A county-owned nursing home was fined more than $150,000 by the Centers for Medicare & Medicaid Services after allowing a staff member who tested positive for COVID to return to work before their required quarantine period ended, according to a government official who voted to approve payment.

The fine dates to early May, but it became public only when a delegation from Carroll County, NH, this week agreed to transfer $101,000 so Mountain View Community could pay the lower fee associated with waiving an appeal.

At a meeting Monday, County Commissioner Matthew Plache (R) told a group of state representatives who oversee the local budget that the facility had been fined when an employee who had COVID returned to work after five days instead of 10. Plache blamed a change in COVID-era rules for confusion that led to the fine, and the penalty was issued after an anonymous complaint.

On Wednesday, Brendan Williams, president and CEO of the New Hampshire Health Care Association, told McKnight’s Long-Term Care News it makes “no sense” that the Center for Disease Control and Prevention’s 5-day quarantine guidance for a person with asymptomatic COVID-19 doesn’t apply to healthcare workers.

Plache said the asymptomatic employee worked the third shift and encountered three residents, the Conway Daily Sun reported.

“None of the residents ended up getting COVID from this person,” Plache said in a local media account. “Nobody was hurt. Because this person worked, there was a problem noted and we ended up in CMS, getting a $155,000 penalty.”

Ultimately, the state delegation voted 13-0 to transfer $101,092 from the nursing home’s salary account to its legal account to pay the CMS fine. The 103-bed facility is already struggling with staffing, falling below state averages for its overall, RN, LPN, and CNS hours per resident day.

“The government objectively underfunds nursing home care and then it further subtracts punitive fines from its underfunding to compel perfection. This is the very definition of lunacy,” Williams said. ”We are facing one of the nation’s sixth-worst nursing home staffing shortages, and yet now this county-owned facility has fewer staffing resources. Must it now raise property taxes as a consequence of a mistake, or just turn away even more discharge-ready hospital patients?”

It’s unclear exactly when in the pandemic the incident occurred. Care Compare shows the 4-star facility had no infection control inspection citations in the last three years. It also has had no listed complaint inspections since before May 2022. The facility’s last regular health inspection in September 2022 led to four citations not related to COVID concerns.