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County Homes Are Shrinking Part of Long-Term Care Picture

At least 13 counties are in the process of selling their nursing homes or considering doing so. Population projections show the population of people 85 and older, the group most likely to need nursing home care, will begin to soar dramatically after 2030, with more modest increases in most regions of the state before then.

Key Characteristics of Residents of County-Owned Homes

Residents of county-owned nursing homes are less likely to be short-stay residents (such as those receiving rehabilitation after surgery) and less likely to have sources other than Medicaid to pay for care than are residents of non-profit or for-profit nursing homes.

Hours of Care Higher in County Homes

County nursing homes are somewhat higher in the nursing staff hours of care provided per resident, per day, compared to for-profit and non-profit homes.

Costs for Employee Benefits Impact County Home Finances

Along with the types of residents they attract and accept, county nursing homes have been impacted more than other homes by increases in costs for employee benefits, driving up overall operating costs and contributing to negative operating margins at county homes.

Mixed Impact in Counties that Sold Nursing Homes

CGR’s research into four counties that sold their nursing homes found that, post-sale, employee benefit costs generally declined, but the homes’ reliance on Medicaid to pay for patient care did not change dramatically, except for a decline in Montgomery County. Changes in the quality of care were similarly mixed. (Note: the closing of the Fulton County Home occurred in 2012 and it is too early to assess the impact of this closure.)