Lawmakers question plans for $24 million nursing home


July 15, 2009
OSSIPEE — With its first major monetary vote on the construction of a new Mountain View Nursing Home facility looming, some county lawmakers are pushing to remove Carroll County from the nursing home business altogether.

On July 29, 2008, the county legislative delegation unanimously passed a motion "to support the replacement of the Mountain View Nursing Home facility" amid lower cost estimates and mounting code violations that could potentially lead to a state shutdown. But now, with the economy struggling and unemployment rising, some lawmakers and residents have reservations about the project's price tag, which has grown to nearly $24 million.

Rep. Betsey Patten (R-Moultonborough), chair of the county legislative delegation, brought those concerns forward to the county commission at its July 1 meeting, warning officials to be prepared to defend their project with numbers and answers. "There is lobbying going on with the delegation members," she said, as the delegation readies for a crucial July 20 vote on $300,000 in site preparation.

By voting for the next step in the process, the delegation would be committing to the entire cost of the project, Patten explained—a pledge that her conservative Moultonborough, Tuftonboro and Wolfeboro constituency in particular has had qualms about.

Noting that "$23.8 million is a hit on the economy," Patten said the county's state representatives were mainly mulling two options: moving forward with the best quality building possible, or getting out of the nursing home business completely.

While willing to gather the data on the latter option, commissioners felt it conflicted with the delegation's 2008 vote to replace the facility. They were also concerned with how discussion of a possible closure would affect the county workforce and the home's roughly 100 residents.

Commissioners further argued that by delaying the project, the county would lose its low interest rate and construction costs. Commissioner Chip Albee added, "Don't lose sight of the fact that our first payment isn't until 2011 The economy today won't be the economy in 2011."

Albee said that according to N.H. Bureau of Elderly and Adult Services (BEAS) estimates, getting out of the nursing home business would still cost about $3.7 million. "It's not going to be free to get out. There are going to be some costs going forward," he said, in addition to the tens of thousands spent on architectural design and preliminary work. He urged lawmakers to consider the time and money necessary to relocate residents, repurpose or demolish the existing building, and settle terminations and other employment issues, if applicable.

He added that closing Mountain View would have other indirect affects on county operations, like how jail inmates are fed. Currently, inmates' meals are made in the nursing home kitchen at a cost of $2.40 each. While the jail is outfitted with a full commercial kitchen, Albee said there would be costs associated with establishing, or outsourcing, a new food service system. He questioned whether the commission could put together accurate, defensible numbers in less than three weeks.

To bring in revenues, the county has considered selling its bed count (a state moratorium on nursing home beds allows transfers but no new additions), but Albee said it wouldn't be a dependable source of income and the sold beds wouldn't necessarily stay in the county. The state has complete control over approving the sale and price per bed.

Rep. Joe Fleck (R-Wakefield), who accompanied Patten, stressed that lawmakers don't doubt that the new facility is needed as Carroll County's aging population grows. However, he questioned whether the county should be in a business that may be better suited for the private sector.

Calling relocation "a logistical move as well as a fiscal move," he argued that it would be in line with the delegation's earlier vote to "replace" the home. Fleck also asked for information on whether residents would have another affordable option. But, he said, if the county decides to move forward, it should do it right by constructing a quality building with "the best design we can afford."

The commission was skeptical as to whether there would be another option for the county's elderly. "We know for certain that there aren't 97 beds anywhere else in Carroll County," said Albee. He added that the county is in the public service business too, and is expected to provide care to its elderly: "That part of the equation isn't monetary."

Commissioner Dorothy Solomon, who has been actively involved with the State Committee on Aging, explained that county homes are an essential option for residents on Medicare or those with conditions that need special care. While private homes aren't supposed to turn these residents down, she said, they often find ways to reject them.

Patten asked the commission to outline the process of leaving the nursing home business, including directing the staff and residents of Carroll County's third-largest employer to a different private facility. "I know I've heard from the public that you shouldn't even bring these questions up because of the staff," she said.

Noting problems with the jail's 2003 construction, she maintained that answering questions early could ensure a smoother process, and while they could "cause angst," she said, "there is angst in the taxpayers."

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