15 percent budget increase seen necessary to keep nursing alive

LACONIA — Saying the future of the County Nursing Home hangs in the balance, the Belknap County Commissioners are recommending a $13.4 million budget for the facility, $1 million of which would be raised by taxpayers — a subsidy four times greater than in current budget.

The commissioner unanimously recommended $13,452,140 be appropriated to operate the facility. The nursing home is underutilized because of chronic staffing shortages that have been blamed on substandard wages paid to nursing staff and other employees.

The proposed amount to operate the skilled nursing facility is 15% higher than its current budget of $11.6 million, of which $237,000 has been raised by taxes. The largest part of nursing home expenses are covered by reimbursement from Medicaid and non-government insurance programs.

“We’re on the road to closing the nursing home,” Commissioner Hunter Taylor said at Thursday’s budget session. “But I’m not ready to concede that right now.”

Taylor said the budget needs to contain enough money for payroll so the nursing home can offer competitive wages.

American Rescue Plan Act COVID relief funds might be used to offset some of the amount that would need to be raised by taxes, commissioners said.

Presently the home is operating at two-thirds capacity, due in large part to the inability to pay nursing staff at a level that is competitive with other health-care facilities in the area.

Meanwhile, the nursing home is concerned that the situation could become even worse in the next few weeks depending on how many workers who have not received the COVID vaccine decide to quit rather than submit to the government mandate for health-care workers, which goes into effect on Dec. 5.

If too many more staff members leave, the nursing home might have to close down another wing, nursing home Administrator Shelley Richardson told the commissioners.

There are at present 27 unvaccinated workers at the home, including contract workers who provide dietary and therapy services, Richardson said.

Taylor and Commissioner Glen Waring said the proposed budget would put the nursing home on a firmer footing, with Taylor adding that any significant cut could have dire consequences.

“If they want to shut it down, then it’s on them,” Taylor said, referring to the delegation.

Commission Chairman Peter Spanos acknowledged the proposed nursing home budget is likely to encounter stiff resistance from delegation members.

“This will be a difficult decision for the delegation,” he said.

To underscore how desperate the staffing situation has become, the commissioners approved granting supplements to salaried nursing home employees who do work outside their regular duties. The additional money would be paid, for example, to salaried staff who in addition to their supervisory duties have also been required to work full shifts as a floor nurse. The commissioners gave short-term approval of the plan in order to reward salaried workers who will have to work additional time during the Thanksgiving Day holiday weekend. But they told Richardson to formalize the policy in time for the commission to consider implementing it long-term at its meeting on Dec. 2.

Spanos tried to remain positive.

“I know things look dim,” he said. “But I want to stay optimistic.”

He said the nursing home budget was a matter of principle.

“We’re being prudent, but we can’t pinch pennies when the survival of the nursing home is at stake,” he said.

“It’s the home of last resort for a lot of people in Belknap County,” Taylor said.