Seller beware.

That's what nursing care experts say about counties like Butler that are exploring privatizing their nursing homes. There's a lot that can go wrong.

At one time, 50 counties operated nursing homes in Pennsylvania. Now, according to the Pennsylvania Association of County Affiliated Homes, 29 counties run a total of 33 nursing homes.

“Situations with privatization are just all over the board. Some counties have had positive experiences when privatizing nursing homes. Other situations have been adversarial, where the new owner has gotten in trouble with labor litigation or heath departments,” said Michael J. Wilt, executive director of the Pennsylvania Association of County Affiliated Homes.

Butler County on Wednesday took a step toward selling the Sunnyview Nursing and Rehabilitation Center, which the county owns, by hiring a real estate firm to evaluate a potential sale.

If commissioners eventually decide to sell the Butler Township facility, Wilt said, they can expect to be approached by 10 to 15 companies interested in buying it.

“That's a lot to sort out if you really want to be sure you sell to the right company. It's who they end up selling it to. And there's never a lack of companies interested in buying facilities in the many counties that sold nursing homes,” he said.

Wilt also said governments have great leeway in the financial and labor requirements they use as conditions for a sale.

Sunnyview is expected lose $1.5 million this year. Commissioners say the facility has lost $7 million during the past decade.

“It is a valuable resource to the community … but skilled nursing care is no longer a sole county responsibility,” said Butler County Commissioner A. Dale Pinkerton, who voted for the study.

Counties that have privatized nursing facilities have done so for a number of reasons, not always financial.

In 2010, Cambria County sold its 370-bed nursing home in Ebensburg, Laurel Crest, to the private company Grane HealthCare.

“More than anything, it was a financial decision that was made. It truly was a financial burden to the county,” said Douglas Langenfelder, president of the Cambria County commissioners.

Langenfelder, who was not a commissioner when the home was sold, said local government is increasingly ensnared in complicated state and federal regulations.

“You really need people with a very high level of expertise to run these places. Government should do things that private industry cannot. You have to ask if this is what government should be doing,” he said.

Grane is being sued by unions for failing to rehire some of the workers after the purchase, according to federal court documents.

Lackawana County also sold its nursing home in 2010 but for different reasons, said Tom Durkin, the county's chief financial officer.

“There was a time when it was losing lots of money,” Durkin said. “The real issue was liability and the headache of operating a nursing home.”

The county was sued when staff left an elderly resident on a toilet for two hours. The woman fell off and died two days later, Durkin said.

The Lackawanna County Healthcare Center has had two owners since the county sold it.

“Commissioners were reluctant to sell it. It used to be that people who could not get into other homes could always get into the county home. They were persuaded that would not happen (this time) due to Medicaid,” Durkin said.

Opinions on the sale were mixed, he said.

“Employees were not so happy. Vendors were not so happy. They used to complain to us about not getting paid. Patients there seemed to be happy,” he said.

Rick Wills is a staff writer for Trib Total Media. He can be reached at 412-320-7944 or at rwills@tribweb.com.

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