Carroll County executive committee approves nursing home budget increases, several transfers

The Carroll County Delegation Executive Committee on Saturday approved adjustments to the county nursing home budget, signed off on multiple year-end line-item transfers and adopted a proposed county revenue total while hearing public comment about agency staffing costs.

The committee voted to raise the nursing-related budget lines — including an adjustment to the licensed nursing assistant (LNA) staffing line — and approved a final nursing-home request presented by staff. The committee also approved a consolidated revenue number for the county general fund plus nursing-home receipts and cleared a package of small transfers to close the fiscal year.

Why it matters: The nursing home budget and related staffing choices were the meeting’s longest and most detailed item. Committee members, administrators and a public commenter discussed the county’s growing reliance on agency (contract) nursing staff, the cost of that staffing and steps to increase in-house hires while containing overtime and agency premiums.

The session opened with public comment from Greg King of Wolfeboro, who pressed the delegation to track agency staffing costs at the nursing facility. “We have hit it now with probably $3,000,000,” King said, referencing cumulative agency spending he has tracked over recent years. King also commended the temporary contract CFO for assembling financials, saying, “I do wanna commend her for that.”

Committee members and staff explained the proposed changes. The nursing-home administrator told members the county expects roughly $2.86 million in agency-staff costs this year and said nursing salaries overall will remain roughly flat; savings were expected only as the county transitions to a new sole-provider contract that has negotiated lower hourly premiums. The administrator said the county had recently hired three new nursing staff and had three more scheduled for orientation.

Committee discussion also focused on facility maintenance and capital needs: building repairs, elevator work and sealcoating for parking lots. The facilities director said elevator upkeep was a major driver of the facilities increase — including about $42,000 in elevator repairs — and described a plan to use an existing capital-reserve account for necessary one-time repairs. Members discussed a proposed capital improvement committee and a multi-year plan for building upkeep.

Members also discussed larger capital funding tied to federal and county grants. Staff said a congressional earmark totaling $2 million had been sought to “advance the capacity of that kitchen” and to create “a municipal and community hub” at the nursing-home site; that funding had not yet been received and would require follow-up approvals, including from the governor and council for any purpose change to other grant funds. The committee discussed pairing that potential congressional funding with roughly $700,000 in other grants and $1.2 million in ARPA funds (for a combined match near $1.9 million) to add a laundry facility and other upgrades.

The committee approved a proposed county revenue figure (county general fund together with nursing-home receipts) that staff presented as the working revenue total for the budget process. Committee members also acknowledged an unusually large one-time increase in revenue the county recognized this year from sources such as Proshare and bed tax distributions; staff said they would consult auditors about how to book that revenue.

A separate procedural issue drew attention: commissioners’ personnel and compensation adjustments. Committee members noted a lack of clarity about whether compensation numbers had been discussed in a nonpublic commissioners’ meeting and whether the delegation had been provided unsealed minutes or a full listing of proposed salary changes. The executive committee agreed to hold some commissioner-related salary decisions for the full delegation later so that members could review staff-provided personnel and salary schedules before final votes.

Votes at a glance (selected) - Motion to accept adjustment to LNA line (final bottom-line number presented as 8,949,925 in committee materials). Motion made and seconded; roll-call: Representative Smith — yes; Representative Gugach — yes; Representative McAleer — yes; Chair (Representative Woodcock) — yes. Outcome: approved. - Motion to approve the nursing-home bottom-line request (staff presented final nursing-home request to committee). Motion made and seconded; roll-call: Representative Smith — yes; Representative Buco — yes; Representative McAleer — yes; Chair — yes. Outcome: approved. - Motion to approve consolidated county revenue figure of $15,089,662 (county general fund plus nursing-home receipts as presented). Motion passed on roll call: Representative Smith — yes; Representative Buco — yes; Representative McAleer — yes; Chair — yes. Outcome: approved. - Multiple year-end line-item transfers were approved to close the fiscal year, including transfer requests listed in the packet as 2024-22, 2024-23, 2024-24, 2024-25, 2024-26, 2024-27 and others. Where roll calls are recorded in the minutes, votes were affirmative (names recorded in roll calls included Representative Smith, Representative Buco, Representative McAleer and the chair). Outcome: approved (unless otherwise noted). - A proposed IT-related transfer to cover a $46,000 line-item was tabled for a subsequent meeting pending additional explanations and documentation; the motion to table passed. Outcome: tabled pending further information.

What members said: Committee Chair Representative Woodcock guided the meeting and pressed staff for clear year-end actuals and explanations of line movements. Administrator and finance staff repeatedly told members they would provide written actuals and follow-up detail — for example, the exact count of agency staff currently engaged and the December 31 year-end actual for the nursing charge.

What’s next: Staff said they would provide the committee with (1) a short series of weekly staffing counts for the nursing home, (2) audited guidance on how to book one-time revenue, and (3) a draft capital-improvement plan in spring to support targeted use of the capital-reserve funds. The full delegation will consider the remaining salary and commission-related questions at a later meeting after members receive the requested personnel and compensation detail.

Ending: Committee members closed the executive committee session after approving the listed transfers and budget adjustments and asked staff to circulate the follow-up documents they requested before the next delegation meeting.