Over tearful pleas and angry protests from staff and residents of San Mateo County's public long-term nursing facility, the board of supervisors voted unanimously Tuesday to shutter the center.

The 5-0 vote to not renew the county's lease with the owners of the Burlingame Long Term Care Facility on Trousdale Drive means laying off as many as 200 workers and moving about 230 disabled, elderly or chronically ill residents. The drawdown of workers and patients -- most of whom are low-income Medi-Cal recipients -- will happen during the next 16 months, officials said in the meeting at the Westin Hotel in Millbrae.

"This place is one big heart," said five-year resident Esther Nord, 63, of the center. "Give us our miracle on Valentine's Day."

She was one of more than 55 supporters who spoke during over two hours of public comment that included songs and a poem.

But supervisors stuck by a recommendation from health system Chief Jean Fraser and San Mateo Medical Center CEO Susan Ehrlich to close the rundown facility, which was built in the 1960s and 1970s.

Fraser said the building, which the county took over in 2003, doesn't meet safety or disability access standards. She pointed to narrow stairwells that make it dangerous to evacuate residents who are confined to beds or use wheelchairs in case of an emergency. She noted, also, that state budget cuts mean a $9 million deficit for the facility's roughly $32 million annual operating budget.

Fraser apologized, but said health care is moving away from large institutions and toward keeping people, with services, in their homes as they age. San Mateo is one of five counties in California that operates a long-term nursing center, she said.

But center supporters warned the officials they were axing a major resource at a time when a "silver tsunami" of baby boomers is creeping toward old age.

County officials said they will not close the facility until every patient has been placed in a new home. Those moves and severance payments to laid-off workers are expected to cost the county about $9 million.

However, there are homeless, young and mentally ill patients who will be difficult to place in new facilities. Resident Anna Marie Tupou, 76, said she didn't know where she would end up, but added, "I trust in God. He will find a place for me."

Joytika Buitrago, 34, of San Francisco, is a supplies manager at the facility. She has four children of her own and adopted two more after her sister died. The news came as a blow to her after 16 years working at the center.

"This is devastating," she said. She'll know by April 1 if she'll lose her job. Some workers might be transferred to other county facilities.

Commenting briefly, supervisors reiterated their concern about safety and cost. Reductions in state health care subsidies in the form of Medi-Cal would require the county to chip in $9 million from its general fund to keep the doors open.

"It's a difficult one, but we have looked long and hard," board President Adrienne Tissier said.

Facility co-owner Mario Muzzi offered to renegotiate the terms of the lease, to no avail. "They already had their minds made up before they came in the meeting," said Leslie Brosnan, a California Nurses Association union representative. "It was just the appearance of democracy."

Contact Joshua Melvin at 650-348-4335.