Sullivan County Health Care, county-owned nursing home, serves 156 residents

Sullivan County Health Care sits at the center of one of the county’s most basic public responsibilities: making sure older adults and other residents who need long-term nursing support have a place to go without leaving Sullivan County. The home is owned by the citizens of Sullivan County and operated by the Sullivan County Commissioners, with its campus at 5 Nursing Home Drive in Unity. That makes it more than a care facility. It is a county service, a public payroll, and a long-term obligation that taxpayers have helped fund.

What the county home is, and why it still matters

The county’s services page identifies Sullivan County Health Care as a Medicaid-licensed home with 156 beds, certified by the New Hampshire Bureau of Health Facilities Administration. It is also described as an Intermediate Care Facility, or ICF, which places it in the part of the care continuum designed for people who need more support than assisted living or outpatient care can provide. In practical terms, that means the home is built to serve residents whose needs are ongoing and more medically involved, not just short-term or occasional.

That public role is why the facility shows up on multiple county pages, not just one. The county lists admissions, insurance, Medicare and Medicaid information, human resources, facilities operations, and a separate renovation project page. Those pieces matter because the home is not only a residence. It is also a managed public institution, with clinical care, billing, staffing, and building maintenance all tied together under county oversight.

What families pay, and how coverage fits in

The posted room rates make the economics plain. Sullivan County lists semi-private rooms at $400 per day and private rooms at $430 per day. The insurance page also says many Medicare residents carry supplemental coverage such as AARP or Blue Cross/Blue Shield, which is a reminder that payment for long-term care often combines public coverage, private supplements, and county billing.

For Medicare residents at Sullivan County Health Care, the county says a fee of $170.50 per day is charged for days 21 through 100. That detail matters because it shows how quickly the financial picture changes once a stay stretches beyond the early Medicare-covered period. Families moving through admissions have to navigate those layers at the same time they are dealing with the care needs of a parent, spouse, or relative.

The county’s setup makes the admissions office a first stop, but it also makes insurance coordination part of the work from the beginning. At a county-owned nursing home, health care and billing are not separate conversations. They happen side by side.

The renovation became a public bill, not just a building project

The biggest recent change is the renovation. By the county’s February 2023 newsletter, the addition and renovation project had officially started construction near the end of 2022 and carried an overall budget of $75 million. The plan includes a new 80,000-square-foot addition, a total renovation of the existing Stearns building, an aesthetic refresh of the MacConnell building, and replacement of aging utilities and site infrastructure.

That scale explains why the project took years to settle. A county nursing home update says the Sullivan County Delegation received an estimated cost of just under $39 million in March 2019 after a preliminary study. By July 2020, after revisions to meet new federal building standards, the project was put out to bid and the cost had grown substantially. The jump from that earlier estimate to the later $75 million budget shows how much the county’s plans expanded before construction finally began.

The public financing turned the renovation into a tax and accountability issue. In August 2022, the Sullivan County Delegation approved about $26 million for the project, and Governor and Council later approved $25,200,000 for the Sullivan County Nursing Home renovation. WCAX described the bipartisan plan as one that would raise taxes across the board, while New Hampshire Public Radio said county lawmakers approved the work after four years of contentious debate. That is the hard edge of public ownership: when the home needs major work, the cost lands in the public arena.

What the renovation changes for residents and staff

The concrete benefit of the project is not abstract. It is a larger and newer campus that tries to catch up with the age of the buildings and the infrastructure behind them. The new addition, the renovated Stearns building, the refreshed MacConnell building, and the utility and site work are all aimed at keeping the home functional for the next phase of county care.

By 2025, residents had moved into the new addition, and a Valley News report said the changes improved their quality of life. That is the clearest measure of whether the project is working: not just whether walls went up, but whether the people living there felt the difference in their day-to-day experience. For families, that means a home that looks and feels less worn down. For employees, it means working in a facility the county has chosen to keep modernized instead of letting it age in place.

If the work had stalled, the county would have kept pushing the same aging utilities, the same older building stock, and the same public costs without the benefit of the new space. The fact that the estimate had already climbed from just under $39 million in 2019 to a $75 million program by 2023 shows how much timing mattered.

Where oversight sits now

Oversight for a public nursing home does not end when the money is approved. The Sullivan County Commissioners hold regular business meetings twice a month, typically on the first and third Monday, which is where county business, including major public assets like the nursing home, stays on the public calendar. The commissioners’ office is listed at 1100 County Offices, 5 Nursing Home Dr., Unity, NH 03743, on the same road as the nursing home itself.

That proximity captures the whole arrangement. Sullivan County Health Care is a residence, a health facility, and a county responsibility all in one place. With 156 Medicaid-licensed beds, a $75 million renovation, and a financing trail that ran through county lawmakers and state approval, it remains one of the clearest examples of how local government can shape care in Unity and across Sullivan County.