While Texas is home to a lot of great sources of state pride, the truth is that when it comes to assisted living options for older adults, in many regions, the pickings are pretty slim.
Nursing homes in particular, while very different from assisted living, have a struggling reputation in Texas. In 11 states, 40 percent or more of nursing homes get the two lowest ratings in an analysis by the Kaiser Family Foundation. Texas ranks especially low, with the highest percentage of one- and two-star homes in the country. In fact, 51 percent of nursing homes in the state rate one or two stars.
But there is a “glass half full” view to this story. While it’s important to understand why Texas nursing homes rate so low, that understanding can be the start of something new, a chance to reevaluate the landscape of senior communities and explore some of the positive and invigorated options that are emerging.
Lay of the Land
It’s worth noting that Texas is not alone in occupying the bottom rungs of the nursing home rating scale. Louisiana follows close behind at 49 percent for one or two stars, with Oklahoma, Georgia, and West Virginia tied at 46 percent. Other states with at least 40 percent of homes ranked in the bottom tiers are North Carolina, Tennessee, Kentucky, Ohio, Pennsylvania, and New York.
Rankings take into account a range of factors. Variables may include government inspections, staffing levels, and self-reported quality metrics (for example, the percentage of residents who develop bed sores or who are injured in falls). While the nursing home industry is skeptical of the ratings, consumer groups say they at least represent a solid starting point for evaluating a community of interest.
Why do Texas nursing homes consistently rank so low? There are a number of reasons for the deficit, including a shortfall in Medicaid funding and alleged understaffing by nursing home operators.
At the same time, the state does register some points in the plus column when it comes to senior living options. In particular, Texas ranks high in terms of the availability of information on senior housing.
While this is a positive sign, consumer advocates say that the kind of information available in government records and reports can only be a starting point. When it comes time to consider a new lifestyle option, it is critical that older folks and their adult children visit prospective communities in person. That’s because the world of senior living is changing, and today there are more options than ever to consider.
The Evolution of Choices for Older Adults
For Texans considering their options, it’s important to realize that nursing homes are not the only residential option available. Assisted living has come into its own in recent years, bringing with it a broader range of options. Assisted living communities still provide the full gamut of medical care but, at the same time, also often have more of a focus on the living environment. While nursing homes are federally regulated and have to fit into a specific mold, assisted living regulations vary by state and there is more flexibility to create environments that are suited to helping older adults age successfully.
Seniors who are still independent and active may turn to assisted living for a number of creative and life-affirming options. Many of these communities strive to make enrichment an integral part of the communal experience, seeking to empower older adults with classes, activities, and a range of participatory opportunities.
Today’s assisted living is a far cry from the stereotypical “home” setting, so fraught with negative connotations. As Texas works to reinvent its senior living landscape, assisted living offers a model that is rich with potential. For those seeking music, art, culinary crafts, or other creative outlets, assisted living recognizes the need for thoughtful expression and vibrant interactions.
Most significantly, the rise of assisted living in Texas means that older adults have a greater range of options than ever before. Decades of low rankings on the nursing home scale have discouraged some in the region from pursuing new opportunities for community living. The fact is, those opportunities are out there.
It’s important to recognize that not every community will be a fit for every person. Each senior living experience is unique. Older adults and their children should explore the options together, in order to glean a true and useful understanding of the changing senior living landscape that exists in Texas today.
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