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Texas Fails In Nursing Home Care, Prompting a Push for Change

A House committee discusses ways to help aging Texans navigate the health care system.
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Texas is the worst state in the nation when it comes to nursing home quality, according to a new report from a national advocacy group – Families for Better Care, out on Sept. 10, 2014.";

Texas is the worst state in the nation when it comes to nursing home quality, according to a new report from a national advocacy group – Families for Better Care.

The group has ranked Texas last for the second year in a row, so Texas lawmakers have been discussing what to do to change this when they return to Austin in January.

On a recent morning, Karen Phillips sang "Jesus Loves Me" with a resident of the Heritage Park Nursing Center in northeast Austin. The resident can’t get out of bed and has a hard time speaking.
Phillips has been visiting her for more than two years.

"There’s some very sweet people on staff here," Phillips says. "That’s very comforting to me."

But one afternoon this summer, she was not comforted by the temperature inside her friend’s room.

"I don’t get hot easily, but I had sweat just pouring down my legs," she says. "I thought, ‘Oh this is really bad.’ So I bought a fan, and the next time I came in and put the fan together and set it up, same thing. I had sweat pouring off of me. "

Phillips says she came back to take the temperature of the room, and she says it was 87 or 88 degrees. Outside, it was in the upper 90s. So she filed a complaint with the state Department of Aging and Disability Services – which oversees nursing homes in Texas.  She says the department took about two weeks to respond.

Now there is a new air conditioner in the room.

KUT called the nursing home about whether the staff is checking the temperature in other rooms where residents might not have visits from volunteers like Phillips. While on hold, the nursing home advertised the quality of life at its facility.

"Residents enjoy bowling, sensory stimulation, laser entertainment and coffee and donuts social," the recording said. "These are just a few of the many events that enhance our quality of life at Heritage Park. Learn more when we return to your call."

The call was answered by Ben Falls, an administrator at Heritage Park. He says the facility follows DADS regulations and guidelines as far as monitoring temperatures in the facility, but otherwise, he declined to comment.

Phillips doesn’t say the air conditioning issue jeopardized her friend’s life, but Texas does have nursing homes that have been faulted for living conditions pose severe health risks. State Sen. Charles Schwertner, R-Georgetown, wants these kinds of nursing homes shut down.

"The ones that are not fulfilling their charge to take care of our seniors – our parents and grandparents who are residing in those nursing homes," Schwertner says.
Schwertner is on the Legislature’s Sunset Advisory Commission, which evaluates state agencies every 12 years. In May, the commission released a report [read a PDF version here] that found the Department of Aging and Disability Services needs do more about penalizing facilities that don’t meet basic standards.

Schwertner is suggesting a three-strikes rule that would allow the Department of Aging and Disability Services to take away these facilities' licenses.

"If they had three of those violations over three separate occasions over 24 months, it would mean the automatic revocation of their license," he suggests.
Critics say shutting down a nursing facility is bad for the industry, but Schwertner says had a three-strikes law been in place over the last two years, it would’ve affected only seven out of 1,200 nursing facilities regulated by the state. He says that’s not too much to ask.

"Closing a nursing facility is something that is done as a last resort," says Melissa Gale, a press officer with DADS. "What we want is for the providers to correct their deficiencies, come back into compliance with the regulations, so they can care for the people who are living at their facility."
But Gale says DADS will support developing progressing sanctions.

"We would definitely support whatever the Sunset Commission decides in the way of enforcement," Gale adds. "We feel like we hold providers who have repeat violations accountable but we would certainly support efforts to strengthen enforcement."

In last May’s report, the Sunset Advisory Commission found nursing homes in Texas had almost 19,000 violations in the 2013 fiscal year. Almost 400 of those violations were a level 4, which means they put patients in jeopardy and could lead to harm or death.

Back at the Austin nursing home’s parking lot, Phillips smiles as she talks about the resident of this home who’s become her friend.  

"She just lays there day after day, just staring at that wall," Phillips says. "She didn’t have a TV when I first started. I don’t think she enjoys it all that much to be honest, but anyway for her to have this very sweet and pleasant disposition given her circumstances – I find that absolutely amazing. I love her and she says she loves me, too."

In the two years she’s been coming to visit her, Phillips has not seen anyone else who doesn’t work at the nursing home come in to see her. She says she hopes when the Texas Legislature reconvenes in January, they’ll pass legislation that would ensure all nursing home residents get treated with dignity and respect.

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