Public Input Needed

There is a lot going on in the world, but Sullivan County residents have a huge local issue to deal with and we need to hear from you. The nursing home complex needs a major renovation. The cost for this project has been escalating, and it is time to make a decision. A dozen people in a room in Newport should not decide this alone. Going forward will create a cost for the next 30 years. If there is any silver lining to COVID, it is that you don’t have to leave your house to participate. There is a public hearing on Monday at 6;30. The sole purpose of calling this meeting is to receive public feedback and answer your questions. We really want to know what you think. You can contact your local State Representative any time. Our contact information can be found at https://www.sullivancountynh.gov/207/Delegation

Please also participate in the hearing.

Background

Sullivan County has the best county nursing home in the state. In addition to  stellar ratings for care and service, it operates at close to a break even point. Hillsborough has a massive facility that turns a slight profit. All other counties subsidize their nursing homes with millions of dollars. We don’t.

Our facilities are very old now, and federal guidelines for facilities have evolved. This matters because it can affect our qualifications for Medicaid income. In the 1960’s, a pretty big project was done to achieve compliance and we are there again. We can pour money into an aging facility that may incur unexpected repair costs, or upgrade to something newer that will last for decades.

Project documents at https://www.sullivancountynh.gov/1220/SCHC-Renovation

Project Problems

The initial proposals were around 25-30 million dollars. We spent 1 million on plans and drawings for the project. As time has gone on, the price tag has now hit almost 50 million dollars. We recently paid more money for a “Guaranteed Maximum Price”, and then learned that this price would not be held for very long. If this project is to go forward, because of bond application deadlines, we need to vote on it next month.

Options

There are several options:

Each of these has a consequence.

Maintain Existing

This will still cost money due to existing needed repairs, and potentially having issues receiving Medicaid funding in the future. The added risk is that with this old a facility, it is difficult to plan future costs. The benefit is that we can wait until COVID is over and see what the economy is like before committing this much money.

Cut Scope to Hit a Set Dollar Amount

We can decide to spend a defined amount of money and make whatever repairs and upgrades are possible. The benefit is that we know the bill and maximum risk. The risk is that that the scope will not cover a major incident/failure in the next few years, and also risks revenue reductions because of lack of federal compliance.

Proceed with Current Design

50 million dollars and a tax increase. The benefit is a better facility, less risk of unplanned repairs, and the potential to increase the “private pay”population. This increase could make the facility revenue positive in the future. We also take care of the federal regulation issue by upgrading to a fully compliant facility.

Build a New Facility

We have the room. This would cost about the same as the current project. I’m not going to lie, just because the estimate today is around 50 million, it is likely to rise through the planning phase. The risk is the huge price tag. The benefit is a new facility and far fewer worries about unplanned repairs and compliance issues. A brand new facility may also attract more private residents. Increasing the ration of private pay vs. Medicaid is how we get to self sustaining, or profitable levels.

Get Out of the Nursing Business

The main benefit is not having the liability if maintaining a huge facility. There will still be a cost in closing down the current facility. The residents will have to be moved elsewhere, the buildings mothballed, severance pay for the few hundred employees, etc. It is cheaper than 50 million, but not free. The nursing home is also our biggest source of revenue. That will go away. We will also be required to pay for our residents who go elsewhere if they are on Medicaid.