LIBERTY, NY — The planned future of Sullivan County’s Adult Care Center—the Care Center at Sunset Lake—involves the transition of its operations into private hands. 

When Sullivan County hired consulting group Infinite Care to run the facility in 2021, the parties agreed at the time to transition the facility’s Certificate of Need—the document that allows a nursing home to operate—from the county to Infinite Care. 

That transition could receive approval from the state within the next few months. Residents of Sullivan County, including some with relatives inside the facility, remain unconvinced that the plan is the best option. 

Sale and lease

Details of the proposed transition are laid out in a review from the NYS Department of Health Public Health and Health Planning Council. 

Sunset SNF Operations LLC, a company set up by Infinite Care, has agreed to the “sale and acquisition of the operations associated with” the adult care center. These operations include a residential health care facility and an adult day care health program.

Currently, Sullivan County owns those programs, and has hired Sunset Consulting LLC (another Infinite Care corporation) to run them. Sunset SNF Operations LLC will purchase them and their associated assets, and will sign its own contract with Sunset Consulting LLC for their management. 

A local development corporation set up by Sullivan County, Sunset Lake Local Development Corporation, currently owns the physical building of the care center. It will lease that building to Sunset SNF Operations, for a term of 20 years. 

Infinite Care, through Sunset SNF Operations, will assume any expenses from operations after the initial date it signed a consulting agreement—October 1, 2021—as well as unspecified other liabilities estimated at $1 million; the assumption of $1 million in liabilities serves as the facility’s purchase price. Sunset SNF Operations will pay Sunset Lake Consulting $400,000 a year to consult on the facility, and will pay the Sunset Lake Local Development Corporation (owned by Sullivan County) $800,000 annually, with a two percent annual increase.

Past all the corporations, the agreement has a simple bottom line: Sullivan County will sell the operations of the care center, and keep the physical building. 

Resident concerns

A group of approximately 15 people attended a meeting of the Sunset Lake LDC on Friday, August 25, protesting against the decision. 

“We need competent management for the facility and a legislator who will make sure that the maintenance, housekeeping and patient care are performed correctly, which obviously they’re not. The facility is a disgrace and no patient, senior or otherwise, should be subjected to the treatment,” said county resident Diane Mestanza. 

One county resident who spoke had a neighbor who went to the facility daily to change his wife’s diaper, having found it was not changed at an appropriate frequency. Another speaker talked of the residents being unable to socialize, left in their rooms at meal times without access to the dining room. 

The Centers for Medicare and Medicaid Services (CMS) evaluated the care center in December and January, finding several issues with the running of the facility. The Sullivan County Adult Care Center currently has one star out of a possible five for its overall rating, with one star for its health inspection, three stars for its quality measure and two stars for its staffing. 

The members of the LDC attributed many of the issues with care to staffing shortages. 

“I’m involved in that facility every day,” said Albee Bockman, LDC member and Mobilemedic founder. “I find the care to be sufficient: not efficient enough, but [it] is a problem in every industry in our country right now of finding staff.”

While LDC members heard concerns from the public, they emphasized that they weren’t the proper figures to hear them. The LDC is just the landlord; it is Sullivan County, represented by the Sullivan County Legislature, which has oversight over the facility

State evaluation

The NYS Department of Health (DoH) has evaluated the proposal to transfer the care center from Sullivan County to Infinite Care. According to a review document prepared for a meeting on August 24, it recommends that the application be approved. 

The DoH reviewed the other adult care facilities managed by the proposed owners, and found them to meet standards. The owners have two New York facilities, both with an above-average rating from the CMS. The same is true for eight of the owners’ nine facilities in Florida. 

Sunset Lake has been consistantly under capacity—62.5 percent—compared to neighboring care centers which filled 80 to 90 percent of their beds. Infinite Care proposes to fix these staffing issues and bring occupancy back into the 90th percentile. 

The DOH recommends approval on some contingencies: the DOH must see an executed consulting agreement for the facility, and the facility must maintain a certain number of Medicaid and Medicare admissions. 

The New York State Department of Health (DoH) Public Health and Health Planning Council met on Thursday, August 24 to consider the approval, but deferred its decision to a meeting in November.