Belknap County Nursing Home Anticipates Shortfall

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Belknap County Nursing Home

By Thomas P. Caldwell, InDepthNH.org

LACONIA — The Belknap County Commission anticipates needing a supplemental appropriation from the county delegation to cover a projected nursing home budget shortfall.

When the delegation approved the nursing home budget in January, members anticipated that they would need to revisit the matter later in the year, after there was more information about how the county’s hiring efforts were going.

Due in part to the pandemic and resistance to vaccine mandates, the nursing home was experiencing staff departures that remained unfilled, and the resident count ranged between 60 and 70 percent of full occupancy.

As a result, the county delegation reduced the commissioners’ proposed budget of $13,452,140 to $12,076,103, pending a better understanding of the situation after a few months passed.

The delegation also refused to fund a pay increase that had been implemented to attract and retain nurses. While the commission maintains that the delegation had approved the increase, the delegation’s executive committee said at the time that they had never been asked to approve the raises, and that a wage study that had been authorized had not been completed.

On May 19, County Administrator Debra Shackett reported that projections place the nursing home budget at $12,239,263 by year-end, or $142,688 over budget.

She said that, as things stand, the full-time nursing salaries will reach $3 million by the end of the year, assuming that vacant positions are not filled in the next month. With a budget of $2,750,000 for full-time wages, that would be a $250,000 shortfall in that category. Under-expenditures in part-time wages will cover part of that, she said.

“If those [full-time] positions are filled and start within a month, we’re actually going to spend closer to $3.2 million, so this $3 million number assumes that we will continue to have vacancies, to everyone’s dismay,” Shackett said. “So it’s a real worry.”

Filling vacant positions would increase health insurance costs, as well, she noted, but the effect on the budget would be hard to predict because it would depend upon which health plan the employees take.

“Health insurance … could go up or down by a lot, quickly,” she told the commission.

Glen Waring, vice-chair of the Belknap County Commission, suggested that they approach the county delegation about the possibility of needing a supplemental appropriation for the nursing home.

“I think the sooner we start that conversation and bring them into that conversation, the better,” Waring said.

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