How do we provide this valuable community service and how is this fair to taxpayers across the state using county funds to subsidize nursing homes?'” said Donnadio. The decline had such an impact on county-run homes that many started operating at drastic losses Donnadio gave an example of daily compensation rates dropping from $240 a day before the cuts to $100 or less now, while the cost of delivering care continues to rise and freeholder boards were forced to sell off the homes to private companies. Gloucester County’s Shady Lane nursing home is one of few still surviving, and the county has no plans to sell the East Greenwich facility anytime soon, said George Strachan, acting executive director of the Gloucester County Improvement Authority, which oversees Shady Lane. “We don’t have any active plans to reduce services or privatize,” said Strachan, who previously worked as the home’s administrator. It’s Shady Lane’s lower-than average percentage of Medicaid patients less than 50 percent, compared to the state average of 79 percent that helped them avoid the financial issues that forced the sale of others, he said. They’ve also been able to reduce costs by pushing short-term rehab services over long-term residential stays, and partnering with the many local health care systems to make that happen. “That’s one of the things we’ve been trying to pursue, and we have agreements with local hospitals because we’re a provider of choice and we have a higher quality of care,” said Strachan, adding that it’s a quality of care sorely needed in local communities. “We take care of residents whose families can’t take care of them,” he said. The Association of Counties has advocated to the state government on behalf of the facilities, successfully lobbying for a freezing of Medicaid reimbursement rates until 2016 and a phasing out of $30 million in “peer grouping” funding that was established 20 years ago to help county nursing homes offset costs private facilities don’t face, such as pension payments for its public workers. That funding 10 to 15 percent of which was required to go toward community programs such as Meals on Wheels was originally set to be terminated all-together, and the phasing out now allows counties to plan ahead, Donnadio said. “That really buys the county some additional time to decide whether or not they want to stay in the nursing home business or not,” he said. “It’s a tough decision for a governing body. You kind of juggle pressure you’re facing from property tax cap restrictions and then providing the service for a Medicaid population that we’ve historically serviced … What happens to these folks when county nursing homes aren’t there any longer and Medicaid beds aren’t necessarily available?” That’s a question that Gloucester County may have to look at more closely in the coming years.