Delegation unanimously approves additional funds for nursing home staffing

LACONIA — Representatives for Belknap County unanimously approved a $750,000 supplemental appropriation for the nursing home at a meeting Tuesday night. Increasing costs of labor, in part related to the nursing home’s reliance on contracted travel nurses, is driving a projected shortfall for the home, while underestimates of its revenue in the budget mean the appropriation was made without placing increased demand on taxes. 

The county projects the nursing home will have around $635,000 more in labor costs than the 2023 budget can cover. The budget process, however, also underestimated the home’s revenue by about $1 million. County commissioners requested an appropriation of $750,000 to include some wiggle room in case expenses jump again.

The county delegation “treated the request very fairly,” Peter Spanos, chair of the board of county commissioners, told The Daily Sun, adding he was “pleasantly surprised” at the unanimous vote and felt its showed the county’s reasoning was well-received.

A motion by Rep. Barbara Comtois (R–Center Barnstead) to appropriate only $650,000 failed in 4-13 a vote. County Administrator Debra Shackett and Spanos explained the extra $100,000 may not be necessary, but that if the smaller appropriation was made and the nursing home’s expenses rose past projections, the delegation would have to convene again to approve more money. Either way, there would be no impact to the burden on taxpayers, and any surplus funds would be put toward the county’s fund balance.

“There's no harm done by transferring the extra $100,000,” Shackett told the delegation. “But if you don't transfer the extra $100,000, and it turns out they need it, then it’s just an inconvenience.”

A motion by Rep. Steven Bogert (R-Laconia) to appropriate the full requested amount was approved unanimously. 

Like providers across the health care industry, the county’s nursing home uses contracted travel nurses in addition to its staff because of its struggles to attract and retain employees. Travel nurses are paid a higher hourly rate — as much as $93 to $120 an hour at the nursing home — in exchange for fewer benefits, through an agency. At the end of a 13-week contract at one location, they may travel to another for a new contract. By comparison, staff nurses are employees of the provider itself; they receive a far lower rate but receive benefits through the health care provider and can remain settled in one locale. 

The nursing home currently operates at two-thirds capacity, according to Spanos, and has about 22 nursing position openings.