Veterans Home asks lawmakers for staff funding as census, waitlist grow

Kim McKay, commandant of the New Hampshire Veterans Home, told the House Finance Division III on March 14 that the facility has reduced its admission waitlist but continues to struggle with staffing and rising prescription costs.

McKay opened by saying the home is licensed for 250 beds and budgeted for 225. Today the facility’s census is 35 residents with four more scheduled to arrive; another 36 applicants are in process. She said improved admissions casework has cut the typical application-to-admission wait from more than a year to about three to six months from the date an application is submitted.

Division members pressed McKay on staffing. She said the home deliberately holds some positions empty until census increases are warranted but that nursing and licensed nursing assistant (LNA) vacancies remain the priority. The home’s overall vacancy rate was described as about 35 percent; McKay said she deliberately holds positions such as housekeeping and laundry vacant until neighborhoods reopen. She said contracted nurses and overtime are used to cover shortfalls, especially on second shift, and that second-shift pay differentials are $4 an hour for nurses and $1.60 for LNAs, with a larger third-shift premium.

Jennifer Doyeg, chief financial officer for the Veterans Home, told lawmakers the budget is a rolled-up summary of the home’s entire request. Committee members asked about prescription drug spending; McKay said the facility contracts pharmacy services and bills the VA for medications related to service-connected disabilities, bringing in roughly $30,000 a month from VA reimbursements now. She said the home is participating in VA “catastrophic disability” applications that could make more medications fully reimbursable, and that national advocacy for an exemption that would let state veterans homes bill the VA directly for high-cost drugs is underway.

The commandant described two other funding streams: federal VA per-diem reimbursement (a portion of overall funding) and a dedicated donations/benefit fund used to pay for resident amenities such as cable television and holiday gifts. McKay said donations are overseen by the home’s board of managers and fiscal controls at the state level and are transferred into state accounts before spending. Lawmakers discussed a provision the home wants restored in HB 2 that would allow limited transfers between line classes for operational flexibility; members expressed concern about incentives to “inflate” one line to move money later and asked for tighter drafting or additional safeguards.

Lawmakers also asked about recruitment and retention programs; McKay described a new electronic learning-management system that will deliver required trainings and CEU credits, and said the home is pursuing outreach to community colleges, workforce portals and hiring fairs. She said retention — not only recruitment — is a central problem, with exit interviews showing staff leave for higher pay, sign-on bonuses, or more flexible schedules in the private sector.

Committee members asked for follow-up documents, including page references for budget lines discussed and further detail on gift/donation fund balances and transfer authority. McKay invited members to visit the campus and noted improvements such as new resident Wi‑Fi and conference-room video capability to support family participation in care-plan meetings.

The Veterans Home presentation elicited a series of operational follow-ups rather than any formal votes. Members noted they want clearer statutory or budget language for transfer authority, and several members urged the home and the department to develop specific, fundable retention incentives that could be evaluated during the budget process.

Ending: Committee staff will follow up on the home’s requested transfer authority language and on prescription-drug reimbursement questions; McKay said she will provide requested page citations and documentation to committee staff.