Hudson Headwaters Health Network serves as a healthcare anchor across rural upstate New York, operating 25 health centers that provide care to more than 116,000 people. As a Federally Qualified Health Center, Hudson Headwaters specializes in serving low-income rural communities.
Their patient demographics tell the story of a community with significant needs: nearly a quarter are over 65, while 47% live below 200% of the federal poverty level. Insurance coverage reflects the economic reality, with 26% using Medicare, 23% using Medicaid, and 5% dually eligible for both programs.
Hudson Headwaters faced interconnected challenges that many rural healthcare providers recognize but few have the resources to comprehensively address. Their patient population was aging rapidly, but long-term care facilities and private home care services remained prohibitively expensive, and most older adults wanted to remain in their own homes.
Simultaneously, their Broad Street site, which provided both primary and urgent care, had exceeded capacity as patient volume increased. They needed a solution that would expand primary care access while providing the comprehensive support services seniors needed to age at home with dignity.
“If you’re in a rural practice, you really have to see everybody. You can’t tell someone to go down the road. There’s nothing down the road,” said Dr. John Rugge, Hudson Headwaters’ founder.
Hudson Headwaters partnered with PCDC to leverage New Markets Tax Credits—a financing tool designed to stimulate investment in underserved communities. The $14.2 million total investment created a 31,000-square-foot facility housing integrated PACE programming alongside primary care, medication-assisted treatment for opioid use disorder, and hepatitis C care.
Now, the PACE program serves 80-100 older adults daily through on-site healthcare services, therapeutic activities, nutritious meals, socialization opportunities, recreational therapies, and exercise programs. While most PACE programs must coordinate with multiple healthcare providers, Hudson Headwaters delivers both comprehensive medical care and the full spectrum of support services needed to keep seniors thriving at home—all under one roof.
The Larose Health Center opened its doors in 2025, achieving Hudson Headwaters’ goal of addressing both capacity constraints and comprehensive care needs for their aging population. The project generated substantial economic impact:
By co-locating PACE services with primary care within their FQHC network, Hudson Headwaters has created a model of integrated senior care that allows rural elders to age at home with dignity and provide significant economic value to the community.