LACONIA — Belknap County commissioners, who were hoping for an immediate turnaround, were disappointed to hear from interim nursing home Administrator Bob Hemenway that it will be 18 months to two years before the benefits of electronic record-keeping can be realized.
Last Wednesday, commissioners approved encumbering $20,000 in funds from the 2015 budget in order to purchase 12 wall-mounted kiosks in 2016, which will allow the Belknap County Nursing Home to begin to implement an electronic medical record-keeping program as soon as possible.
The change is designed to stem an estimated $185,420 yearly loss in Medicaid income due to lack of adequate documentation of services provided for residents.
Hemenway said the Medicaid reimbursement rate for the county, which will drop from $161.33 a day to $154.46 on July 1 next year, is based on 2013 data, which means that it will be some time before the rates are updated to reflect the changes.
But he noted that most of the seven county nursing homes in the state which have been using an electronic medical records program have turned their situations around and are receiving increased reimbursements.
The county currently uses PointClickCare software for the nursing home, but licensed nursing assistants do not have access to it, so their information is recorded on pieces of paper and entered into the system by other people.
“What’s critical is the LNAs. The work they do is not being captured for reimbursement.” He said that the county is losing $6.87 per patient each day for each of the 74 Medicaid-covered residents, which amounts to over $185,000 a year.
He said that another advantage of the electronic system is that it lists required daily tasks for each patient, ensuring that all procedures are completed and recorded.
Commissioner Hunter Taylor (R-Alton) supported the transfer. “We should go ahead now because of the amount of money we’re losing,” he said.
Commissioner Richard Burchell (R-Gilmanton) said he thought the request was premature.
County Administrator Debra Shackett said it will cost $13,754 for the software for the system, which also has a monthly charge of $1,627.
The commissioners elected to take the $20,000 needed for purchase of the kiosks from the 2015 capital improvements budget line.
Commissioners did reject a proposal from Belknap County Nursing Home to add $21,753.45 for two 16-hour per week dishwashing positions for the home’s Dietary Department budget.
Dietary Manage Carolee Sliker sent a memo to the commissioners which said that House of Corrections inmate labor has proved unreliable, resulting in a situation in which the cook on duty is not getting out of the kitchen until 8 p.m. resulting in overtime costs of $2,800 per year.
Commission Chairman David DeVoy (R-Sanbornton) said he is opposed to the proposal at the present time and would like to see how things work out with the county’s plan to pay prisoners $3 a day for their work in county facilities.
Corrections Department Superintendent Keith Gray recently told commissioners that he currently has 12 inmates available to work, and estimated that it would cost $15,427 a year to pay inmates for their labor.
The inmates would work in the Belknap County Home kitchen, washing dishes, as well as at the county home and corrections department laundries, or as part of the grounds crew and farm crew at the county home. There would also be some off-site work at locations like the Belknap County Fairgrounds or in communities which ask for prison labor for specific projects.
Gray said that those eligible to work will be minimum risk, nonviolent offenders and that waivers might be sought in order to allow those awaiting trial to participate.
DeVoy said he thinks that work is the best rehabilitation for prisoners and getting more inmates working is a good idea.
Commissioners decided to use $15,000 from a $93,000 budget line for programs in order to pay prisoners for their work after being told by Shackett that a $200,000 contingency line in the 2016 draft budget would be virtually exhausted if agreements are reached with three county unions on a new contract.
She said that cost of living raises and step increases for workers in the State Employee Association affiliated unions in the nursing home, sheriff’s department and corrections department would cost $198,966.
Commissioners also approved a $6,919 contract with Hiller New England Fire Protection of Belmont for installation of a fire suppression and detection system for the Sheriff Department’s communication building.
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