Public nursing homes face potential crisis

Aug 11, 2012

County-run nursing homes across New York state face growing crises as county governments, strapped for cash, consider ending their historical role as providers of inpatient care to the elderly.

Counties as geographically diverse as Fulton and Niagara have already sold their nursing homes, and counties around the state including Albany, Steuben, Washington, and Chautauqua have also considered selling or closing the homes.

Steven Acquario, the executive director of the New York Association of Counties, says it is the first tangible effect of the financial vise that counties face. He says the closure of the nursing homes would be a break in a tradition that dates back to colonial days, when local governments provided alms houses and early hospitals for the needy.

Acquario says while counties remain financially afloat, they are starting to suffer from a kind of social bankruptcy when they are unable to provide core social services.   

“This is the first casualty that we’ve seen of this social bankruptcy,” he said.

Acquario says the two percent property tax cap approved last year by Governor Andrew Cuomo and the state legislature is contributing to counties’ fiscal squeeze. Counties rely on property taxes for much of their revenue to provide services. He says costs for pensions and health care, including the pensions of the workers at the nursing homes, contribute to the problem. And counties believe there are too many unfunded mandates that add to their cash crunch.   

The New York State Comptroller, Tom DiNapoli, in a report earlier in the week, said all local governments in New York face a grim new fiscal reality, as tax revenues and state and federal aid decline, unemployment remains high, and the recession continues to linger.

Acquario says he does not believe that private nursing homes can pick up the slack. He says most of the county nursing home residents are on Medicaid, which many private facilities are reluctant to accept.  

“The counties are the providers of last resort,” Acquario said.

He says many county leaders are loathe to close the nursing homes or scale back services, but feel they have no choice. Counties have asked state officials to grant the 34 nursing homes across New York a special status, to gain more funds, but so far have received no answer.

And Acquario says New York is not alone. States including Illinois, Indiana, Minnesota, Pennsylvania and Texas are also selling public nursing homes or closing them altogether, in what he calls a “troubling trend.”