HARRIS –– The Skilled Nursing Unit (SNU), a 64-bed nursing and rehabilitation center located at Garnet Health Medical Center –– Catskills’ Harris campus that offers short term and long term nursing care, is slated to close at the end of September.

However, Garnet Health Medical Center –– Catskills CEO Jonathan Schiller said he’s told the 39 current residents in the SNU and their families that for whatever reason, if there’s an issue, and they can’t move until the first week of October [for example], “we’re going to do the right thing, take care of them and make sure it’s a safe transfer.”

Schiller said nursing home reimbursement has been very challenging, especially for hospital-based nursing homes, with changes made several years ago at the federal level.

As a result, Schiller said they’ve seen two significant changes in the nursing home industry.

The first, he explained, is that nursing homes need to be at 95 percent occupancy to remain sustainable. The second is that in order to get there and gain economies of scale, nursing homes are becoming part of large regional and national chains.

Schiller said that has been happening right here in Sullivan County, with the Roscoe Nursing and Rehab Center, Achieve Rehab and Nursing Facility, and most recently, the Care Center at Sunset Lake, which is on track to be leased to Infinite Care.

“The problem is we face all of those same economic challenges trying to run a nursing home and we really can't sell our nursing home to a chain or our operating certificate,” said Schiller. “That doesn't work for a nursing home inside a hospital.”

Schiller said over the past several years the SNU has been struggling financially and losing money, with 2020 representing a $1.4 million loss. The hospital has to subsidize any losses at the SNU each year.

“We’re just not in a position to be able to continue to do it,” he said. “One of the learnings we had as a result of the pandemic is that we just can’t continue to use the hospital revenues to make up for the shortfall [at the SNU], especially when there’s other quality nursing homes in the county that aren’t full.”

Schiller said while there are other nursing homes in the area, they are the sole community hospital, so protecting the hospital and future services is very important.

“We need to use those financial resources that we've been using to subsidize the nursing home to continue to grow our outpatient services,” he said.

Some of the services Schiller mentioned include mental health, as well as substance use disorder and opiate addiction services. He said they’re also continuing to recruit specialists.

“They’re looking to come, but they want the latest clinical technology and that all costs money,” said Schiller, “and if we continue to subsidize the nursing home, we wouldn't be able to make those types of investments.”

What’s next?

Schiller said the hospital has met with the SNU’s 39 residents and the New York State Office of the Ombudsman to share the details [of the closure] with them. He said they also reached out to their families to let them know the hospital will work closely with them over the next couple of months to find the most appropriate placement for the residents in other nursing homes in the county, all of which have beds available.

Schiller stressed that the decision to close the SNU is not reflective of the staff.

“It’s important to note that they have done nothing wrong, they do great work ... they haven't made any big mistakes that need to be fixed and we don't have a clinical crisis going on,” said Schiller. “This really is just the state of the nursing home industry, and it’s not something, in my view, that's going to change.”

There are 60 employees at the SNU. Schiller said he met with the staff on Thursday, and reviewed with them that there are several hundred jobs across all the Garnet Health facilities and locations that they can apply for or transition into.

“There’s plenty of opportunity for our staff to find other employment within the health system, or some of them may choose to follow the residents into the nursing homes, which of course, we would support as well,” said Schiller. “We just want to be compassionate, generous and support each individual as they make their choices.”