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In 2010, 92 percent of county-owned nursing homes in the Empire State outside of New York City lost money. The study released this week from the Rochester-based Center for Governmental Research says the 33 remaining facilities have little chance to survive without major changes. So how are things here in Genesee County?

County manager Jay Gsell says they’re aren’t much better three years after this study was focused. The Genesee County Nursing Home is operating at an expected $2.5 million dollar deficit in 2013 despite multiple effective cost-cutting initiatives implemented this year.

“The county nursing home is now actually borrowing money from the county general fund,” Gsell said, ”just to pay our bills and meet payroll every two weeks. It’s still very much an uphill battle.”

In recent years six counties have sold or closed their homes and 13 more are currently in the process of or actively considering selling. In Genesee County, the number of beds in the adult home has been reduced as the focus shifts to increasing people in rehab beds and adult day care to keep numbers on par while dealing with an aging population.

Gsell says, ideally, New York State would step in.

“There is no light at the end of the tunnel as far as the state of New York is concerned,” Gsell said, “and realistically their general statements are that public sector nursing homes in the state of New York probably are not on their list of top things that they will be looking for, one, to either help us with deficit financing or, two, changing the nature of our reimbursement, particularly as far as Medicaid is concerned. So really, we’re left off to our own devices.”

About 70 percent of nursing home residents depend on Medicare. Gsell says reimbursements due to a new state policy have been a big cause of the problem.

“We just lost $3 to $4 dollars a day on a Medicaid bid because the state went to regional pricing at the beginning of this year,” Gsell said. “To make a bad situation worse, what was already about a $90 a day deficit in terms of cost versus reimbursement for Medicaid actually went further south.”

In order to significantly cut costs, the nursing home has implemented measures such as converting a little café into vending machines, using more nurse practitioners, and moving from independent contractors to a single contractor. Technological upgrades have also made it easier to determine the most updated monthly expense reports. Borrowing from the county general fund though could mean other bigger projects get deferred.

“There is nothing out there at this point that looks like that deficit will just, so to speak, magically go away,” Gsell said. “What opportunity costs will be missing in terms of other priorities as far as things like roads and bridges and in some cases major capital projects in the future, like the possibility of having to build a new county jail?”

The county legislature, which acts as the board of directors, continues to reiterate that it has made no decision to sell or look into selling and Gsell insists it will stay open.

The study recommends counties thoroughly assess future options as well as continued collaboration at the county, state and federal levels.

Here is a link to the entire study:


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