A nurse with money in their pocket
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New Hampshire nursing homes on average paid about 20% more in labor costs per day from 2019 to 2021 due in part to the ongoing workforce crisis, according to a new report. 

Data released Monday by the New Hampshire Health Care Association, in conjunction with regional accounting firm BerryDunn, revealed that average facility wages per patient day increased from $154 PPD in 2019 to $184 PPD in 2021 — a 19.53% increase. 

When including contract labor, total wages increased from $169 PPD in 2019 to $208 PPD in 2021 — a 23.66% increase. 

The American Health Care Association’s latest survey found that providers have seen their costs rise 41% over the last year. 

In New Hampshire, skilled nursing occupancy dropped 5.27% from 2019 to 2020, and a further decline of 3.34% from 2020 to 2021. Medicaid cost reports for providers in the state show average loss from patient care services increased from $25.24 PPD in 2019 to $33.13 in 2020, and $74.41 in 2021, the analysis also found. 

“Overall occupancy decline, increasing cost of labor, supplies and utilities, as well as increased cost of compliance, has led to acutely negative margins from resident care services,” BerryDunn principal Lisa Trundy-Whitten and senior manager Olga Gross-Balzano wrote in the report. “On average, facilities reported net losses from patient care services (excluding any COVID-19 funding) at over $62 PPD for 2022.” 

The findings support an earlier analysis that projected 55% of the state’s 73 licensed nursing homes to have operating margins below negative 7.5%, making them “facilities at financial risk.” Just 16% of the state’s nursing homes were categorized as being at risk in 2019, according to Brendan Williams, NHHCA president and CEO. 

“We are absolutely reeling from an unprecedented public health emergency, unchecked staffing agency price-gouging, and the worst cost inflation in 40 years,” Williams said in a statement Monday. “The state bolstered long-term care in 2020 and 2021 with CARES Act federal funds, and we pray it will provide one-time grant aid with its American Rescue Plan Act funds.”