How Does Proposition 6 Impact the State of Care in Nursing Home Facilities?

How Does Proposition 6 Impact the State of Care in Nursing Home Facilities?

In a recent article for Living Blue in Texas, Travis Boldt, Director of home healthcare agency At Your Side Home Care in Houston, highlighted the stark disparity in elder care standards in Texas compared to the rest of the country.

When loved ones require extensive, near-constant supervision and support, nursing home facilities are often a necessity — for those who can afford it. One such example is Alzheimer’s disease, which affects nearly 6 million individuals in the U.S. — and rates are expected to balloon to eight figures over the next 30 years.

But it’s not just the financial burden families have to worry about.

Opting for any type of care — whether a nursing home facility or an at-home care solution — isn’t a decision made lightly. It takes a great deal of consideration about what is, ultimately, best for our loved ones, and it’s not always easy to place your trust in someone outside of the family.

You certainly don’t expect that trust to be violated.

Shockingly, that’s exactly what happens in nursing care facilities all over the country. In 2021 alone, the World Health Organization reported that two in three nursing home staff admitted to committing abuse in the past 12 months. Around one in six residents aged 60 or over had experienced some form of abuse.

Sadly, the signs of nursing home abuse can be difficult to spot at the best of times. Abuse and negligence aren’t solely marked by unexplainable cuts and bruises or visible symptoms of malnutrition. These are certainly common, but abuse also presents in other ways, from inappropriate touching to emotional neglect and gaslighting. Victims of abuse may not be comfortable coming forward and may even cover for their abusers. Add in the prevalence of residents with conditions such as Alzheimer’s being targeted because of their cognitive impairment, and it can be hard to spot the vital signs of abuse.

Then, in March 2020, when COVID-19 cases increased in the Lone Star State, Greg Abbott imposed restrictions on assisted living and nursing home facilities to protect vulnerable residents.

It wouldn’t be until March 2021 — a full year after restrictions were first implemented — that residents in the state could hug their loved ones again.

The impact of restrictions has been keenly felt by loved ones of residents of nursing homes and assisted living facilities.

Victoria Ford, chief policy and regulatory officer for the Texas Health and Human Services Commission, commented that visits from family and friends were “vital to the mental health and well-being of long-term care residents”.

A report by Altarum, a nonprofit organization that helps state health agencies improve care outcomes, highlighted the shocking impact of restrictions on residents.

In a survey of residents, Altarum reported that, unsurprisingly, 76 percent of respondents felt lonelier during lockdowns, while a whopping 64 percent said they didn’t leave their rooms to socialize. Even fewer — just 28 percent — went outside at least once a week, down 55 percent compared to before the pandemic.

During this time, rates of nursing home abuse also increased. With facilities closed to visitors, abuse could continue behind closed doors without the fear of visitors spotting the signs.

Proposition 6

More recently, in November 2021, Texans overwhelmingly approved eight proposed amendments to the Texas Constitution. Among them is Proposition 6, which came about as a direct response to the COVID-19 pandemic.

Proposition 6 — the Right to Designated Essential Caregiver Amendment — was passed by 1,275,369 to 176,054 and allows assisted living facility residents to designate an essential caregiver to visit them in person.

It has led to a new state law, Senate Bill 25, which creates further guidelines for such caregivers, including that they must be allowed to visit for at least two hours per day and that visits must include “physical contact between the resident and essential caregiver”.

Its goal is to avoid prohibiting in-person visitation — as we saw in the past year — ever again.

The question is, will it help?

Improved visitation rights if care homes have to close once again — especially now that the highly contagious omicron variant of coronavirus has made its way to Texas — can only be a good thing. When a designated essential caregiver can physically see and touch their loved ones every day, even the less-visible signs of abuse and negligence can become apparent.

But the problem with care in Texas stems much deeper.

In the most recent report card from Families for Better Care, a nursing home resident advocacy group, Texas was ranked the worst in the nation — for the third consecutive time. It flunked five out of eight categories and scarcely performed any better in the remaining three categories.

According to the report, almost 90 percent of nursing homes were staffed at or below the minimum number of caregivers required to adequately meet residents’ needs.

More shockingly, one in five Texas nursing homes was cited for severe deficiencies — including abuse, neglect, and mistreatment.

Brian Lee, the group’s executive director, said, “The best thing Governor Abbott and the Texas Legislature can do to improve the state’s nursing home quality ranking is by legislating a definitive state staffing standard that boosts direct resident care and then by allocating the funds necessary to pay for the staffing mandate”.

While improved visitation rights are a step in the right direction for ensuring our elderly residents receive the respect, care, and attention they deserve, reforms are desperately needed to address the care crisis.

Dr. Louis Patino is the founder of Patino Law Office, with offices in San Antonio and McAllen. As a personal injury lawyer, he helps personal injury victims, including those who suffer care home abuse and neglect.

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