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County officials present $243,343 in long‑term care write‑offs and plan revenue‑cycle changes
Summary
Finance and long‑term care staff told commissioners the county is recommending $243,343.37 in write‑offs for aged accounts and is pursuing revenue‑cycle management changes, asset‑search services and Medicaid process improvements to reduce future losses.
Rockingham County finance and long‑term care leaders on Feb. 20 presented a recommended $243,343.37 in write‑offs for long‑term care receivables for fiscal 2025 and outlined steps to reduce future uncollectible accounts.
Why it matters: The write‑offs represent accounts aged more than two years that staff said are already accounted for in the county's allowance for uncollectible accounts, limiting immediate revenue impact. Commissioners were told the write‑offs primarily affect the long‑term care population the county serves and that staff are adopting new collection and Medicaid‑eligibility practices to reduce similar future write‑offs.
What staff told the board: Finance staff said the bulk of the accounts were aged over two years and that historical documentation gaps and changes in Medicaid or property transfers sometimes limit collection prospects. County staff described a multi‑pronged strategy: consolidating older batches of uncollectible accounts, improving front‑end Medicaid screening for new admissions, working with Merrimack County's business office for Medicaid policy education, and evaluating a commercial asset‑search service (a vendor that charges approximately $80 per search) to detect transfers in-look‑back periods.
Liens and collection: Commissioners asked about liens on real estate and collection prospects. Staff said liens remain on records and, in some cases, may be paid when property transacts, but practical and legal barriers — for example, homestead protections or joint tenancy with rights of survivorship — can delay or limit collection. Staff noted occasional recoveries years after filing a lien but said many liens remain unlikely to result in near‑term collections.
Revenue‑cycle management (RCM): County leaders reported a new RCM effort to clean the books and change practices to reduce future write‑offs. Staff emphasized that improved intake workflows, earlier Medicaid determinations, and targeted follow‑up should reduce aged receivables over time.
Ending: The board approved the recommended write‑offs and asked staff to continue RCM efforts and return with updates and projections.
