Long-term care facilities struggle as COVID-19 declines | Local News



Even though many residents of Galveston County are starting to imagine a future after the coronavirus pandemic, Kimberly Mostek, administrator of the Gulf Healthcare Center in Galveston, is not sure life will ever return to what it was before in Galveston. long-term care facilities, she said.

Because long-term care facilities were hotbeds of coronavirus outbreaks in the early months of the pandemic, heads of state and business have forced changes in how the industry operates – by restricting the number jobs that members of a predominantly transitional workforce could both occupy and require more protective equipment to interact with residents.

Although the number of COVID cases is declining, these changes and the additional costs they entail are here to stay, Mostek said. This means the industry, long underfunded, is struggling without state help, she said.

“Without help, we will have no choice but to reduce staff,” Mostek said.

About two-thirds of Texans in long-term care facilities are covered by Medicaid, said Cara Gustafson, spokesperson for United in Care, a coalition formed to advocate for better Medicaid reimbursements for long-term care facilities. duration.


Before the pandemic, Texas ranked 49th in the country for its Medicaid reimbursement rate, Gustafson said. During the worst months of the pandemic, state leaders approved an increase in funding of about $ 19.63 per day, from about $ 141 per day to $ 160, to help facility operators compensate additional costs.

That increase is expected to expire at the end of July, however, and facility operators across the state are worried about what that might mean for the future of the industry, Gustafson said.

It is not known exactly where the Texas Legislature is located on request. The $ 285 million needed to maintain the current level of funding until 2023 was not included in the state budget but was included on a wish list, Gustafson said.

Officials are working with lawmakers to secure the funding, Gustafson said.

Galveston County lawmakers did not immediately respond on Tuesday to requests for comment on their support for keeping the reimbursement rate higher.


Dealing with COVID-19 has been an expensive proposition for facilities caring for the elderly and frail, who were among the most vulnerable.

Take for example the cost of something as simple as a case of medical gloves. They were used even before the pandemic, but this took on new significance as more interactions with patients required personal protective equipment, Mostek said.

Before the pandemic, Mostek could buy a case of gloves for the Gulf Healthcare Center for around $ 29. That cost skyrocketed to $ 141 at the height of the pandemic and has only declined to about $ 107 per case recently.

And personal protective equipment isn’t the biggest chunk of a facility’s budget – employee payrolls, Mostek said.


Long-term care facilities struggled even before the pandemic with a low-paid and mostly transient workforce, Gustafson said. Because many nurses and aides were not paid well, they often took shifts at multiple facilities, she said.

And, as the facilities struggled to attract talent, they relied on that transitional workforce to compensate for staff shortages, Gustafson said.

But state leaders, in response to major viral outbreaks in long-term care facilities, ultimately banned nurses and helpers from working in more than one location at a time, Mostek said.

“It was a good decision at the time,” Mostek said.

But Mostek was forced to increase its staff in response to the directive, she said. Before the pandemic, an average shift at the Gulf Healthcare Center was about five aides and three nurses per shift; now it’s about seven helpers and four nurses.


And many employees have left the long-term care industry for higher-paying jobs with other healthcare providers due to stagnant wages, Gustafson said.

With the realization that they won’t be able to work more than one job for the foreseeable future, these workers are unlikely to return, she said.

Facilities have been hit by the perfect storm as the increase in required staff has come just as more families have pulled loved ones away from long-term care facilities, Mostek said.

The Gulf Healthcare Center housed around 90 residents before the pandemic, Mostek said. Now her number of clients is rarely outside the 60s, she said.

If the Texas legislature does not keep Medicaid funding at higher pandemic levels, it will mean a loss of more than $ 24,000 per month on the facility’s budget, Mostek said.

Mostek on Tuesday was not sure what the loss of funding would mean beyond reducing its staff, but it would have serious consequences, she said.

This funding model is not sustainable, said Gustafson.

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