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Delegates to vote on nursing home funding

Wolfeboro businessman questions costs

November 30, 2009
OSSIPEE — On Monday Nov. 30, the Carroll County Legislative Delegation will vote on whether to approve about $23 million for a new nursing home proposed by the Carroll County Commissioners. While some have committed to supporting the project, others are mulling an "11th hour" call to slash the cost up to $9 million.

Last week, in front of a crowd of about 100 people, Wolfeboro businessman Paul Zimmerman, of Tuftonboro, suggested the commissioners redesign the proposed new nursing home so it would only cost around $14 million. Because a large crowd was expected, the meeting took place at Mountain View Nursing Home's cafeteria. Most people in the audience were seniors. Some had wheelchairs and walkers.

The delegation, made up of 14 state representatives, is scheduled to vote on approving the money on Nov. 30 at 9 a.m. at Mountain View Nursing Home.

In July, the vast majority of delegates voted to pursue plans for a state of the art nursing home costing $23.5 million. The design calls for an 85,000 square foot home holding 103 beds. Each resident would have a private room and a bathroom. Groups of about 12 rooms would be clustered together around a common living room and a small kitchen.

Delegation Chair Nancy Patten (R-Moultonborough) stated she is going to review the information Zimmerman sent her by mail. She had been away last week.

"I will look at it, consider his options and then ask for a recommendation from the Commissioners on their response to it," stated Patten. "I am open to looking at reducing the cost but have to be sure what will be sacrificed for a lesser price."

Other delegates who had similar responses include: Dino Scala (R-Wakefield), Chris Ahlgren (R-Wolfeboro), Stan Stevens (R-Wolfeboro), Joe Fleck (R-Wakefield), and J. David Knox (R-Wolfeboro).

But Susan Wiley (D-Sandwich) and Tom Buco (D-Conway) said they have decided to stick with the $23 million plan.

"All the designs have already been made and now they are coming in and

disrupting the process," said Buco. A redesign would be expensive and delaying construction could jeopardize the county's ability to have a good financing rate, said Buco. In a follow up e-mail, Buco stated Zimmerman had legitimate questions, but that those questions had already been answered.

Wiley said process has gone on for many months. She listed off about 85 meetings held during which Zimmerman could have shared his opinion. The nursing home project has more visibility than any other project in New England, she said.

Karen Umberger (R-Kearsarge) said she voted against the project in July and would do it again on Nov. 30.

"I have not changed my mind," stated Umberger who couldn't attend the meeting last Wednesday.

The remaining six delegates could not be reached.

After the meeting, Zimmerman said he joined the process late because he initially had faith the delegation was going to be well informed. But relatively recently, he began to change his mind.

"The delegates have not been doing their homework," he said.

The crux of Zimmerman's argument is the new nursing home will cost much more per room than it should. Zimmerman estimates the new nursing home will cost $230,000 per bed while Merrimack County's nursing home, in Boscawen, cost $167,000 per bed. The Golden Living Center, a private 115-bed nursing home in Erie, Penn, only cost $140,000 per bed. The cost-per-bed figures are calculated by dividing the price of the entire building by the number of beds, according to Zimmerman. Merrimack County's nursing home was built in 2008 and the Golden Living Center was completed in 2009.

During the meeting, Zimmerman's attorney Randy Walker, of Walker and Varney of Wolfeboro, presented the information.

When Commissioner Dorothy Solomon asked why Zimmerman wasn't doing it himself, he replied "it's not my profession."

Walker suggested it would drive down cost if the new nursing home had a blend of private and double rooms. As the plans are now, the county could buy nursing home resident's their own house for the price per bed.

But County Commissioner Chip Albee said a $15 million option with double rooms was already examined and rejected. The reason being, the $23.5 million option would begin to have lower operational costs over 25 years because it would have a higher occupancy rate.

The current nursing home, which also has 103 beds, loses about $2 million per year because its occupancy rate is about 97. That's because residents have to share a room. When a resident leaves he or she has to be replaced by a person of the same sex.

"No where in here do I see any reference to the operational side," said Albee of the Zimmerman report. "Our expectation was you had extraordinary information — we've had 101 meetings with no participation from your group."

Delegates said having private rooms increases the chance of attracting nursing home residents who are able to pay with private insurance, which pays a higher reimbursement rate than Medicaid.

But at the same time, Ahlgren was intrigued with Walker's suggestion of having a blend of single and double rooms. Having such a combination may reduce the cost of the nursing home to $18 million.

"Why didn't we see a middle of the road option," said Ahlgren who added at $23 million, the new nursing home would cost everyone in the county about $500. Carroll County has about 46,000 residents

"This is certainly an 11th hour proposal and its unfortunate it's so late," said Ahlgren. "But it's a chance to take a hard look at what's going on."

Only a handful of people in the audience spoke. Most of them seemed to favor the $23.5 million design but Conway resident Mary Ann Shakir said the commission should scale back the plans.

"If you can't afford private rooms you should be in a semi private room," she said.

But Conway resident Don Litchko said in his profession he's had decades of experience looking at layouts and he feels the commissioners were proposing a good plan.

Residents Sandy Stowell and Lorraine Donovan also supported the new nursing home. Stowell said the county shouldn't treat its elderly like "throwaways."

Resident Diane Guerriere said single rooms are important. Her brother, who is 51, is in the home because of medical issues.

"When he needs extra care after midnight they need to wake up the roommate, flip on the light, and pull a curtain that doesn't block any sound," she said. "There is no dignity in that."

When she finished speaking the audience burst into applause.

Martin Lord and Osman
Salmon Press
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