Merrimack County approves nursing-home rate increase, and creates full-time clerk role

The Merrimack County Board of Commissioners voted to raise the nursing home private‑pay room rate effective July 1 and to reclassify two part‑time health information clerk positions into one full‑time clerk position.

Commissioner David Shurtleff said the rate change is needed after the state changed how it calculates pro‑share reimbursement. Heather Mokwin, nursing‑home staff member, told commissioners an unchanged private‑pay rate would leave the nursing‑home budget about $2.2 million short of the amount budgeted for the year. The board approved a private‑pay rate increase that staff said equals a 47% rise from the current private room charge.

The county presented an estimate that the state’s new pro‑share formula would not cover the full shortfall. Heather Mokwin said the rate adjustment would cover roughly half the gap and that nursing‑home management will pursue additional internal cost control and revenue measures to close remaining deficits.

Commissioners and staff described specifics the public will see if the change is approved: the rate change would take effect July 1; the nursing home plans to give at least the required 60 days’ notice to residents and families, and staff will call families in advance of any written notice. The home also proposed rolling monthly television and phone charges into the single daily private‑pay rate; Wi‑Fi/internet was not included. Nursing‑home staff estimated roughly 30–40 residents have phones and that cable/TV is the larger utility cost.

On staffing, Jen Ridland and Wendy Heath, nursing‑home staff members, asked the board to approve converting two part‑time health information clerk posts into one full‑time position to improve retention and ensure floor coverage. They said turnover in part‑time roles hindered consistent coverage across the facility’s three patient floors. The board approved the reclassification; no named roll‑call votes were given during the motion beyond the voice yea/nea process used by the board.

Commissioner Shurtleff and other commissioners asked for an annual review process so future rate changes can be adjusted up or down depending on actual costs and census. Staff emphasized the county will review the private‑pay rate each year using the nursing home cost report.

The board’s approval directs nursing‑home staff to implement the new rate and to proceed with the staffing reclassification. Staff said they will next distribute resident/family notices and finalize the internal budget adjustments and posting for the reclassified position.