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Bucking the Trend – County-Run Nursing Homes

News regarding New York nursing home care in recent months has centered on one development–the privatization of formerly public-owned facilities. In the past, most New York counties owned and managed their own facilities to provide long-term care for seniors in their community.

However, due to a range of factors, those homes became significant financial weight on county budgets. Local officials looking for ways to get out of the red increasingly decided to sell off their nursing home operations to private companies. The idea often made intuitive sense, considering the facilities often cost the county millions more each year than they brought in. New York Medicaid reimbursement amounts often fail to cover the actual cost of providing support to each senior resident.

However, the privatizations have worried many elder care advocates who wonder if the quality of care will decrease post-sale. Thus far it is hard to say with certainty if private homes automatically provide lower quality care. It remains incumbent upon each family to investigate the quality of each individual home to find the location that is the best fit for your elderly relative.

Pleasant Acres Nursing and Rehabilitation Center in York County
But not all counties have decided the privatization path is the way to go. For an example of how some public bodies are reacting to the pressures, one need only look to our neighboring state to the west. Instead of selling their nursing home, officials in York County, PA are working in various ways to lower costs internally, with the hopes of making it financially feasible for the facility to remain state-owned.

Commissioners reported in a recent YDR Politics story that they expect their latest cost-saving measures to shave at upwards of $1.2 million off costs this year alone, with more savings coming in future budget. Last year the county paid a $7.3 million subsidy to the home to cover costs. In 2013 that subsidy is set to decrease to about $5.9 million.

Officials explain that the savings came from a variety of sources, including:

*Staffing Changes – By moving to various automotive protocols, administrators have been able to shave about two dozens staff positions, lowering employment costs.

*Medicaid Reimbursement Increases – State lawmakers increased nursing home reimbursement funds from Medicaid, resulting in a nearly $600,000 increase to that facility alone. It is unlikely that New York would follow suit in this regard, considering that the state’s Medicaid Redesign Team continues to look for ways to cut reimbursement, including by funding more efficient at-home care.

* Electronic Medical Records – The shift to electronic medical records has greatly improved administrative efficiency, reducing staffing and other costs.

It is impossible to know whether these or other changes would work to save county-run nursing homes in New York. But, at the very least, it is a reminder of the many different factors that go into nursing home administration and management that may affect the future availability of long-term care for New York seniors.

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