Sullivan County budget rises 6 percent as nursing costs climb

Sullivan County’s proposed $44.7 million budget puts the county’s nursing-home bill at the center of the tax debate. Spending would rise about 6 percent, driven by debt service, personnel costs, health insurance and a $3.8 million agency nursing line item. County delegates took the plan to a public hearing in Newport, where the cost of county-run care was front and center.

Sullivan County Health Care in Unity is owned by the county’s citizens and operated by the county commissioners to provide residential nursing care. The facility is Medicaid licensed for 156 beds as an Intermediate Care Facility and is also a Medicare-approved Skilled Nursing Facility, which makes staffing, insurance and nursing coverage central budget items rather than background expenses.

The county’s fiscal year runs from July 1 to June 30, and the County Delegation reviews the commissioners’ budget before voting the funds. That made the June 11 hearing at the State Court House Complex, 14 Main Street in Newport, a key checkpoint in the process. Commissioners are scheduled to meet again June 15 at 3 p.m. at Sullivan County Health Care in Unity, where the next round of budget discussion will show how much room remains to absorb the rising care costs without putting more pressure on taxpayers.

The spending debate comes as Sullivan County continues to finance a major overhaul of the Unity campus. County officials say the renovation and revitalization of Sullivan County Health Care is the largest Capital Improvement Plan project the county has undertaken, a $75 million effort. Forty-five percent of the project is funded by forgivable loans or awards from the State of New Hampshire and the federal government, and the county has authorized bonds up to $35 million for the rest.

A 2021 project presentation described the renovated facility as a 156-bed design with 148 beds in operation, underscoring how closely capacity decisions, staffing levels and budget choices are tied together. For county leaders, the immediate question is how to keep long-term care stable while covering a heavier operating bill, protecting other county priorities and limiting the hit to local taxpayers.