My bill in the Texas Legislature won’t levy a nursing home ‘granny tax’

The political professionals in Austin who are trying to kill my effort to improve Texas nursing homes by calling it a “granny tax” should be ashamed of themselves.

No one is talking about taxing anyone’s grandma.

But “facts” like that can hurt real people if left unrefuted.

I am a family practice doctor from Gatesville, not a career politician. I know my neighbors, watched kids grow up and adults age.

Some of my patients age into decline and require assistance despite their best plans. My grandmother lived in a nursing home for many years.

For me, like a lot of Texans, the quality of long-term care is very personal.

There is no argument about this: Long-term care is underfunded in Texas.

For more than two decades, I’ve seen the nursing homes I visit have struggle with low staffing levels and turnover as high as 90 percent for registered nurses, caused by the state’s low Medicaid reimbursement rate.

My legislation, House Bill 2766, would bring in much-needed funding to improve Texas nursing homes without increased state spending.

The House approved my bill on Thursday and passed it on to the Senate.

New money would enable nursing home owners across the state to raise wages, improve training and invest to enhance their facilities.

HB 2766 would help nursing home owners retain good staff, and that will improve the quality of care more than any other thing I can think of. In a long-term care setting, a familiar face with personal knowledge of a resident’s needs and routines can make all the difference.

HB 2766 would do this by creating the Nursing Facility Reinvestment Allowance, or NFRA.

The NFRA will allow nursing home owners to put up their own dollars to pull down additional funds from the federal government.

The plan is simple: Each nursing home would put up the same amount per resident day. When the federal dollars are returned, nursing homes would see an increase in their Medicaid payment.

Nursing homes would have the opportunity to earn additional reimbursement if they meet certain quality metrics.

The wording of the bill expressly prohibits the nursing homes from passing on the allowance to their patients, either directly or indirectly.

The fee comes from the nursing home’s revenue — not the residents.

Talking about Medicaid and nursing homes isn’t just a discussion about poor people, but about the elderly who have outlived their savings. It affects middle-income Texans.

In fact, a majority of nursing home residents rely on Medicaid.

For a patient in a nursing home to be eligible for Medicaid, they must “spend down” to an income of less than $2,200 per month and have assets of less than $2,000. They may have a house, car and a burial policy.

By law, these patients on Medicaid cannot be assessed any extra payment or bill from the nursing home.

The NFRA is an idea brought forward by long-term care providers themselves. It does not expand Medicaid. It does not add to our state budget.

It allows Texas to capture federal dollars to supplement health care funding just like 43 other states are doing.

It’s a smart way to improve long-term care and avoid using state revenue. It’s also the only viable plan on the table right now to improve Texas nursing homes.

For me, that makes it a no-brainer.

Shame on the political professionals who would hurt elderly Texans with their cute phrases and misinformation. The more than 90,000 Texans who will go to sleep tonight in a nursing home are more important than political games.

As a Christian, I want to ensure our elderly receive quality care in the final stages of life.

As a conservative Republican, I want to see that we meet the needs of Texans in a fiscally responsible way.

The NFRA meets both these obligations, and that is why I am proud to work for its passage.

This story was originally published May 12, 2017 at 4:11 PM with the headline "My bill in the Texas Legislature won’t levy a nursing home ‘granny tax’."