Two Nursing Home Groups Sue Texas for Higher Medicaid Payments

[NRSKarenRN, BSN, RN]

Copyright 2002 Knight Ridder/Tribune Business News

Copyright 2002 Fort Worth Star-Telegram

http://webpublisher.lexisnexis.com/index.asp?layout=story&gid=1730000973&did=451S-PSK0-01CV-H11H-00000-00&cid=1920004392&b=sFort Worth Star-Telegram...01/30/2002

AUSTIN, Texas--The two largest nursing home organizations in Texas joined in a federal lawsuit Tuesday against the Texas Department of Health and Human Services that seeks to force the state to increase Medicaid payments to facilities that provide long-term care.

The move by the Texas Association of Homes and Services for the Aging and the Texas Health Care Association pits the nursing home industry in Texas against the state agency that administers the federal Medicaid program. The industry is arguing that the state's comparatively low reimbursement rates have pushed many nursing homes past the brink of bankruptcy.

"This lawsuit is the only hope we have to solve the nursing home crisis that has forced more than 40 percent of all Texas facilities into bankruptcy and caused hundreds of millions of dollars in losses each year by those that are still in business," said Austin lawyer Dean Davis, who represents the industry in the court action.

The original lawsuit was filed 11 months ago in U.S. District Judge Sam Sparks' court in Austin. In it, the Texas Alliance for Nursing Homes claims that the state has failed to comply with an earlier legal agreement regarding proper Medicaid reimbursements for Texas nursing homes. The alliance claims that more than 70 percent of Texas nursing home residents depend on such payments.

Sparks has rejected the state's motion to dismiss the matter, and that motion is pending in the 5th U.S. Circuit Court of Appeals in New Orleans.

In a "friend of the court" brief filed with the appeals court, the Texas Association of Homes and Services for the Aging and the Texas Health Care Association said the state is not living up to a 1997 agreement to increase Medicaid reimbursement rates. Texas pays homes $ 85 per occupied bed per day, which ranks the state 45th in the nation.

Homes say they are losing an average of $ 12 a day for each Medicaid patient enrolled.

The lawsuit could lead to further budget woes for Texas Medicaid, a multimillion-dollar federal-state partnership that provides health care for disadvantaged Texans. Growth in prescription drug costs and other factors has led to recent budget shortfalls.

The attorney general's office, which represents state agencies in lawsuits, said it would not comment on the matter because it remains pending in court.

State Sen. Mike Moncrief, D-Fort Worth, carried successful legislation last year that will pump $ 175 million into the nursing home industry to boost the hiring of nurses and nurses aides and to assist in the cost of purchasing liability costs.

Moncrief, who will leave office next year, said more money is needed because Texas has long lagged behind other states in providing care for elderly and disabled residents.

"We rank 45th in the nation in Medicaid reimbursement," said Moncrief, chairman of the Senate Health and Human Services Committee. "We rank 46th in the number of nurses aides at these facilities and 47th in the number of registered nurses. This issue is not going to go away."

[Mijourney]

Hi. Gee, I don't see any mention of "grannie cams". In addition to more money, nursing homes really need better oversight of management and boards and better education of all staff and family in properly caring for the disabled and the disabled elderly.

[teeituptom, BSN, RN]

I live here in Texas. And Ive lived here for almost 2 dacdes now. It still amazes me that Texas, one of the richest states in the union. Can not provide for care for not only the elderly, but also children and single women. Texas also is near the bottom of the list for providing health care for children and young women also. They also continously have budgetary woes when it comes to dealing with the education system. And also for care of those who are mentally challenged.

The school system ranked last year ranked at either 47th or 48th. Where does all this wealth that texas has to offer go to. It is not to the people in this state thats for sure. They pay billions to entice big businesses to move here, but they wont take care of the people. Cuts to the school system, the mental health programs, Insurance of any kind for the poor. Where does it go to. That is the billion dollar question.

I live here and I love this state, I just dont understand why we cant take care of our own people, be they elderly,poor, or whatever.

No I did not vote for Bush

Thomas