Senate approves rule requiring most Medicaid nursing-facility dollars be spent on direct care

The Texas Senate on May 1 passed committee substitute Senate Bill 457, a measure requiring nursing facilities that receive Medicaid to spend a defined share of those Medicaid dollars on direct patient care and to disclose greater ownership information.

Senator Lois Kolkhorst, the bill sponsor, said the legislation would create “a patient care rate ratio” that “intends that at least 85% of Medicaid dollars are spent on front facing care,” and described exemptions and floor protections for struggling facilities. She moved the bill through the floor process; it passed final passage by recorded voice with 31 ayes and no nays.

The bill sets an outcomes-centered spending requirement that counts direct-care items — such as salaries of direct care staff,…