Town‑run nursing home seeks staffing investments and aims to grow Medicare and private‑pay mix to shrink subsidy

Rob (presenter for Our Island Home) outlined operating and programmatic requests for the town‑owned nursing facility and described steps to improve staffing and revenue mix during a lengthy Finance Committee discussion on Feb. 2.

Rob said the department proposes several EIRs including a part‑time housekeeper, a part‑time administrative clerk to staff the front desk, additional certified nursing assistant (CNA) staffing and an $80,000 workforce development line to subsidize training in partnership with Upper Cape Tech and Mass Senior Care. "That $80,000 budgeted is for what we're calling a workforce development grant," he said, explaining the program could subsidize up to $20,000 per employee for as many as four trainees who would agree to a four‑year work commitment.

Rob said the facility is pursuing recruitment and retention incentives such as employee housing subsidies and a $72,000 travel/training budget. He described recent operational improvements: admissions rose in 2025 to 47 and the facility’s private‑pay revenue was increased in the approved 2026 schedule. On current finances he summarized, "it's approximately 5,000,000 in revenue, 10,000,000 in expense, give or take." The manager outlined an internal target mix — an average census of about 40 with a higher share of Medicare and private‑pay residents — that could materially reduce the town subsidy if achieved.

Committee members pressed on revenue detail, capital needs and the facility’s physical constraints. Rob said there is preapproved capital for windows and fire‑safety upgrades but that major expansion is likely infeasible without full renovation because code requirements trigger broader upgrades. He recommended pursuing a long‑term replacement building rather than piecemeal renovations. The committee scheduled further capital review ahead of town meeting and set a public hearing the next day.