Carroll County nursing home administrator stunned by firing

OSSIPEE — Patti Cain, the former assistant director of nursing at Mountain View Community nursing home in Ossipee, is still in a state of disbelief after she was abruptly fired last month after 12 years of service and in the middle of a staffing crisis.

County officials say the decision was strictly business.

Cain of Wolfeboro, who says she has 44 years of nursing experience, worked at Mountain View for about 12 years. She was in management at the nursing home, third in line behind Administrator Dee Brown and Director of Nursing Sue Dodier.

Most of Cain’s duties entailed staff development and scheduling, and updating policies and procedures as well as direct resident care.

But that all came to an end on Nov. 9, when Cain said she was summoned to a meeting with Brown and Human Resources. Cain said she was told she was “done” and asked to pack up and leave the building.

On Dec. 1, she confronted Carroll County commissioners, who oversee the budget for the county-run nursing home, about her firing.

She spoke with the Sun about it on Dec. 20. “There was no warning, and the decision was made without any discussion with the director of nursing,” said Cain.

She said she asked if she could apply for another job at Mountain View, but “they told me no, I could not work in the building.”

The Carroll County Independent quoted Dodier as saying the loss of Cain’s position “devastating.”

The firing comes as Mountain View struggles with staffing.

“We are a nursing home in the midst of the worst nursing crisis I have seen in my 44 years of being a nurse,” said Cain.

She said she received no notice from the county. “They gave me two seconds,” said Cain. She said she was offered three weeks’ severance. The message from county officials, she said, was, “Here you go, pack your bags and leave.”

She said declined to sign the separation agreement, and turned down the severance pay.

“If I signed, it basically meant I would go away quietly. So I opted not to sign that because at this point, I just feel like this is a big deal,” she said.

Cain told commissioners at the Dec. 1 meeting she had sent them a letter seeking to appeal her firing to the legislative delegation. Chair Terry McCarthy (R-Conway) said she didn’t receive the letter and Cain gave her a copy. McCarthy said she would get back to Cain soon.

Cain said later that county officials told her the delegation wouldn’t hear her appeal because her position was being abolished. Cain said she’s asked for a formal letter stating the same but has not gotten one.

Wolfeboro resident and Cain family friend Gary Brockney came before commissioners at their Dec. 15 meeting to express shock at how Cain was treated.

He said, “There’s something real smelly going on. I need to look into how this all came about and get the answers to people that are wondering. They have gotten no answers.”

McCarthy told him, “It was strictly budgetary. ... It was up to the nursing home administrator. One of them wanted the position to be taken out. It’s over $100,000 a year.”

McCarthy said the position became unneeded after Brown was hired.

Mountain View Community nursing home’s proposed 2023 budget is about $16.8 million.

On Dec. 20, Brown told the Sun that eliminating the assistant director of nursing position freed up money so other staff could be paid better.

“There’s no doubt about it that our staffing is at a critical level,” said Brown, adding that many staff are underpaid.

“Given the economic situation, a lot of staff are able to find higher-paying jobs even in fast food or as store clerks, and can make more money there than they can make working here caring for the elderly,” she said.

She said the nursing home has about half the nurses it should have, which means staff are putting in a lot of overtime and management is taking on extra work as well.

Per shift there should be 16 licensed nursing assistants to provide all the daily care of residents, but there are only four licensed practical nurses, four medication nursing assistants and one nursing supervisor.

“We’ve been able to kind of piecemeal with a lot of great staff picking up extra hours, and some of our management staff taking on shifts, and they’ve been exceptional at trying to help out,” said Brown.

“But they’re exhausted. We’ve been going through COVID for two years ... Staff deserve to earn a respectable wage for what they’re doing.”

LNAs start at $15 per hour, she said.

Brown said that the money saved by terminating the assistant director of nursing would be divided among staff who could see raises of 75 cents per hour.

She said “it’s very challenging” to balance the financial restraints and the need for nursing staff.

Brown explained Cain wasn’t allowed to come back as a rank-and-file nurse.

“It’s customary business practice that you don’t take a high-level person and then move them down to the floor, because it won’t work the same way with the staff,” said Brown.

Staff, she said, “will always see (the former manager) in that administrative role.”

Cain said the firing felt personal and speculated that perhaps her outspoken nature got her axed. At a county meeting last year, Cain objected to the commissioners’ proposing to spend a large chunk of American Rescue Plan Act funds on rehabilitating the former nursing home and a much smaller amount on staff stipends. She noted at the time that staff were struggling to get by due to the pandemic.

Cain said people have told her she may have “poked the bear,” meaning she frustrated her superiors too many times, but Cain said she was just trying to do the right thing. Since she was let go, she’s received a number of letters of support.

“I will not apologize for who I am or what I do,” said Cain.

Brown denied that politics were involved in the decision. She called Cain a “great asset” and said the decision to terminate the assistant director of nursing position wasn’t easy.

Asked what her plans are now, Cain said the story shouldn’t dwell on her as an individual but rather the situation at the nursing home.

“I am a survivor, and I will do what I need to do to survive,” said Cain.

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