Add Montgomery County to the growing list of Pennsylvania counties selling nursing homes to private operators.

The topic hits home in Butler County as commissioners consider the privatization of Sunnyview Nursing and Rehabilitation Center. Sunnyview, a 200-bed nursing home, is losing about $1 million a year.

That’s not an unusual scenario. Many county governments established nursing homes more than a century ago when medical assistance didn’t exist, but now the counties are losing money in an increasingly complex medical environment. Private home operators are lining up to buy these county assets, convinced they can run the homes competently and profitably.

Last week, Sunnyview’s union employees overwhelmingly rejected the county’s request for concessions — an option described by Commissioner Bill McCarrier as “the final offer.” In response to the employees’ rejection, commissioners were voting today to hire a Chicago firm to put the county home on the market.

Meanwhile in Montgomery County, with 15 proposals to buy the Parkhouse nursing complex, commissioners awarded the sale to Mid-Atlantic Health Care, a Maryland company, for $39 million.

Parkhouse, with its 470-bed nursing center, 15 independent living apartments and adult day care center, had been the largest item in Montgomery County’s budget. It also had become one of the largest financial drains, running as much as $7 million a year in the red.

To qualify for the sale, Mid-Atlantic had to address several of the Montgomery commissioners’ concerns, reflected in the request for proposals, pertaining to the care and admissions of county residents, long-term viability as a nursing home and fair treatment of existing employees.

Montgomery County’s chief financial officer, Uri Monson, said, “Senior staff reviewed the proposals very carefully, . . . in particular making sure resident care was a primary goal, that the expertise existed to handle resident care (and) that employees would be taken care of appropriately.”

The concerns in Montgomery County apply here as well — they are never far from any discussions about the potential sale of Sunnyview.

County-run nursing homes throughout the state, including Sunnyview, often take indigent patients other nursing homes might not accept.

There’s no need to change that policy, and patients in that category need not worry about losing their home. It would be a simple matter for Butler County to require a buyer to continue admitting patients who qualify for Pennsylvania Medicaid assistance, the state-paid insurance system that helps cover nursing-home care.

Some counties have done exactly that. Cambria County, which sold a 370-bed home in 2010, required the buyer to continue accepting Medicaid patients. The arrangement appears to be working.

“We did ask for a certain level of those patients, 75 percent,” Cambria County Commissioner P.J. Stevens said in an interview with the Erie Times. “Before the sale, it was 80 to 90 percent. And they are not turning those patients away.”

It’s the right of Sunnyview residents and employees to protest the prospective sale of the home, and letters appearing on this and future Editorial pages in the Butler Eagle will reflect their opposition.

Nonetheless, if commissioners determine the sale of Sunnyview is in the county’s best interest — and they’re likely to make that determination — then it might be a better strategy to drop useless efforts to block the sale of Sunnyview and instead press for safeguards and assurances for union employees and indigent patients when an imminent sale takes place.