1 week Ago By By Travis Clardy President, Texas Health Care Association
On a Sunday after church in a nursing home in Nacogdoches, a sweet grandmother sits with a warm smile as her husband tells stories to their grandchildren about the early days, the hard work, and the family values that shaped our great state. In the next room, a caregiver adjusts a blanket, offering a kind word and a familiar face. For so many Texans, these aren’t just facilities — they’re communities.
Places where lifelong connections are honored, where care goes beyond the physical, and where dedicated staff members know each resident’s personal story often as well as their own. Thousands of Texas families rely on these facilities to care for their loved ones, but unfortunately, long-term care as we know it is under existential threat thanks to a new federal mandate. To be frank, hundreds of these critical facilities are facing closure.
I want the public to know that the Texas Health Care Association (THCA) is fighting to protect long-term care professionals, their residents, and the families they serve, but we are in a battle against federal overreach that is putting some of Texas’s most vulnerable residents in jeopardy. In April of this year, the federal government finalized new rules to create the first-ever minimum staffing mandate for nursing homes across the country. It may sound nice, but the reality is grim.
Now, it’s no secret that there is a shortage of nurses and long-term care facilities struggle to hire and retain qualified staff. THCA is the leading voice in the Texas Legislature working to solve this issue. We advocate every day for changes that will increase the scope and capacity of the long-term care workforce and improve the quality of care in Texas.
A one-size-fits-all approach like this mandate from the federal government is not the solution. In fact, it will be virtually impossible to implement and risks upending the industry altogether. Estimations put the cost to Texas long-term care providers at upwards of $725 million, and the federal government is offering no additional funding to support this financial crunch.
Despite sincere efforts to increase staffing over the last several years, over two-thirds of the nursing homes in the state do not currently meet the new requirements. A mandate from the federal government does not magically change the realities around securing the staffing desired at these facilities. The truth is that even if facilities and providers did have the money to hire the additional nurses, there are not enough nurses in Texas to fulfill these onerous blanket requirements.
The state would need 12,705 more caregivers. I’ve witnessed firsthand the efforts that long-term care providers are putting into bolstering staffing and improving their quality of care. I’ve seen the good faith effort made to recruit and retain staff.
Resident care is our first priority. This new rule demands that nursing homes hire more caregivers as though lack of effort is the reason more staff are not hired. But a State of the Sector Report found that as of March, 99 percent of nursing homes surveyed were hiring, 89 percent of which were actively soliciting RNs.
And 94 percent of facilities reported that it is difficult to recruit new employees, with 67 percent citing a lack of interested or qualified candidates as one of the biggest obstacles. That’s why the THCA is leading the charge against the crippling federal staffing mandate in the courts. Alongside our national partner, the American Health Care Association (AHCA), and a handful of individual providers, we are suing to stop the unfunded staffing mandate.
The implication that long-term care facilities are simply not trying hard enough is categorically false. Data shows that nursing homes had raised wages within the last six months, offered bonuses, including sign-on bonuses, and promoted or trained internally. But it’s not enough — nationally, nursing facilities still have 112,00 fewer workers than in February 2020.
Nursing homes are already having to turn away new residents or close their doors due to the workforce shortage. This misguided mandate will force care facilities to refuse even more families. Texas Attorney General Ken Paxton also filed suit in August, citing the need to hire over 10,000 nurses overnight to get into compliance with the new rules and highlighting the particular damage these requirements would do to rural facilities.
If the federal agency responsible for this rule cared about resident care, it would listen to the stakeholders who warned against the dangers of this policy. Now the agency is listening to us in court. At the end of the day, this fight isn’t just about policies or courtrooms — it’s about protecting the people who’ve given so much to our communities and preserving the places they now call home.
Our commitment to Texas families and the dedicated staff who care for them runs deep, and we’ll keep working to safeguard the deserved support, resources, and stability. Together, we can ensure that our nursing homes remain places of comfort, dignity, and community — just like they’ve always been..
