As New York’s aging population grows, access to nursing home care is shrinking. Advocates warn that facility closures, staffing shortages and Medicaid underfunding are creating “nursing home deserts,” leaving seniors and their families struggling to find care.

“There have been dozens of nursing homes that have closed in New York state,” said Mark Olson, executive director of Shaker Place Rehabilitation & Nursing Center. “What is happening is patients are backing up into the hospitals because they can’t be placed due to the lack of beds.”

The New York State Department of Health reports approximately 599 nursing homes statewide, but advocates argue that this number is insufficient, especially in rural areas where facilities are sparse. Since 2019, the state has lost over 5,600 nursing home beds due to closures and decertifications.

What You Need To Know

  • Staffing shortages force nursing homes to compete with higher-paying industries
  • Rural areas face critical care gaps, with some families traveling 90+ miles for nursing homes
  • Advocates call for increased Medicaid funding to prevent further closures and improve access 

One of the biggest challenges facing nursing homes is staffing shortages. Many facilities are struggling to retain workers as hospitals and other industries offer better wages and benefits.

“Nursing homes need to be able to compete in the labor market against big-box stores,” said Stephen Hanse, president and CEO of the New York State Health Facilities Association (NYSHFA). “Right now, they’re paying $20 or $21 an hour with health benefits.”

Pay for nursing home staff is directly tied to Medicaid reimbursement rates, which advocates say are far too low to cover costs. On average, facilities lose $56 per resident, per day under current rates.

“Medicaid underfunding is pushing facilities into financial crisis,” Hanse added. “We need a significant increase in the Medicaid rate to drive employment and reduce these nursing home deserts.”

The state has taken steps to address the issue by increasing Medicaid reimbursement rates by 10% over the past three years. This includes a 7.5% recurring increase in 2024 and a one-time $285 million investment slated for 2025. However, advocates argue that these measures fall short of what is needed to keep facilities open and adequately staffed.

For families, the impact of closures can be devastating. Diane Conroy-LaCivita, executive director of Colonie Senior Service Centers, said some families are forced to travel up to 90 miles to visit loved ones placed in distant facilities due to local bed shortages.

“When somebody gets placed… you struggle with families saying, ‘When can I actually go and visit my loved one?’” Conroy-LaCivita said.

Experts warn that without significant changes, the crisis will worsen as New York’s senior population grows. By 2030, nearly one-quarter of state residents will be age 60 or older — a demographic shift that will further strain long-term care resources if no action is taken.

Advocates are calling on lawmakers to prioritize elder care funding in the upcoming state budget and consider reforms like Senate Bill S4275, which aims to strengthen oversight of nursing home closures and ensure transparency during the process.

“The time for action is now,” Hanse said. “If we don’t invest in Medicaid rates and staffing solutions today, we’ll see even more closures tomorrow — and families will continue to suffer.”