Challenges to quality care in Texas nursing facilities

The American population is aging. Predictions for the future estimate that nearly 50% of those over age 65 will need long-term institutionalized care in nursing facilities at some time. Texas has gained national attention for the difficulties it faces in providing quality care to this vulnerable group. Nursing facilities face challenges in reimbursement, regulation, medical direction and nursing care, quality improvement, and ethical dilemmas. This article will attempt to present these challenges and offer solutions consistent with the goals and desires of consumers and providers.