The Blueprint:
More than 40 nursing homes closed statewide since 2014
Long Island nursing homes lose $85 per Medicaid resident daily
54% of Long Island nursing homes operate at a loss
Stuart Almer urges legislature to allocate half of $1.5 billion budget to nursing homes
Nursing homes in New York State are in crisis. Not a crisis of our own making, but one born of chronic, systemic underfunding. It has pushed us to a breaking point, putting access to quality care for older adults increasingly at risk. Despite years-long pleas from providers and advocates, the state has delayed meaningful action, leaving nonprofit nursing homes, adult care facilities and home care agencies struggling to keep pace with rising costs, persistent workforce shortages and growing regulatory demands.
LeadingAge New York has tracked provider closures for years and is sounding the alarm as the pace accelerates. Since 2014, more than 40 nursing homes have closed statewide, with nearly 20 percent of those closures occurring in just the past two years. In 2025 alone, 13 adult care facilities shut their doors, and since 2019, 18 certified home health agencies have closed. Without adequate funding, additional closures are not only possible – they are likely.
On Long Island, nursing homes serve more than 60,000 individuals per year, with 95% of the admissions coming from hospitals. The majority of nursing home residents are covered by Medicaid; however, the gap between the cost of care and Medicaid reimbursement has grown to a loss of $85 per resident, per day for the average home. More than half of Long Island nursing homes are operating at a loss – 54% – which helps explain why the region has seen two nursing home closures since 2023 alone. For public and not-for-profit homes, which tend to staff better, that gap is closer to $150 per Medicaid resident, per day. Older adults deserve a fair and sustainable reimbursement structure that reflects the true cost of per-resident care, including labor, clinical supplies, food, utilities and regulatory compliance.
Long Island’s population is aging, and the need for quality long-term care services is surging. Nursing homes have historically borne the brunt of Medicaid cuts, receiving only a small fraction of new healthcare funding. The governor’s budget proposal currently earmarks
$1.5 billion for hospitals and nursing homes; we implore the legislature to begin correcting years of underinvestment by allocating at least half of this funding to nursing homes this year.
As the president and CEO of a large, not-for-profit provider of long-term care on Long Island, I know first-hand the difficulties faced by chronic underfunding. Providers simply cannot continue operating under current reimbursement rates. If more facilities disappear, the consequences will extend far beyond residents and families – hospitals, emergency rooms, and the broader healthcare system will all feel increasing strain.
The men and women in our care gave to this community for decades. They raised families here on Long Island. They paid taxes, built businesses, served in wars and contributed in ways too numerous to count. In the final chapter of their lives, they deserve to be cared for with dignity, competence and compassion. That is what we strive to provide every day. But we cannot do it alone — not without adequate and sustainable funding. The time for action is now.
Stuart Almer is CEO of Gurwin Healthcare System in Commack.