Industry leaders say a shortage of direct care staff is affecting the ability of nursing homes to maintain quality and provide much-needed care to the community’s most vulnerable seniors.

The Texas Center for Nursing Workforce Studies documented a 97 percent staff turnover rate for certified nurse aides and an average 90 percent turnover rate for registered nurses and licensed vocational nurses.

The report released this week by the Texas Health Care Association details the challenges with recruitment and retention of nursing staff in Texas.

“All too often, long-term care providers in Victoria or the rest of Texas are scrambling to fill shifts instead of focusing on continuous improvement because they can’t compete in the labor market,” said Kevin Warren, association president and CEO.

Warren said providers in Victoria are concerned about the lack of nurses and direct care staff.

Currently, 2,573 people work in nursing homes in Victoria and its six surrounding counties. But in a statewide survey, only 8 percent of respondents in the long-term care industry believe there is an adequate supply of nursing personnel.

“As our aging population continues to grow, the problem is only going to get worse,” Warren said.

According to the U.S. Bureau of Health Workforce, the Gulf Coast will need another 13,877 nurses just to keep up with the expanded demand by 2030, as Texas is projected to experience a widespread shortage of registered nurses.

Texas nursing homes are challenged with one of the lowest nursing home Medicaid reimbursement rates in the nation.

The state’s Medicaid rate falls almost $10,000 short of the cost of care on an annual basis per Medicaid resident, according to the news release.

More than two-thirds of all residents in Texas nursing homes rely on Medicaid to cover their costs after depleting their assets.

“The state’s low nursing home Medicaid reimbursement rate and heavy regulation are affecting the ability to retain nursing staff as they look for other opportunities out of the long-term care business,” Warren said.

Victoria’s strong economy is partly to blame for the workforce shortage, he said. The unemployment rate has hovered at about 4.2 percent in recent months, according to the Texas Workforce Commission.

Warren said this leaves nursing home operators unable to raise wages to hire and retain staff, who can quit and easily find another job with higher pay or less stress in other service industries or health care sectors.

In many rural communities, nursing homes are one of the largest employers and economic drivers. Nursing homes in Victoria County account for more than $77.1 million in total economic activity.

He said the data supports what anyone in long-term care already knows: Staffing is the key to being able to provide quality care for patients.

The report notes that with a more satisfied, well-trained and committed staff, nursing homes see increased retention rates, which contribute to better overall performance of the center.

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Laura Garcia reports on health and nonprofits for the Victoria Advocate. She may be reached at or 361-580-6585.

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Features Editor

Laura has covered health and nonprofits in the Crossroads since 2014. She's also mom to a toddler, loves journalism conferences and is a big fan of sci-fi and crime TV.

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