12-12-23
\nTo: Strafford County Commissioners
\n Strafford County Administrator<\/p>\n
Re: Nursing Home Proposals<\/p>\n
Commissioners and Administrator Bower,<\/p>\n
Since the onset of your push for a new nursing home, we have consistently discussed in public
\nhearings, as well as written communications, our desire for clarity and transparency of
\nprocess. To date, however, perception and reality have been the opposite. Your actions have
\nbeen clandestine and secretive, eliminating any trust that existed. In the following
\ncommunication, we hope to once again relay our concerns and opposition to any nursing
\nfacility absent a well-informed delegation and a well-developed plan that requires due diligence
\nby all involved. <\/p>\n
Transparency, Clarity and Trust<\/strong> <\/p>\n Let us begin with transparency, clarity, and trust issues. Many of us are keenly aware that For those that were present, recall at the first presentation put upon us, Commissioner The delegation later learned that the original iteration had to be scrapped, as it had been Next, most of the delegation learned of \u201cTaj Majal 2.0\u201d, not by a pre-briefing by the Finally, a recent query of Jonathan Hale (Warrenstreet) that Rep Turcotte sent only to him, Furthermore, recall that it is alleged the bidding timeframe for architects for this massive and Cost Estimates<\/strong><\/p>\n The costs shown on the various paperwork for the current proposal (Taj 2.0) we have received At $560+ per square foot (not including mechanical and bond interest), how is it that the cost Location 2019 2020 2021 2022 2023 Furthermore, the proposed nursing home costs more than private high-end LifeCare senior \u201cMid-level assisted living costs between $263 and $335 while high-level AL costs between $344 and [Above quote from article: Senior Living Industry Could See Construction Slow Further in 2023 For perspective, at the low-end construction estimate of $165M, each of the 215 units Next, the design is extremely inefficient when you consider the costs of heating and cooling, as Then we have a daycare facility? An enclosed atrium? Stores? What will be the added costs When discussing the design, solar, and heat\/cooling system, Warrenstreet mentioned \u201cif the Warrenstreet mentioned that they believe costs will be increasing another 20% soon. We \u201cBut, as the construction market is expected to contract, the Weitz report also showed that inflation [Above quote from article: Senior Living Industry Could See Construction Slow Further in 2023 It has been mentioned over and over, but it needs repeating. County nursing homes are Revenue Estimates <\/strong><\/p>\n When the final tally is done, will Lori Shibinette’s estimated revenue calculations be valid, or Estimates of 94% occupancy appear unreasonable and extremely unlikely since the population Bower recently made the plea that we need to be able to keep residents at the facility after an Options and the Path Forward <\/strong><\/p>\n From day one, the Commissioners have attempted to push a single, solitary proposal on the When asked about an addition to the existing home, followed by renovation of the current Conclusion<\/strong> <\/p>\n While some sort of nursing home improvements may be necessary, it would appear that the As fiduciaries for the taxpayers in Strafford County, we should not be looking to compete with Sincerely,<\/p>\n Representative Claudine Burnham – Milton 12-12-23 To: Strafford County Commissioners Strafford County Administrator Re: Nursing Home Proposals Commissioners and Administrator Bower, Since the onset of your push for a new nursing home, we have consistently discussed in public hearings, as well as written communications, our desire for clarity and transparency of process. To date, however, perception and reality have been […]<\/p>\n","protected":false},"author":2,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_et_pb_use_builder":"","_et_pb_old_content":"","_et_gb_content_width":"","footnotes":""},"categories":[1],"tags":[],"class_list":["post-764","post","type-post","status-publish","format-standard","hentry","category-newspage"],"_links":{"self":[{"href":"https:\/\/lenturcotte.org\/lt\/wp-json\/wp\/v2\/posts\/764","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/lenturcotte.org\/lt\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/lenturcotte.org\/lt\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/lenturcotte.org\/lt\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/lenturcotte.org\/lt\/wp-json\/wp\/v2\/comments?post=764"}],"version-history":[{"count":1,"href":"https:\/\/lenturcotte.org\/lt\/wp-json\/wp\/v2\/posts\/764\/revisions"}],"predecessor-version":[{"id":765,"href":"https:\/\/lenturcotte.org\/lt\/wp-json\/wp\/v2\/posts\/764\/revisions\/765"}],"wp:attachment":[{"href":"https:\/\/lenturcotte.org\/lt\/wp-json\/wp\/v2\/media?parent=764"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/lenturcotte.org\/lt\/wp-json\/wp\/v2\/categories?post=764"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/lenturcotte.org\/lt\/wp-json\/wp\/v2\/tags?post=764"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}
\ntransparency has been negligible to non-existent. The original nursing home that we deemed
\nthe \u201cTaj Majal\u201d was thrust upon us without even a hint or a previous heads-up. You then
\nattempted to pressure the delegation into an artificial timeline based on the threat of \u201cwe will
\nlose federal dollars\u201d, and we are once again witnessing that same argument\/tactic being
\nutilized. Fortunately, conservative arguments prevailed and the delegation was able to pause
\nthe coordinated rush of the first nursing home and stop the full-scale bonding.<\/p>\n
\nMaglaras and the several from the Democrat caucus begged us to \u201dtrust\u201d and \u201chave faith\u201d in
\nthe commissioners and the administrator. During this presentation, Maglaras stated (in
\nreference to the nursing home proposal) \u201cthis has never been done in New Hampshire,
\nprobably not in the United States, I got the idea from Europe\u201d. The original \u201cTaj Mahal\u201d was
\nproposed at a cost of $170 million. <\/p>\n
\nproposed on a site that was had not been properly vetted or assessed for things such as
\nwetlands or Indian artifacts. The fact that Warrenstreet, the Commissioners and Administrator
\nBower hadn’t known the property was ill-suited (a simple site walk should have highlighted the
\nwetlands), yet started and proposed a design estimated at $170+ along with the associated
\ncosts to date, shows incompetence by all involved. So far, our county\u2019s citizens are $500K in
\nthe hole, the money taken from \u201ccounty funds\u201d without delegation approval. It is our belief that
\nthe commissioners have gotten used to decades of the rubber-stamping of their budgets and
\nactions by a majority Democrat delegation and assume the current delegation would approve
\nhuge bonding and let this unauthorized spending go unchallenged.<\/p>\n
\nAdministrator or Commissioners, but rather in the newspapers. Again, no forewarning, no
\ndiscussion, no transparency.<\/p>\n
\ncame back with cc:s to Maglaras and Bower. When Rep Turcotte asked him if he had
\nconferred with them prior to answering his questions, he said no, but that \u201cI let them know by
\nemail that I received your questions and they gave me permission to respond to you\u201d. Why
\nwas permission to respond to a delegation member required or believed to be required? This
\ndoes not come across as being transparent, rather the opposite, as it appears as a
\ncoordinated operation that limits transparency. <\/p>\n
\nexpensive project was but a couple weeks, hardly time for any firm to produce a rational bid.
\nDue to our concerns, it would appear Warrenstreet may have been pre-selected ahead of time.<\/p>\n
\nranges from $130M to $165M (recent meeting now has costs at $170 million again). When
\ninterest on bonds is included, Strafford County citizens are being asked to build a $300 million
\nfacility. We can also assume that these figures do not include mechanical heating\/cooling
\ncosts, potential solar panel installations which probably gets the construction costs over
\n$200M. <\/p>\n
\nfor a nursing home in Strafford County NH is more than the cost of a new hospital in downtown
\nBoston (see chart of hospital costs throughout the USA below)? <\/p>\n
\nNational
\nAverage $362.69 $371.48 $382.12 $400.11 $419.18
\nNew
\nYork, NY $484.88 $494.19 $506.94 $523.11 $540.45
\nChicago,
\nIL $436.50 $444.21 $456.40 $474.03 $494.76
\nBoston,
\nMA $414.67 $427.46 $433.44 $454.36 $479.38
\nLos
\nAngeles,
\nCA
\n$409.55 $419.04 $430.83 $452.05 $475.20
\nAnn
\nArbor,
\nMI
\n$362.97 $369.02 $382.83 $396.83 $409.43
\nOmaha,
\nNE $330.20 $340.43 $352.74 $363.59 $383.59
\nDenver,
\nCO $323.44 $333.80 $345.51 $362.23 $378.97
\nAtlanta,
\nGA $322.76 $329.05 $342.71 $359.46 $375.52
\nPhoenix,
\nAR $320.55 $327.81 $332.73 $351.97 $373.71<\/p>\n
\ncommunities by a whopping $150-$200 per square foot. Like the proposed nursing home,
\nthese communities have independent living, assistant living, memory care, etc.<\/p>\n
\n$429 per gross square foot, according to the report. That\u2019s compared with a mid-level range of $226
\nand $304 and a high-level range of $297 and $369 last year.\u201d<\/p>\n
\nBy Nick Andrews | April 7, 2023]<\/em> <\/p>\n
\nproposed would cost $767,000 each. You could build 470 homes costing $350,000 each for
\nthe same amount of money. <\/p>\n
\nwell as initial construction costs. While it MAY be efficient for nursing staff, these inefficiency
\ncosts need to be calculated. <\/p>\n
\nof these unnecessary employees? What would construction costs be absent these unneeded
\n\u201cextras\u201d? <\/p>\n
\ndesire is to be green\u201d. When constructing or remodeling any new structures, the county\u2019s
\n\u201cdesire\u201d should be to do so based on lowest overall costs to the citizens of our county, not on a
\ndesire to \u201cbe green\u201d. As a representative mentioned, natural gas exists on our county complex
\nalready. <\/p>\n
\nbelieve that, however, to be another pressure tactic. We, buttressed by others, believe that we
\nare in a unique inflation bubble brought on by Covid (chain of supply issues, supply\/demand
\nissues, and hundreds of billions of dollars being tossed around by Fed\u2019s for all sorts of building
\nand construction). The following mirrors our thoughts:<\/p>\n
\non building material could level off in the next three years. The cost of asphalt paving, reinforcement
\nbars, fabricated pipe, sheet-metal, structural steel, plywood and lumber are expected to see negative
\ncost growth as soon as this year.\u201d <\/p>\n
\nBy Nick Andrews | April 7, 2023]<\/em> <\/p>\n
\nsupposed to be for the indigent population of Strafford County, not competition for high end
\nprivate Continual Care communities.<\/p>\n
\nend up putting the county’s taxpayers on the hook for huge annual losses? In her presentation,
\ncalculations were based on $130M in construction costs. Since that presentation, projected
\ncosts have jumped conservatively by $35 – $40 million. Add in the contingencies, solar
\ninstallations and a geothermal installation, the optimistic revenues portend annual losses
\ncounty taxpayers will have to fund. <\/p>\n
\nrates at the nursing home had been in a steady decline even before Covid hit.
\nShibinette also assumes we will somehow attract private payer residents at $450 per day (that
\nis $164K per year) and Maglaras at our recent meeting predicts reimbursement rates of $600
\nper day ($18,000 per month, $216,000 per year). Private payers can find a LifeCare facility
\ncurrently for $100K or less per year. A Strafford County Nursing home is not supposed to
\nmirror private, high-end communities. Like it or not, private payers will not be looking to live in
\na county nursing home meant for an indigent population. A belief that \u201cif we build it they will
\ncome\u201d is outside of the realm of possibility. <\/p>\n
\ninjury or issue normally requiring hospitalization as a reason for a new facility. When asked,
\nBower stated 15-20 residents a year normally utilize temporary, outside hospital or
\nrecuperative care for an average of 6 weeks. Doing the math, that equates to an equivalent of
\n2 residents annually, or less than 1% of a fully-occupied nursing home population, hardly a
\nnumber that will make or break the current nursing home facility.<\/p>\n
\ndelegation. A \u201cgrand-plan\u201d, high-end facility based on a mythical European model that brings
\nwith it a price tag of nearly $200 million not including interest on bonds.
\nWhen delegation members have asked about renovating the existing facility, the question is
\nbrushed away with a response of \u201cthat won\u2019t work, we looked at it\u201d. But as of yet, we have not
\nseen anything to support that statement. In fact, problems such as alleged asbestos and
\ncaulking around windows has been used as an excuse as to why a renovation cannot be done
\nand a completely new facility is needed, yet the current nursing home has previously been
\nproposed as a homeless facility without any renovation, part of a yet bigger \u201cthree-legged
\nstool\u201d plan. <\/p>\n
\nfacility, that receives the same type of answer. Sullivan County, after years of exploring options
\n(which we have not done in Strafford County), utilized this exact strategy. We are told to
\nexplore this option, \u201cit would require delegation approval for funding\u201d. Yet to date, the
\ndelegation has approved none of the funding of the $500,000 that the commissioners and the
\nadministrator have poured into their desired project to date.<\/p>\n
\ncommissioners, the county administrator and Warrenstreet have no desire to pursue any
\noptions other than their \u201cTaj Mahal\u201d projects. As mentioned above, transparency has been
\nsomewhere between severely lacking and absent.<\/p>\n
\nhigh-end private-payer facilities and we should not be placing huge bonding debt onto our
\ntaxpayers that revenues will be unable to support without taxpayer subsidies. There is an
\nexcessive amount of money to be spread around to multiple businesses with the building of a
\nnew facility, but that exorbitant amount of dollars comes from the county\u2019s taxpayers. As the
\nproponents of this excessive endeavor, the commissioners and administration must perform
\ntheir \u201cdue diligence\u201d. As a delegation, we must also. As of yet, that has not been sufficiently
\ndone.<\/p>\n
\nRepresentative Cliff Newton – Rochester
\nRepresentative Kelley Potenza – Rochester
\nRepresentative Len Turcotte \u2013 Barrington\/Strafford<\/p>\n","protected":false},"excerpt":{"rendered":"