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Column: Input sought on Sullivan County nursing home renovation

  • Sullivan County officials are considering a $49.5 million renovation for the county's nursing home in Unity. (Courtesy Sullivan County)

Published: 9/18/2020 10:10:14 PM
Modified: 9/18/2020 10:10:02 PM

The Sullivan County Delegation, made up of state representatives from Sullivan County, met on Aug. 11 for a presentation from County Manager Derek Ferland and Facilities Manager Mary Bourque regarding the guaranteed maximum price and bids for the renovation project for the Sullivan County Health Care Facility in Unity.

The delegation met a second time on Sept. 14 for a hybrid public hearing on the issue in the Newport Courthouse, with Zoom and telephone access for public participation. The presentations can be found on the Sullivan County website, www.sullivancountynh.gov (type “renovation” in the search line). Please take some time to review them to see the details and options being considered.

Here is a brief summary of the project and the alternatives available:

Complete renovation of county nursing home to quality and code upgrades.

This plan for renovation, which has been in the works for the past year, was originally estimated at about $35 million. It included demolishing the Sanders wing (built in 1931), and updating to code and renovating the remaining buildings (Stearns and MacConnell). But it has finally come in at a quote of $49.5 million, on a 90-day bid price guarantee that is soon to time-out.

There are many factors that contribute to this enormous construction cost, a lot of which involve code and occupancy requirements (space per patient, additional fireproofing and bariatric-designed rooms, etc.). Demolishing the outdated Sanders wing and building a new wing in its place, plus renovating existing buildings, would take 36 months to complete. The disruption and inconvenience to patients and staff caused by sectionalized construction could affect the resident census numbers. Also affecting the outcome may be higher labor and material costs of construction as a result of the COVID-19 pandemic. In fact, some contractors declined to bid on this project due to the long construction schedule.

This proposal would be funded by money we have saved in our capital reserve fund ($4.5 million), a $45 million, 29-year bond issue at very low market rates, and some increased county taxes, between 22 cents and 40 cents per $1,000 of assessed value. The average county tax rate would range upward from $2.57 to $2.97 per $1,000 (with tax rates varying by municipality affecting 2022 budgets).

In addition to the semi-private rooms with two instead of four occupant beds, the renovated facility would feature an added physical therapy rehab floor that would generate additional revenues.

Plans have already been drawn up for this proposal and the bonding hearing held on Sept. 14, so the next step is at hand for decision by the county delegation to approve or reject the bond critical for the project to move forward. This must be decided by Sept. 28, according to statute. However, there is also some public feedback that $50 million is too much for that renovation when new construction might be a better choice for a state-of-the-art facility with a longer and better quality functional life span.

Here are the optional plans for consideration:

Continue operating the current facility.

The “null” or “do nothing” alternative implies ascending maintenance needs and increasing costs, attended by frequency of problems and repairs with 50-year-old plumbing, heating and electrical systems for a structure that’s already two building code versions behind.

Adverse residency impacts and emergency repair situations commensurate with age and condition might also put state licensure at risk. An older facility is also less attractive for retention and growth of the resident population.

Get out of the health care business altogether.

A possible but chilling prospect, this option comes with the complete shutdown of the community nursing home, sending our resident families and friends to distant facilities, the loss of some 200 jobs, and the costs of decommission, sale or demolition of the remaining building, and we would still be obligated to the state for our county share of statewide human services costs of $5.2 million.

Such a loss to the county and its communities would be a severe blow to our growth, cohesion and self-esteem. At this point we have heard no voices for this option.

Proceed with a more frugal, limited renovation project.

Setting a budget cap for X amount involves another extensive and expensive project redesign that amounts to a “cutting corners” approach, which would mean fewer beds than the 156 authorized and lesser quality renovation overall. The county has already spent more than $1 million in engineering evaluations and architectural design and planning, so we’d have to redo all that at additional expense.

This option does not enable growth for the future and is counter to the trend that shows more demand for better facilities represented by our aging baby boomer population and generations to follow. A marginal improvement still does not provide a satisfactory life span extension for the facility, and a less-attractive rendering may draw fewer for private residency and more at lower Medicaid rates.

Build a totally new nursing home facility.

It is estimated that a new facility would cost $50 million to $60 million, a more firm projection than the current renovation project of $50 million, which might very well increase from construction, labor and material cost overruns to approach the build-new option.

The construction phase for a new facility, at 18 months, would be shorter than the 36-month renovation timeline, and there would be zero disruption to residents as operation of the current facility would continue during that period. The savings here comes from building on county land, also in Unity, instead of property acquisition and utility development costs, and having the county biomass facility for heat generation instead of a standalone heating plant.

A peripheral consideration is that the project would be held back a year while new plans were drawn up, and that gives us time to emerge from the COVID-19 situation for more solid budgets thereafter.

There are also thoughts to sell the vacated facility to an assisted living operator, which would provide a complimentary companion facility for senior services.

Some overall public feedback thus far seemed to favor a new building over renovation due to the concerns that the pandemic may tend to drive up costs, as well as a building materials crunch caused by the western wildfires and Gulf hurricanes.

As your state representatives, we solicit your input now to make the right decision for our county and communities. Again, our decision deadline is Sept. 28. Sullivan County residents, please let us know your preferences as soon as possible, and if you have any questions. A full description of the project is available on the Sullivan County website, or call the Sullivan County administration in Newport at 603-863-2560.

Rep. Judy Aron, of Acworth, can be reached at Judy.Aron@leg.state.nh.us and 603-843-5908. Rep. Walter Stapleton, of Claremont, can be reached at Walt.Stapleton@leg.state.nh.us and 603-995-1034.

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