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Fight to improve Texas nursing homes set for House vote Saturday

HB2766 would increase funding for long term care without state spending

Austin,Texas (PR MediaRelease) May 5, 2017

State Rep. J.D. Sheffield (R-Gatesville) takes his fight to improve nursing homes to the House floor on Saturday, as HB2766 is set for debate.

HB2766 would bring in much-needed funding to improve Texas nursing homes without increased state spending. This new money would enable nursing home owners across the state to raise wages, improve training and invest to enhance their facilities.

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.

“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,” Sheffield said. “In a long term care setting, a familiar face with personal knowledge of a resident’s needs and routines can make all the difference in the world.”

Sheffield, a family practice doctor from Gatesville, defended his bill from an on-going misinformation campaign.

“The more than 90,000 Texans who will go to sleep tonight in a nursing home deserve the best quality of care we can give them,” he said. “The political professionals in Austin trying to stop our effort to improve Texas nursing homes by calling it a “granny tax” are deliberately misleading Texans. No one is talking about taxing anyone’s grandma.”

There is no argument that long term care is underfunded in Texas. For more than two decades now, nursing homes have struggled with low staffing levels and turnover as high as 90 percent for registered nurses, all caused by the state’s low Medicaid reimbursement rate.

Passing HB2766 is personal for Sheffield, who has spent more than 20 years working as a family practice doctor in his rural community.

“I’m not a career politician. I know my neighbors in Gatesville. I’ve 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,” Sheffield said. “For me — like a lot of Texans — the quality of long term care is very personal.”

Sheffield also said his faith is an important factor behind his support.

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

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. Under the NFRA, 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.

The NFRA is an idea brought forward by long term care providers themselves. It does not expand Medicaid. It does not add to the state budget. It allows Texas to capture federal dollars to supplement health care funding just like 43 other states are doing.

Once HB2766 becomes law, the provider community will develop the Nursing Facility Agent Corporation, or NFAC.  The NFAC will be modeled after a similar program in Missouri and will be a voluntary, private, non-governmental mechanism to give the long term care industry the ability to prevent any negative impact on those who live in Texas nursing facilities as well as the facilities that serve them. To be overseen by a board of Texas nursing facility representatives, the NFAC is designed to create a fund to offset the costs paid by low and no-Medicaid providers in Texas.

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


Dr. J.D. Sheffield is a family physician who has made it his life’s work to care for the families in his community. He has served House District 59 since 2013, and was the long-time medical director at Coryell Medical Clinic and chief of staff at Coryell Memorial Hospital.


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