Thursday, October 20, 2011

Institutional Care Requirements For Texas Medicaid

The majority of nursing home residents in Texas are funded by Medicaid.


According to Lou O' Reilly, Texas ranks near the bottom of the United States' list of states and their expenditures on nursing home care per resident. Staffing levels are also a problem, due to a countrywide shortage of nursing staff and a rapid turnover of those who work in long-term institutional care. Medicaid, the state health insurance system, is financed in Texas by 60% state funds, and 40% federal funds.


Licensing


Nursing homes must be licensed.








All nursing homes wishing to be approved for Medicaid funding must apply to the Texas Health Department, who will carry out an inspection. The facilities and the level of care will be examined. If approved, a license will be issued. The home will have to follow a range of measures incorporated into Medicaid regulations from the Nursing Home Reform Act 1987.


Staffing


The Nursing Home Reform Laws stipulate that all Medicaid-approved nursing homes have to be adequately staffed. However, this has been criticized as being vague, and most states, including Texas, have introduced their own regulations. Each home should appoint a director of nursing (DON), and a registered nurse should be on duty for 8 out of 24 hours, 7 days a week. A licensed practical nurse (LPN) or licensed vocational nurse (LVN) should cover the remaining hours.


Other Regulations


All residents should have an individual care plan, and this should be regularly reviewed. Restraints, whether physical or chemical, should not be used unless this has been approved by the Department of Health. Each home should have a documented complaints procedure. If a resident or relative wants to take a complaint further than the administration of the facility, she should be advised to contact the Texas Department on Aging (TDoA) ombudsman, who will follow up the complaint.

Tags: Each home, Each home should, Home Reform, home should, nurse should, Nursing Home Reform