Six years ago, Sullivan County officials warned that continued county operation of the Care Center at Sunset Lake was financially unsustainable and began pursuing private operation as a way to preserve the facility without placing an ever-growing burden on taxpayers. That transition was never completed, and the county now says the very financial problem it identified in 2020 has become too great to overcome.
The history of Sunset Lake since then is not simply a story of state delay or a failed management agreement. It is also the story of a sustained political effort to keep the nursing home in public hands, led in part by officials and advocates who opposed the county’s privatization strategy and ultimately succeeded in dismantling the structure created to carry it out.
The Sullivan County Legislature created the Sunset Lake Local Development Corporation in 2020 as part of a broader effort to move the nursing home toward private operation. An outright sale was initially contemplated, though the plan later shifted toward leasing and private management while retaining public ownership of the property. County officials argued at the time that the existing model was not financially sustainable and that some form of private operation offered the best chance of preserving the facility.
Legislator Luis Alvarez opposed the transfer of the Care Center to the LDC, casting the lone dissenting vote when the Legislature formally approved the move by an 8-1 vote. The county nevertheless continued with the privatization strategy and later selected Infinite Care Management to operate the facility under a long-term arrangement.
Sullivan County remained the licensed operator while a Certificate of Need application worked its way through the state Department of Health. Approval of that application would have transferred operating authority to an Infinite-affiliated entity, but after nearly three years the transfer was never completed.
By 2023, opposition to the transition had moved directly into the state approval process.
On Nov. 2, 2023, five days before a county election, Catherine Scott appeared before the Public Health and Health Planning Council’s Committee on Establishment and Project Review as it considered Infinite Care’s application. Scott, who was then seeking election to the Legislature, was joined by Alvarez and former Sullivan County public health official Lise Kennedy.
The meeting transcript indicates at least some coordination among the speakers. When Alvarez was called to speak, he asked that Kennedy be allowed to go before him.
Scott explicitly asked the committee not to act on Infinite Care’s application before voters had an opportunity to weigh in on the future of Sunset Lake.
“Please do not make a decision about this,” Scott told the committee, referencing the election scheduled for the following Tuesday and candidates running on keeping the facility in public hands.
Scott also challenged the distinction between Infinite Care’s formal status as a consultant and its practical role at Sunset Lake, arguing that the company’s personnel were deeply involved in the facility’s daily operation.
“This may be a consulting contract, but these people are there handling the day to day,” Scott said.
Kennedy made the point even more directly.
“The county is very much hands off. Infinite Care does everything,” Kennedy said.
During the committee’s discussion, state Department of Health official Mark Furnish emphasized that, whatever role Infinite Care played in managing the facility, Sullivan County remained legally responsible for Sunset Lake because it continued to hold the operating certificate.
“The operator is the county at this point, Sullivan County,” Furnish said. “They, in the eyes of the Department of Health, are on the hook for all of the powers, the clinical, the financial, everything.”
Kennedy also raised broader concerns about Infinite Care’s performance and financial condition. She alleged that the company had not made a promised $3 million investment, had failed to provide required quarterly financial reconciliations and had not demonstrated sufficient financial capacity to take over the facility. She also alleged that Sullivan County had paid federal fines she believed Infinite was contractually responsible for and argued that staffing and care had deteriorated.
The state did not approve the transfer in 2023, and the application remained unresolved. After Scott won election and took office, the political direction surrounding Sunset Lake moved more decisively toward continued county control.
Scott joined the Sunset Lake LDC and, by March 2024, was already asking fellow board members whether the corporation should be dissolved. She remained consistent in her desire to keep Sunset Lake in county hands, while Legislator Matt McPhillips also supported moving away from the LDC structure.
The corporation was ultimately dissolved in 2025, and the Care Center property was transferred back to direct county ownership. For opponents of privatization, that outcome represented the fulfillment of the position they had advocated for years: Sunset Lake would remain public rather than transition into private operation.
At that point, county operation was still being presented as a viable path forward. In July 2025, Scott welcomed newly appointed Care Center Administrator Kayshawn Macharie and said she looked forward to working with him to make Sunset Lake “the premier facility of its kind in the County.”
Within months, however, the outlook had changed dramatically. County officials began viewing closure as a realistic possibility by late winter 2026. Infinite Care subsequently decided to end its consulting relationship with the county and stopped pursuing the operating certificate transfer, leaving Sullivan County faced with the cost of fully staffing, equipping and operating the facility on its own.
The county announced in August that Sunset Lake would close. County spokesman Dan Hust said Infinite Care’s withdrawal did not directly cause the decision, but acknowledged that the two issues were related.
“Without Infinite Care and in the face of spiraling costs, including the substantial expense of completely refitting the Care Center with County employees and equipment, even temporarily, the County is not in a fiscal position to continue operations,” Hust said.
He said poor ratings and negative inspection reports did not play a role in the decision.
The closure affects 94 residents, although several have already relocated. County officials say they are working with the state Department of Health and area nursing homes to place the remaining residents and that relocation itself will not create additional costs for Sullivan County.
The outcome brings the debate over Sunset Lake back to the financial question that first drove the Legislature toward privatization in 2020. County officials warned then that Sullivan County could not indefinitely sustain the cost of operating the nursing home and pursued private operation as a way to preserve the facility without requiring taxpayers to absorb ever-growing losses.
Alvarez opposed the original LDC transfer. Scott later joined the political effort to stop or delay the Infinite transition, directly asked state officials not to act on the CON before the 2023 election and, after taking office, helped move the county away from the privatization structure by pushing to dissolve the LDC.
That political movement ultimately prevailed. The private transfer never materialized, the LDC was dissolved, and the facility returned to direct county control.
Now the county says it can no longer afford to operate it.
For Scott, Alvarez and others who fought the privatization effort, that leaves one question that is difficult to avoid:
Was keeping Sunset Lake in public hands more important than keeping it open?
Atticus Reed
Sullivan’s Legacy Contributor
