Pennsylvania counties are deciding between fight or flight when it comes to owning nursing homes.

Wednesday night, Schuylkill County became the latest to put its nursing home, Rest Haven in Schuylkill Haven, up for sale.

"It cost us $220 a day per resident at the nursing home and we are reimbursed from medicaid $175 a day so if you do the math it translates into approximately a $2-million deficit per year," said Schuylkill County Commissioner Frank Staudenmeier.

County officials say dwindling Medicaid and Medicare reimbursements are at the top of the list of reasons to sell.

But some counties are fighting to find ways to maintain ownership without overburdening the taxpayer.

In Lehigh County, Cedarbook nursing home ran a deficit of $3.4 million in 2013 and $2.6 million in 2014.

County Executive Tom Muller says the facility is a top rated asset to the community that can be profitable once again.

But he says some county commissioners are doubtful.

"I know full well there are some of them who would like to sell the nursing home and get out of the business.," said Muller.

Lehigh, Schuylkill and Northampton Counties all have private companies running their nursing homes.

Northampton County Councilman Lamont McClure says after taxpayers voted to hold onto Gracedale in Upper Nazareth, the county made extensive capital improvements and worked on boosting Gracedale's population.

"There may come a point in the future (and we are not there yet because we haven't tried everything that we can try) where the county contribution becomes too great for taxpayers to bear, but right now we have a moral obligation," said McClure.

Lehigh and Northampton County officials say they have no plans to sell.

And are doing everything they can to be more competitive with private nursing homes in the area.