Strafford County's new nursing home plan takes shape: Will it be approved in time?

DOVER — Strafford County leaders are hopeful the county's delegation of state representatives will approve scaled-back plans for a $146 million new nursing home on County Farm Road.

Last year, the delegation rejected plans for a $170 million nursing home project, with some calling it too ambitious and costly.

"We have given them everything they asked for, everything they said they wanted to see," county commissioner Bob Watson said Thursday of the new plan.

"We worked really hard to accommodate their thoughts," said County Administrator Ray Bower. "We are trying to do this without impacting the integrity of what we are trying to accomplish."

If the new nursing home moves forward, county leaders hope to convert the existing Riverside Rest Home, also on County Farm Road in Dover, into transitional housing, to help address the needs of the county's homeless population.

What the new nursing home would include

The plan calls for a single five-story building with 285,000 square feet of space and 215 beds. A nursing station would be located at the center of each floor.

"Each wing is capable of various uses," said Jonathan Halle of Warrenstreet, the Concord-based architects for the project. "It can be regular care, dementia, young adults, geropsych, whatever is the need and that can be adjusted."

Strafford County Commission Chair George Maglaras has touted the plan's "Main Street concept." The front area of the first floor would include a lobby, chapel, community/meeting room, barber, post office, clothing boutique and a café in an atrium-style area open up to the fifth floor.

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Support services, like dietary, housekeeping, receiving and the necessary mechanicals, would be at the rear of the property. Two elevators, a public one in the front of the building and a service elevator in the rear, are included. Administration, including social services and infection control, would be on the second floor. Admission services would be in the front of the first floor.

How the nursing home could be funded

The estimated $146 million cost for the new version of the project includes the building, grounds, furniture, fixtures and equipment. Commissioners are working on ways to reduce the impact to taxpayers, including no tax impact for the first year.

The county is still within the timeframe to use $15.6 million in federal American Rescue Plan Act funds to help with some of the cost, which would come from via the state of New Hampshire.

"We have applied for the money and to make sure we get it, we need to have the plan and spend it by December 2025," Bower said.

Bower said the plan is rather than one bond to fund the remainder of the project, to do a series of smaller bonds, in increments.

Former NH health commissioner working on county nursing home project

Bower said the county hired Lori Shibinette, who was the commissioner of the state Department of Health and Human Services during the coronavirus pandemic. She is helping develop plans for the project. A registered nurse, Shibinette previously was the chief executive officer of the Merrimack County Nursing Home, where she also had served as clinical director.

Bower said Shibinette created a three-year plan, showing the time needed to get the new facility up to full-capacity operations.

"In year one, we want to make sure the (bond anticipation note) does not impact taxes," he said. "In year two, we think we'd break even and in year three, we should begin to show profit. It's a very achievable goal."

A report detailing revenue projections for the new nursing home notes how limitations at the Riverside Rest Home affect the county's ability to open up new beds and attract and retain qualified staff.

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The report indicates the number of patients is down, because of space limitations and programs the staff cannot run at the current location but would with a new facility. They project a return of nearly 74% of population in year one in a new nursing home, nearly 84% in year two and a return to almost 100% by year three.

The report states Riverside is qualified to participate in Medicare Part A program but has had to limit participation, also because of a lack of space in the facility. A new facility would allow the county to offer Medicare Part A to all qualified patients.

When could a new nursing home be approved and built?

Maglaras said he feels if county leaders can show the effort to limit impact on taxes, he believes it might help sway the delegation, which consists of all the members of the New Hampshire House from Strafford County.

On Thursday, Bower presented a timeline for the project, which includes getting the $15.6 million in federal funds allocated from the state.

If all went well, with a successful delegation vote, construction could begin on the new facility in late summer 2024.

Bower said to achieve that, the delegation vote would need to be held by mid-December of this year, which would kickstart the final design and permitting processes.

Bower said they have reassembled the building committee, comprising members of the county delegation: Rep. Daniel Fitzpatrick, D-Strafford, chair; Rep. Chuck Grassie D-Rochester, vice chair; Rep. David A. Bickford, R-Strafford, Rep. Allan Howland, D-Strafford, Rep. Jessica LaMontagne, D-Strafford, Rep. Clifford Newton, R-Strafford, and Rep. Joe Pitre, R-Farmington.

After rejecting a $150 million bond for the project last year, the delegation authorized spending more than $6 million for the planning and design of the less expensive alternative.

This article originally appeared on Fosters Daily Democrat: Strafford County NH new nursing home plan seeks approval again