No one in Texas hospital doubts the need for more skilled nursing care facilities. patients are leaving sooner and sicker, creating discharge-planning logjams. Few nursing facilities offer the subacute care these patients need--and in the current climate their operators can be increasingly selective about whom they choose to admit. These factors, coupled with lowered rates of hospital occupancy and yawning Medicare reimbursement gaps, are all reasons that furnishing skilled nursing care is an increasingly attractive option for Texas hospital administrators. For hospitals considering furnishing various long-term subacute care options, A. Ray Pentecost III, DrPH, offers a nuts-and-bolts guide. Pentecost, who is both a licensed architect and nursing home administrator, is director of the Health Environments Institute in The College of Architecture at the University of Houston, and is also president of Gerontological Health Consultants Inc. of Katy, Texas.