the skilled nursing workforce, over the course of the pandemic.

Last year, lawmakers directed the Department of State Health Services to distribute $2 billion for “surge staffing” in long-term care facilities, but some of this funding went to hospitals and infusion centers, as well. The same bill also provided the state’s Health and Human Services Commission with additional funding for staffing needs in these homes: $200 million in grant funding for nursing homes and $178 million for assisted living facilities.

Tuesday’s hearing focused on more long-term solutions and sustainable funding sources.

Chairman Representative James Frank said it was important to highlight what “good” homes were doing right, while weeding out facilities that are not prioritizing patient care.

“It makes it really hard to excited about putting more money, when the money is not actually going to help take care of the patient better,” Rep. Frank said.

Ducayet suggested lawmakers require facility owners to be more transparent in reporting financial information. She also recommended increased salaries for staff, retention bonuses, longevity pay, and minimum staffing ratios — which would require facilities maintain a certain number of employees per resident.

Vice President of Advocacy at LeadingAge Texas, Alyse Meyer, testified to lawmakers about barriers and unnecessary delays in getting nursing assistants tested, certified and licensed to work in these facilities.

“To have, you know, a months-long delay between training and testing causes them to find employment elsewhere,” she said.

Several people testified that staffing shortages were already a concern in nursing homes and assisted living facilities prior to the pandemic.

“For nursing homes in total in Texas, we need an additional 7,000 registered nurses and an additional 12,000 certified nursing assistants — and that’s pre-COVID. Again, that’s how far behind we were before the pandemic came,” said Kevin Warren, President and CEO of the Texas Health Care Association.

He said the goal was to incentivize these health care workers to see “long-term care as a long-term profession.”