Future of NY’s County-Owned Nursing Homes in Jeopardy

The future of nursing homes owned by counties in New York state are largely in jeopardy, according to a report from the Center for Governmental Research (CGR) of Rochester. 

The New York State Health Foundation funded the study to identify key consequences of previous decisions to shift nursing home beds from the public sector to the private sector.

While virtually all nursing homes across New York, whether operated by a county, for-profit company, or nonprofit operator, face “wide-ranging” challenges, county-owned homes have an especially troubled future, notes CGR. 


The financial stability of county-owned homes has eroded in recent years, where in 2010, 92% of the county homes in the state outside of New York City lost money, with median losses per resident day doubling since 2006 and quadrupling since 2001.

As a result, county homes are rapidly losing market share to non-public homes, particularly to for-profit providers, CGR notes. 

Much of the annual operating deficit faced by the 33 counties that own and operate nursing homes is attributable to high costs of employee benefits, especially for employee health insurance and pension costs. 


The average employee benefit costs per resident per day in county-owned homes rose 181% in the 10 years ended in 2010, which CGR notes is largely due to long-ago negotiations by state and county-elected officials and union leaders.

“Without intentional, collaborative efforts by key stakeholders to address these issues and implement needed changes, most county homes have little chance to survive,” wrote the study’s authors. 

But it seems that recent sales and closings of homes have yielded positive results, such as reduced costs to counties and, in some cases, have led to improvements in facilities as well as care. 

“In exploring the future of county nursing homes, county leaders must do due diligence, ranging from exploring ways of reducing internal costs and enhancing revenues to weighing the potential for selling the home, and if so, carefully considering to whom and under what conditions,” research authors wrote.

Written by Jason Oliva

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