County officials outline recruitment steps, write-off reductions and targeted wage moves for long-term care

Rockingham County commissioners on June 12 heard updates on nurse recruitment at the county long-term care facilities, approved a one-time wage adjustment for assisted living staff, and authorized write-offs for older long-term-care accounts.

Senior staff reported that clinical hiring remains a priority. In the long-term-care nursing home, officials said they had 36 staff RNs and 23 agency RNs, and for licensed nurse aides (LNAs) there were 37 staff and 42 agency personnel, reflecting continued reliance on agency workers. Senior director-level speakers described outreach to local nursing schools, efforts to become a clinical instruction site, and coordination with HR and outside vendors to increase applicant flow. “We still have a lot of hiring to do,” a senior long-term-care official said; “we should not be taking our foot off the gas.”

The board approved a one-time wage adjustment of $1.75 per hour for four eligible assisted living positions as recommended by long-term care and finance leadership. The motion as read in the record was moved and recorded as approved by roll call.

Financial actions tied to long-term care also moved forward. Commissioners approved fiscal-year 2025 long-term care services write-offs totaling $153,006.42 (patient liability and private-pay portions) and sheriff's office write-offs of $109. Senior staff explained those write-offs represent older accounts, many dated before the end of 2019, and that the county will continue collection efforts on accounts with liens. “Because it's a write-off, we don't give up. We don't give up all collection efforts,” a finance official said.

Commissioners also amended per-diem wage schedules to add a per-diem nurse practitioner position at an approved rate of $85 per hour; the board approved the schedule change and the candidate is proceeding to orientation.

Why this matters: The county's long-term care operations are labor-intensive and face regional workforce shortages; approved wage measures and recruitment outreach are intended to improve retention and reduce agency reliance, while write-offs and billing process improvements aim to better capture revenue and control losses.

Next steps noted in the meeting included finalizing recruitment contracts with clinical education partners, implementing more proactive Medicaid filing procedures to reduce future write-offs, and rolling out internal billing changes to accept credit card and ACH payments for some accounts.