04172021 Sullivan County Health Care Nursing Home Vote

A large sign is seen posted at the entrance of the Sullivan County Complex in Unity, which is home to the 156-bed Sullivan County Health Care facility, the county department of corrections, and a gazebo constructed by members of the Transitional Reentry and Inmate Life Skills (TRAILS) program in October of 2019. A vote on the proposed renovations at the Sullivan County nursing home has been set for April 26 by the Sullivan County delegation following a public hearing held on Tuesday.

NEWPORT — The Sullivan County delegation has set a date later this month to vote on the proposed nursing home renovation project, which is expected to cost $54 million.

The 13 delegates representing communities in Sullivan County held a public hearing on Tuesday for the project, which would replace the oldest building in the complex with a modern and energy-efficient building, improve living spaces, create more common areas and maximize operating efficiency by redistributing nurse workstations and returning the county laundry services to the nursing home.

The Eagle Times has summarized the county’s responses to key questions asked throughout this process, including those asked by county residents on Tuesday.

Why is the county proposing this project?The Sullivan County nursing home consists of three buildings, each added over time as industry practices and regulations evolved: the original Sanders building, built in 1931; the Stearns building, built in 1970; and the McConnell wing, built in 1997.

The Sanders and Stearns buildings in particular are not designed to meet modern regulations or residential expectations of today’s seniors or families, according to Sullivan County Facilities Director Mary Bourque.

Current state and federal standards require all beds to have a window and a resident-to-bathroom ratio of 2:1, for example. The Sanders building, which the county closed, does not have bathrooms connected directly to residents’ rooms nor a dining room. The Stearns building, which is still in use, has a dining room and bathrooms directly connected to rooms but resident-to-bathroom ratios of 4:1 in many cases. Additionally, only some residents in the Stearns building have a window by their bed and the facility has an overall lack of common space for families to visit with residents.

While these standards were grandfathered in, any major renovations would then require a facility to comply with the new regulations, according to Bourque. The county will have to make such renovations to upgrade its plumbing, ventilations, and electrical systems, some of which are in critical need but whose work will be intense and “invasive” to residential living.

“The moment we touch those systems and start disrupting residents’ spaces, the state will require us to meet the new codes,” Bourque explained on Tuesday. “So it’s not [simply] a matter of repairing what’s there.”

Is this the best time fiscally to do this project?The project cost and timing in regards to current economic uncertainties have arguably been the largest concern among the delegates. This concern factored significantly last September when the delegation rejected the project by a vote of 11-1.

Several delegates who voted no last September suggested waiting a year or two to see if the economic outlook improves, while others wanted the county to study alternative approaches, including but not limited to building a new nursing home in a more central location or reducing the project’s scope by reducing the facility’s bed capacity.

This year, however, some officials are worrying that delaying the project further will only escalate the cost.

Since 2019, the projected project cost has jumped from $39 million to $54 million in large part due to the rising costs of construction material and labor shortages as well as recent federal regulations which required the county to adjust their building plan.

To illustrate the rapid changes to construction costs and interest rates, the estimated cost at present is $5 million more than the amount rejected by the delegates in September.

Several officials warned that the cost of construction is likely going to increase in the near future.

“All the recommended contractors [I speak to] . . . are booked,” said Rep. Skip Rollins of Newport, who works at LaValley Building Supply. “As long as we have an influx of people moving into the area, wanting to build a house or buy a house and remodel, our prices are going to remain extremely high.”

The migration of families to New Hampshire over the past year has resulted in bidding wars over available homes and to hire contractors, driving up the cost of contractor services, Rollins explained.

Sullivan County Commissioner Ben Nelson also speculated that bond rates, which are still at historic lows, are inevitably going to rise again in response to federal spending levels and that building costs will likely increase should Congress pass the The American Jobs Plan, a proposed $2 trillion infrastructure bill by the Biden administration.

“If anyone can show me a scenario where the construction costs are going to go down in the next five years, I would love to hear it,” Nelson said.

Delaying the renovations further could also mean costly risks should any of the home’s systems fail, county officials warned.

“Between the heating infrastructure and the plumbing infrastructure, if there is a major failure our worst-case fear is that we’d be putting the health and safety of our residents and staff at risk,” said County Manager Derek Ferland.

Ferland also provided a scenario in which the delegation approves a partial bond funding of $35 to $40 million, rather than $54 million. The county would cover the remaining funds using $8 million received in the federal American Rescue Plan Act and $5 million from the county’s Capital Reserve Fund.

The cost of the bond would also depend on the terms selected and the final maximum price guarantee for the construction portion.

The county delegations will vote on the proposal on Monday, April 26, at 7:30 p.m.

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