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Foley Facility Serves a Very Special Need (Op Ed)


Today the Suffolk County Legislature is scheduled to vote as to whether the County should sell the John. J. Foley Skilled Nursing Facility. Those supporting the sale of the facility feel that Suffolk County no longer needs to provide long-term skilled nursing care given that there are many private sector facilities providing such services on a regular basis. The argument has merit; government should not be providing services that the private sector is perfectly capable and willing to meet. However, this argument ignores something vital when it comes to the population served by the JJFSN Facility.

The JJFSN Facility meets a critical need for the community that is absolutely not being met by nursing homes in the private sector. The average age of this facility’s population is in the mid to late 50’s, and nearly 95% of the patients are on Medicaid. According to a recent report from the County Legislature’s Budget Review Office, out of the 170 patients currently living in the facility, 50 to 60 are considered to be very difficult to place in any other facility. These patients are far more challenging in terms of their care and have what is called a lower ‘acuity,’ which is reimbursed by Medicaid at a lower rate. Acuity refers to the amount of skilled medical care a patient requires. An example of a lower acuity patient is the 40-year-old quadriplegic who is unable to feed or bathe himself but otherwise does not require skilled medical nursing care or the individual suffering from a traumatic brain injury who now suffers from behavioral issues and requires constant supervision so he does not harm himself or another patient. Patients in these situations are the ones other nursing homes shun, and we have at least 50 such individuals who call the JJFSN Facility home.

Private nursing home operators, including those proposing to purchase the JJFSN Facility today, will not accept these people. They are running a business and rightly intend to make a profit. However, the bottom line is that patients with lower acuity don’t generate high enough Medicaid reimbursements to turn a profit.

My predecessor in the 7th Legislative District, John J. Foley, fought hard to keep Suffolk in the skilled nursing home business. The facility was named after him because he believed it to be the County’s duty to provide assistance when it was clear that no one else would or could. John Foley understood the need for this facility. He believed that it was our duty to care for the most vulnerable residents who are unable to care for themselves, and I agree with him completely.