Carroll County committee still undecided about old nursing home plan
June 02, 2011OSSIPEE— A committee formed to decide the fate of the current nursing home remained uncertain following their second meeting May 23, asking the county commissioners to bring more information to the June 27 meeting of the full county delegation.
The home has the main building plus four wings. There is $100,000 built into the cost of the new nursing home that is slated to be used for tearing down two wings of the old home once the residents are all moved in to their new home. The anticipated move-in date is sometime in September. The delegation also approved $15,000 for a feasibility study on what to do with the old home and half of that has been spent.
A straw vote was taken at the end of the committee meeting, after they had a chance to hear from two contractors, and the vote was in favor of hiring Bonnette, Page and Stone to oversee renovation of the old nursing home. At their May 25 meeting, commissioners formally voted to hire that firm. Commissioner David Sorenson said the cost of hiring that firm is uncertain, as they will receive a percentage of the total cost of renovations and that hasn't been decided yet.
"I think we are in agreement that the old building will be renovated at least for the (UNH) Cooperative Extension," said Commissioner Dorothy Solomon. She went on to acknowledge that whether just two wings will be torn down or all four is still undecided.
County Delegation Chair Rep. Betsey Patten said it has been the intention for at least the past six or seven years that the old home would be used to house the Extension and to get them back at the county complex. Currently, the county pays about $43,000 rent in Conway to house the Carroll County branch of that program. Sorenson said that money could be used to fund annual payments on a renovation loan for the old home.
NH Rep. Mark McConkey, a member of the county committee that will make the recommendation to the county delegation of what to do with the old home, said there needs to be a "clear and concrete reason" to save any of the wings. "This really needs to be precise," he said.
Several ideas have been tossed around including leasing space to a dialysis program, leasing space to the probation department so they can be closer to the jail instead of their current quarters in Wolfeboro, or leasing out space to a business. All of these, said Sorenson, could generate revenue for the county. He supports keeping the core of the old home plus two wings, even if the wings have to be "mothballed" for now and kept for future use.
There is the question of why a new nursing home had to be built if the current one can still be used. The difference, said Sorenson in previous meetings, is that the home is no longer suitable for housing nursing home residents and no longer met all the requirements of the state and was in danger of being closed down. Using the building as office and activity space does not require the same higher standards as a building used to house people. Former county commissioner and citizen-member of the committee Chip Albee has spoken at many meetings about the need for a clear plan and stressed, in his opinion, it would be very short-sighted to just tear down usable building space and not take into consideration possible future needs of the county complex.
A portion of the old building will be used to house the pellet boiler system and the county has received a grant for the installation of that system. Maintenance supervisor Bob Murray told the committee that that system is expected to save the county 43 percent in heating costs by switching from propane to the wood pellet system. This new system could also be used to heat the old home, Sorenson said.
After research, Murray recommends the county "get into the laundry business" and do all county laundry onsite instead of the current practice of contracting with an outside laundry service. There would need to be room in the old home for this as well as storage and work space for the maintenance department, neither of which have been built into the new home.
Commissioner Asha Kenney did not express her opinion at the weekly commissioner's meeting or the committee meeting but did appear to be taking very thorough notes throughout both meetings.
In other nursing home news, the commissioners had approved adding additional conduit to the new nursing home "if it is within reasonable cost" to offer an alternative down the road. Currently, Time Warner Cable is running its wiring and components in the home. In the future if this is ever changed to satellite television, installation of the conduit now will save costs later, explained Murray. When asked how soon the conduit would need to be installed, he said, "yesterday" and that time is of the essence before all of the new sheetrock in installed. The prices came in too steep, however, at $14,000 and commissioners opted to add only partial conduit at Murray's recommendation, installing metal piping from the electrical room to the attic.
A sample of the old home's roofing has been sent out for testing to see if it contains asbestos. If it does, that will make a $28,000 increase in the cost of tearing down the two old wings, according to estimates commissioners have received. The $100,000 budget to tear down the two wings and enclose the openings with brick would still cover all costs, said Sorenson.
Two companies have been sent requests for proposals for moving the furniture and equipment from the old home to the new and a list of volunteers is being created for anyone interested in helping with the move.
The commissioners have voted to hire a landscape designer from Sandwich who will be submitting a cost for her services and a list of needed materials. Commissioners will be putting the landscaping materials out for bid when they received the list.
Rather than accepting the contractor's pricing for resident rooms accessories of $236,000, nursing home staff will be trying to get better pricing for these items that include wastebaskets, lamps, clocks, and bedspreads, in hopes they can get a better deal working directly with suppliers and cutting out the "middle man."
In response to a question about the $250,000 nursing overtime budget, home administrator Sandi McKenzie said those costs are consistently going down, and it has been a focus of hers since taking her position. One of the things she was charged with when hired was reducing the amount of contracted nursing services. That annual budget used to sit at $500,000 and has been reduced to $20,000. McKenzie explained that when nursing employees are absent for vacation or personal time, those shifts have to be filled. It was common practice in the past to call a temp agency and pay $75 per hour for a contracted nurse. Now those additional shifts are first offered to employees as overtime. The home does have a list of per diem (on-call) nurses who are called but have the option of working if they can or want to work the open shift. Additionally, said McKenzie, given the nature of the business, it is "of utmost importance" for residents to have the continuity of care that comes with assigning staff the residents are familiar with to overtime shifts versus bringing in outside staff to work with them.
Jail Nursing Services
Two commissioners voted to enter into an 18-month contract with PrimeCare Medical, Inc. to manage inmate medical services at the county jail at an annual contract rate of $399,916. The county's total 2011 budget for medical services, including salaries, benefits, education, and medical supplies is $496,973. Currently, there are two nurses on staff at the jail. Those nurses would become employees of PrimeCare if they are hired on by that firm. PrimeCare will take on the responsibility of scheduling, staffing, ordering supplies, and managing the medical care of inmates, taking this burden away from the jail superintendent. The contract also states that PrimeCare "indemnifies and holds harmless the county and its representatives and employees from and against any and all lawsuits." Sorenson explained, for example, that is an inmate complains he or she did not receive their medication at the right time, PrimeCare will handle that and the commissioners will not have to. The contract is being sent to the county attorney for review before signing. The purpose of entering into an 18-month contract, said Sorenson, is to have the contract be in line with the county's budget cycle of January-December. Commissioners Sorenson and Solomon felt the contract term of July 2011 through December 2011 would not be enough time to fully gauge the effectiveness of the contract so opted for the 18-month term. Commissioner Kenney wanted the contract term of July 2011 to July 2012 and made a motion to that effect. When it came time to vote on the 18-month term, she did not vote against it but rather "abstained" and did not give an explanation.
Sheriff Chris Conley confirmed at the May 25 commissioner's meeting that his second-in-command, David Meyers is now being paid a salary of $85,000. Of that, $25,000 is for the work he does as information technology (IT) specialist for the sheriff's office and dispatch center computers, radios, and telephone system. Conley said that in 2010, Meyers had 337 hours of overtime and 90 percent of that was dedicated to managing this apparently complex group of systems that only Meyers is trained to do. Conley said the salary package and dual position has been specifically tailored to Meyers' skills and will not be offered automatically to the future person who might fill that position. Conley said the county is very fortunate to have someone so highly skilled in the IT sector who is also a sworn law enforcement official.
When asked if anyone else in the department has been trained or is being trained to work on these systems in the event of Meyers' absence, Conley said there is no one. He said there was a deputy that was "trying for many, many months working with him but did not have the skills or the aptitude to actually stay in the field so we transferred him back to regular deputy and he has since resigned," said Conley.
Sorenson said there is a backup plan as the county has contracted with a firm that manages the rest of the computer systems at the county complex. He said, however, that that firm stepping in and knowing the sheriff's office system will require "a learning curve" since that company has not been given any access to the sheriff's department systems to learn about them. Conley did not indicate at the meeting whether he is working towards a backup plan.