It was fast, it was dirty, it was over before I knew it, and then we couldn’t talk about it.”

Catherine Scott

If one thing I've learned, if you're not part of the solution, then you're damn well part of the problem. So choose your side.”

Mark McCarthy

SULLIVAN COUNTY, NY — Sullivan County and New York State Department of Health (NYS DoH) Officials announced on Wednesday, August 19 that the Sullivan County Adult Care Center (ACC), also known as the Care Center at Sunset Lake, would close, ending the facility’s tenured history providing healthcare to the residents of Sullivan County.

The County cited ongoing financial difficulties and the withdrawal of the consulting firm that was operating the facility as reasons for the closing. In 2021, consulting firm Infinite Care signed an agreement with the county to operate the ACC for 10 years with the end goal of having the ACC’s operating license, known as the Certificate of Need, transferred to Infinite Care. However, in late July Infinite Care decided to withdraw from the facility after facing delays from the 

Legislature Chair Nadia Rajsz said in a release about the closure that it was a difficult decision, but in the end a majority of legislators agreed that the facility should close so it doesn’t become a burden on the taxpayer.

“This is not something the County wanted to do, but our challenging finances and the lack of ability to transfer operations to our consulting firm has left us no choice but to initiate the closure process,” Rajsz said in the release. “The majority of my colleagues and I agreed that taxpayers cannot afford to continue the costly operation of the Care Center while facing enormous revenue losses and quickly increasing costs throughout County government.”

At the Thursday, August 20 meeting of the Sullivan County Legislature’s Executive Committee, Rajsz outlined the financial difficulties that led to the decision to close the facility. Rajsz said that the county has covered the facility’s budget shortfalls, even though the facility was supposed to be self-sustaining. She also said that infrastructure upgrades to the facility, as well as 

“The care center is supposed to be self-sustaining, but to date, the county has covered 22.8 million in shortfalls, with little expectation of seeing that funding returned,” Rajsz said. “Approximately 10 million worth of work on the nearly 40-year-old structure has been identified by our Department of Public Works, particularly with plumbing, the building envelope [and] kitchen upgrades.”

County Communications Director Dan Hust expanded on this in an interview with the River Reporter. Hust said that it would have been unsustainable for the county to operate the facility while dealing with declines in sales tax.

“It was the annual cost of operating, maintaining and furnishing the facility that’s become unsustainable,” Hust said following the announcement. “We’re seeing other costs climb for services and programs that we are mandated to provide, all the while facing declines in sales tax receipts, which is a major revenue generator.”

Hust also said that if the ACC were to remain open it would be a burden to the county taxpayer, saying that, “a property tax increase is already anticipated to help fund the 2027 county budget, and that increase would be higher if the care center remained with the county.”

Legislator Catherine Scott, who did not support the closure of the facility, said that when legislators had conversations to close the facility the county’s financial difficulties were at the top of their mind. Scott described these “financial constraints” as “serious” and worthy of discussion, as they could have risked other services being cut or eliminated.

“We were really anxious about the numbers. We saw a potential $14.5 million shortfall for the year, which jeopardizes other services,” Scott said in an interview with the River Reporter . “That's something that we all take very seriously: is that we want to make sure that we're preserving service”. 

Scott said that during this discussion the idea of closing the ACC was discussed as a way to ease the county’s financial situation, saying  “It came up that closing the facility would reduce stress on an already stressful financial situation.”

It all started last March

Scott raised issues with the manner that the issue was discussed, saying that the discussion happened too quickly and blindsided legislators. 

“We went into executive session to talk about contracts. We had not previously discussed, as a group, the possibility of closure,” Scott said. “But we went in to discuss contracts. We weren't taking a vote. It happened so quickly that some of us were in shock.”

“It was fast, It was dirty, It was over before I knew it, and then we couldn't talk about it,” Scott said in an interview with the River Reporter. “This started out as a conversation, and it turned into a hot debate. This was a heated debate about this particular facility, and it was over before I knew it was happening.” 

Scott was not the only one who took issue with these discussions. Vice Chair of the Legislature Luis Alvarez, who wanted to keep the ACC open, said that he wasn’t sure of how the agreement was reached. 

“It’s very hard to explain what really happened,” Alvarez said. “We all agreed on closing it. I don’t know how I agreed with it, but I did.”

This confusion spilled out into the legislature’s meeting, where legislators could not remember who voted what or who was even present at the vote. Legislator Joseph Perello said that Alvarez was in support, while Scott said Alvarez, along with her, Legislator Brian McPhillips and Legislator Matthew McPhillips, were against closing the ACC. Legislator Terry Bernardo said she was absent from the vote, which would have made it a tied vote.

“It was chaos,” Scott said after the meeting. “There is some confusion over it.”

Scott said that the way the decision was made has complicated the argument to close the ACC, saying “I think what we saw today is that it was a little hard for some folks to stand by what happened because of the manner in which it happened.”

A gag order and a leak

After a majority of the legislators agreed to close the facility, the county then submitted a closure plan to the DoH outlining every step of the process. Per state regulations, the county and anyone with knowledge of the closure plan could not act or speak about it publicly. According to DoH’s Facility Closure Plan Guidelines, “no announcements or actions related to the proposed closure should be taken prior to receiving approval.”

“Until that closure plan was approved by the state, the county was forbidden from saying anything in any public manner or to anyone about this, because the state wanted to have this coordinated,” Hust told the River Reporter. “The Department of Health would not allow anyone, including legislators, to talk about this publicly.”

During the legislature’s meeting, members of the public complained that the legislature, with one member calling legislators “cowardly” and “unforgivable” for hiding behind the gag order. Rajsz said that it was not their decision but the states, and that speaking about the decision before DoH approved it would have violated state law.

“Notice of this decision could not be made to anyone until the New York State DoH approved a closure plan per state law,” Rajsz said. “I'm not sitting in jail for this.”

Scott said that despite disagreeing with the decision, she stayed silent because if the information leaked it would have had harmful consequences for the ACC’s staff, residents and the families of residents.

“I kept my silence because I understand that that information getting out prior to an approved communication was harmful, harmful for employees who would then question whether or not they were going to have a job harmful for residents who wouldn't understand whether or not you know what was happening, and we would not be able to talk to them to give them guidance. So I understood the impact of defying that gag order.”

However, the gag order was defied by an unknown source. Notice of the ACC’s closure was leaked onto social media, with moderator of several Sullivan County focused Facebook groups Bill Liblick posted on one such group named Sullivan County Post on Wednesday, August 19 at 12:05 a.m. that the ACC was to be closed, saying in a post “Breaking news: Sullivan County to close nursing home. Blames county financial crisis and lack of ability to run facility.”

Members of the public expressed outrage at the way the information leaked, calling for an investigation into who leaked the information to Liblick.

Lou Setren, whose mother was in the ACC, said “I was promised that an investigation is underway to determine how this leak ended up in a social media post, and whomever, whether singular or plural, who is responsible for that leak be held accountable for their actions.”

Scott also shared the outrage, saying the leak did real damage to those connected with the facility. “I think that there needs to be a serious investigation,” Scott said. “that was very harmful to people who were already facing the worst day of their life.” 

Hust said to the River Reporter that the county had planned to tell the public on Wednesday morning regardless of the leak. Hust said that “the County did not sanction that post and regrets the unnecessary trauma and dismay it added to an already very difficult day for both Care Center staff and residents.”

In a post on Thursday, August 20, Liblick said “The focus should be how they allowed the nursing home to be closed and who is responsible - not how Sullivan Post found out!!”

Relocating residents

The DoH approved the county’s closure plan on Thursday, August 13. Now, the county will begin the process of finding new suitable accommodations for the residents of the ACC.

The County has said it will work closely with the DoH to find accommodations for the ACC residents. "The county will ensure that no resident will be left without a skilled-care option," read the press release announcing the closure. "The entire process is anticipated to conclude by the turn of the year."

Hust said that the county has already begun that process. “We’ve already informed a number of nursing homes in the wider region in New York, Pennsylvania and even New Jersey to help find new accommodations for our 93 residents that best fit their needs,” he said to the River Reporter.

Members of the public expressed concerns about that process, saying that this process will remove these residents from Sullivan County, putting them far away from their families and putting them in strange communities they don’t have knowledge of. 

“The people of this county, the most vulnerable people of this county now are going to get shipped to Connecticut, New Jersey,” former county legislator and former town of Neversink supervisor Mark McCarthy said during the public comment period. 

“The DOH is well aware that there are an insufficient number of long-term care beds in this county to serve the population,” Setren said. “Further, they are aware that there is a shortage of long-term beds across the region. It's not going to be easy to place 93 residents in other facilities.”

Alvarez also expressed this concern, saying that he was unsure of where the residents were going. During the executive committee meeting he said “I don't know where we're going to put those 93 [residents] because I know that we spoke yesterday, we were calling all different facilities trying to figure it out. I don't know where they're going to go.”

Alvarez also expressed concern for the families who will now have to travel to see their relatives. He explained his late wife was briefly in Westchester county, and that visiting her was a difficult task due to traffic and trying to find out an optimal time to travel. Alvarez sympathized with the families and residents of the ACC, some of whom will have to undergo this ordeal.

“It is not an easy task, but I was there every day. I spent it with her,” Alvarez said. “If I was having such a hard time, and it was very difficult…imagine what everybody’s going through. Do we want this for the people that were promised that we were going to take care of them and now we’re not doing that?”

During the meeting, Rajsz reiterated what the release said, saying that “no resident will be left without a skilled care option.”

Fate of the employees

The county also will work to find new employment for the county employees who work at the ACC. The county will try to reassign employees to other openings in the county according to their credentials and job availability. If a county employee cannot be reassigned to another county job, the Center for Workforce Development will work with them to find them a new position. Hust said that a job fair for those employees has been discussed, but not planned yet.

“We have 86 employees that are being given options where possible based on their experience, for vacant county jobs,” Hust said in an interview with the River Reporter. “That won’t cover everybody. We don’t have 86 vacancies that I think they would all qualify for, but wherever possible that’s what we’re going to do.”

Hust also said that the county will not relocate non county employees that work at the facility, who will be relocated by the staffing agencies that employ them.

“Our focus and concern is on our 86 county employees,” Hust said.

Lise Kennedy, an outspoken supporter of the ACC and former Director of Patient Services at Sullivan County Public Health, empathized with the staff of the ACC. “I feel for the staff…in their hurt and confusion. I hope they can find new jobs where their employers treat them much better than you did.”

Kennedy had previously said that one of the best things about the ACC was the staff, saying that “One of the main things that made it so good was that it was staffed by you know residents of Sullivan County who had been working there long term. They knew all the residents really well and the residents knew the staff and felt understood by them.”

Both Legislators Alvarez and Scott were present at the ACC on Wednesday morning to break the news to the staff about the facility’s closure. Both said that a lot of the staff were not concerned about their own jobs, but concerned about the futures of their residents and who will take care of them.

“People are upset that they’re not going to have a job,” Scott said. “But their primary concern…who’s going to take care of our residents.”

“Nurses were more concerned not about losing their job; they were more concerned about the people they were serving. Was somebody going to be taking care of them the right way, the proper way,” Alvarez said. “They were more concerned about who's going to take care of that patient that I've been taking care of for years and years and years. That's the dedication of the people of this county.”

“These folks have been through so much over the last six years. A lot of the people who work there really pour their heart into the work that they do,” Scott said. “The people who are there are dedicated.” 

Future of the building

Legislators and other county officials will decide on how to use the former ACC building after the closure. Hust said that while the county is not in a fiscal position to consider the future opening of another county run facility, the county would be open to having a non-county run facility to fill the gap left by the ACC.

“I think the county would welcome other agencies and for-profit companies that might be interested in citing a facility similar to what the care center is in Sullivan County,” Hust said.

For more reaction's to the ACC's closure, click  here.