Dive Deeper. Talk Smarter.
It’s easy to be a keyboard critic, ignoring the complex math and regulatory tightrope skilled nursing homes walk every day. In New York, the gap between public perception and the nuanced reality of senior care is particularly wide. Instead of participating in and promoting misinformation, we invite our community to join us in advocacy and education! We encourage you to explore some of the common myths below and find a deeper understanding of how skilled nursing homes operate in New York State and how you can be part of the solution.
Nursing Homes in New York State: Myth vs Reality
“The CEO is probably making a million dollars and hiding money.”
As a 501(c)3 non-profit, our financial health is a matter of public record.
Every year, we file a Form 990 with the IRS, which details executive salaries and how every dollar is spent. Our leadership compensation is based on industry benchmarks, and current leadership actually make LESS than the prior CEO or other CEOs of smaller entities in the Chautauqua County region. CEOs have significant personal financial and legal risk, and the hours and travel a CEO puts in on behalf of the organization when calculated actually reduces the CEO’s salary to be equivalent per hour to a entry level nursing staff. Any surplus funds are reinvested directly back into the facility—covering everything from new specialized beds to building repairs. We operate with “open books” because our primary “shareholders” are the residents we serve.
“Why do they spend time doing paperwork instead of being with my loved one?”
We are one of the most regulated industries in America.
Nursing homes are more strictly regulated than hospitals. The NY Department of Health (DOH) can walk through our doors at any hour, unannounced, to inspect everything from the temperature of the soup to the exact phrasing in a medical chart. We welcome oversight because it keeps residents safe,
but it also means our staff spends hours every day on mandatory paperwork and compliance—time they’d much rather spend sitting and talking with your loved ones.
“Why can’t their families take care of them, they should stay at home.”
‘Home care’ isn’t aways a safe alternative.
We often hear that seniors should just stay home. While we support independence whenever possible, the reality is that many of our residents are “non-ambulatory” (unable to walk or move on their own). Providing 24/7 care for a non-ambulatory loved one requires specialized equipment, medical training to prevent bedsores and infections, and at least three people working in shifts. For most families, this level of clinical care is physically and financially impossible to maintain safely at home.
“The staff is lazy.”
What may look like a casual conversation is often a critical clinical “handoff.”
In a high-stakes environment, nurses must constantly huddle to discuss vital sign shifts or medication updates for 30+ residents. Additionally, “charting” at the desk is a legal safety requirement—if it isn’t documented, it didn’t happen. If a call bell isn’t answered immediately, it’s typically because that staff member is mid-task with another resident’s high-risk transfer. Our team averages 5–7 miles on foot per shift to ensure everyone stays safe.
“They have too many people working in administration and not enough nursing, dietary, and ancillary staff.”
We’ve already cut “from the top” to protect the front lines.
When budgets get tight, despite false rumors, we don’t start with resident services. Over the past several years, we have significantly reduced our management and administrative staff. We are operating with a “skeleton crew” in our offices so that we can put every available dollar toward the CNAs, nurses, and therapists at the bedside. Many of our management staff have not had salary increases in years and donate portions of their income back to Heritage.
“They are wasting money on the wrong things”
In New York, our budget isn’t a choice – it’s a Law.
Most people think nursing homes can spend their money however they want. As a non-profit, we aren’t “padding pockets.” We are working within a strict legal framework that dictates exactly where every dollar goes each day. As a non-profit, there are no “owners” taking home a profit. A common myth is that nursing home leadership is “pocketing” extra cash. In a non-profit organization like ours, every single cent of “margin” is legally required to be reinvested back into the facility, the staff, and the residents.
“It won’t affect me if a local nursing homes closes.”
If our doors close, our local hospital and emergency room WILL feel the impact.
Nursing homes are the “safety valve” for the entire healthcare system. When a nursing home in a rural area struggles, the local hospital backs up. If we aren’t here to take patients who are stable but need therapy or long-term care, those patients stay in hospital beds. This leads to longer ER wait times and fewer available beds for emergencies for everyone in our county. We don’t just serve our residents; we keep the local healthcare system moving.
“The administration doesn’t care about our complaints; they just ignore us.”
We view family feedback as a vital tool for improvement.
To ensure no voice is lost, we follow a state-mandated formal grievance process that requires us to track and respond to every concern within a set timeframe. We don’t just listen; we are held legally accountable to act. We encourage you to use these formal channels so we can document and resolve your concerns effectively.
“My in-laws nursing home in Rochester is way nicer.”
Being a rural nursing home in NY comes with unique “invisible” challenges.
From higher transportation costs for supplies to local environmental factors like rural pollution or aging infrastructure, keeping a facility running in a small town is a labor of love. Unlike big city facilities, we don’t have a massive pool of contractors or specialists next door. We rely on a small, dedicated village and an increasingly small pool of available staff to keep our residents safe, warm, and cared for. Heritage shares the same struggles of rural skilled nursing homes across the state that have closed, and we fight every day to keep your loved ones cared for in Chautauqua County.
“They serve horrible meals.”
Our kitchens function as a clinical department where meals are designed as medical interventions.
Many residents require specific textures (like pureed or mechanical soft) to prevent choking, or low-sodium plans to manage heart health. While these regulated meals may look different than restaurant fare, they are carefully balanced for caloric and nutritional needs. We take all flavor feedback seriously and would love for you to join our building administrator to discuss how we can balance these medical requirements with your loved one’s personal preferences.
“Nursing homes make a huge profit every day.”
Medicaid pays less than it costs to provide care.
In New York, Medicaid covers a majority of nursing home residents, but the reimbursement rates have been frozen or underfunded for years. While the cost of electricity, food, and medical supplies has skyrocketed, the amount we receive to care for a resident hasn’t kept pace. Running a rural, non-profit home like Heritage means we are constantly “doing more with less” because the state’s payment covers only a fraction of the high-quality care our seniors deserve. Each day, we lose $150 on each Medicaid resident entrusted to our care. Like any other non-profit you support, your tax-deductible donations help us offset the loss covered each day to fulfill our mission.
“They don’t hire enough people to work there.”
New York is facing a historic nursing shortage, especially in our rural communities.
Our current team members are truly the heart of this home, often going above and beyond to bridge the gap. We are actively recruiting, but we refuse to lower our standards for the quality of people we bring into our residents’ home. We are actively recruiting for the right fit so that we can continue providing high-level
care without compromising on quality or safety.
How you can help!
ADVOCATE
Write to your state representatives to ask for fair Medicaid reimbursement rates for non-profit homes. CLICK HERE to learn more.
VOLUNTEER
See the work we do firsthand and get to know the realities of skilled nursing care. CLICK HERE to learn more.
SUPPORT
Your donations to our non-profit help us provide the “extras” that the state budget doesn’t cover. CLICK HERE to give.