In a May 1, 1998 report entitled “Nursing Home Privatization: What Is the Human Cost?” the Pennsylvania-based Keystone Research Center found that privatization of seven county-owned nursing facilities in Pennsylvania, or even the attempted privatization of those facilities, led to reductions in staffing, shortages of medical and resident care supplies, and reduced quality of care for residents. The arguments made in support of privatization – that county facilities cost too much money and that turning public facilities over to private, usually for-profit entities can save money while preserving or improving nursing home quality – are not realized. To the contrary, private for-profit owners typically drastically cut staffing, leading to dramatic declines in quality of care for residents. Often, the private owners reap large profits. Despite these results, privatization continues, in Pennsylvania and other states, with the same arguments in favor of privatization and the same negative outcomes for residents and staff.
A recent example is a county-owned facility in Beaver County, Pennsylvania, now called Brighton Rehabilitation and Wellness Center. Once the facility was sold to private owners in 2013, the new owners changed both the facility’s admissions practices (reducing its less profitable Medicaid census) and its staffing practices (substantially reducing staffing levels). It also increased profits for its owners through related-party transactions, paying the owners’ companies increasingly high rents and management fees. During the coronavirus pandemic, hundreds of residents and staff members became infected with COVID-19 and many died. The facility was identified as one of the worst-performing facilities in the country, becoming a candidate for the Special Focus Facility (SFF) program in February 2018 and an SFF in 2021. During the coronavirus pandemic, the state appointed a temporary manager at Brighton, federal and state investigators executed search warrants at the facility, and the state Attorney General confirmed an ongoing criminal investigation at the facility.
Although not all counties own and operate nursing facilities, the National Association of Counties reported in June 2020 that, nationwide, counties own and operate 449 nursing facilities and directly support 758 facilities. The Center for Medicare Advocacy releases a report today discussing the sales of county facilities in Pennsylvania, Illinois, and New York to private owners.
Oct. 20, 2021 – T. Edelman, M. Edelman
 Keystone Research Center, “Nursing Home Privatization: What Is the Human Cost?” (May 1, 1998), https://www.keystoneresearch.org/sites/default/files/krc_nursing_home_priv.pdf
 The Special Focus Facility program identifies nursing facilities that have more problems than other facilities, more serious problems than other facilities, and a pattern of serious problems over a long period of time (three years). They have additional standard surveys each year and “progressive enforcement.” The Centers for Medicare & Medicaid Services names 88 facilities at a time as SFFs and identifies another 400+ “candidate” facilities that meet the criteria for the program. https://www.cms.gov/Medicare/Provider-Enrollment-and-Certification/CertificationandComplianc/Downloads/SFFList.pdf
 National Association of Counties, NACo Brief: Nursing Homes & Covid-19, p. 3 (Jun. 2020), https://www.naco.org/sites/default/files/documents/Nursing%20Homes%20and%20COVID-19_v5_06.19.20.pdf