New Staffing Standards Could Reduce Capacity in New Hampshire Nursing Homes

The staffing mandate could significantly reduce the number of available nursing home beds in New Hampshire, according to reporting in the Concord Monitor.

The regulations are causing concern among local nursing home administrators.

“The impact of the rules could be that we close more beds,” Kathryn Kindopp, administrator of Maplewood Nursing Home in Westmoreland, told the Monitor. Currently, 40 out of Maplewood’s 150 beds are not in use due to staffing shortages.


According to national analysis by the American Health Care Association, long-term care facilities will need to hire about 100,000 additional staff members nationwide. In New Hampshire, the shortage of healthcare staff is particularly severe due to high demand, a limited supply of new graduates, and pandemic-related retirements.

“On any given day, if we had a nurse call out we wouldn’t be meeting that threshold,” nursing home administrator David Ross told the Monitor, adding that his facility, Hillsborough County Nursing Home, already has 50 out of 300 beds out of service because of staffing shortages.

Brendan Williams, president and CEO of the New Hampshire Health Care Association, said the mandate is likely to increase facilities’ reliance on contract workers, which would come with higher costs and potential disruptions in resident care.


“It’s discomforting to the residents to have strangers by the bedside,” he told the Monitor.

In New Hampshire, the vacancy rate for registered nurse (RN) positions is 17%, significantly higher than the national average of 10%, creating a “marketplace of desperation and scarcity,” according to Williams.

Williams said he anticipates that these new rules will face legal challenges and notes that the extended timeline for rural facilities does not solve the fundamental issue of staff shortages.

In the meantime, Kindopp told the Monitor she is assessing new federal rules to see if Maplewood qualifies as a rural facility, which would grant them more time to comply with these requirements.

“We want to hire more high quality staff, but in the absence of the availability of these individuals, we focus on meeting the needs of our current residents and choose to admit — or not admit — based on their needs and our ability to meet those needs with our current staff,” she said.

The new rules also stipulate that a RN must be present in the building at all times, a significant increase from the previous requirement of eight hours per day.

“We used to have an RN in the building at all times, but in the past few years, we have struggled to hire RN’s for the overnight shift in particular,” Kindopp told the Monitor.