With more than a football field of unused space inside the county complex in Boscawen, Merrimack County commissioners have a $50 million plan to renovate the McLeod Building, the site of the former nursing home, to create an expanded assisted living facility and memory care unit.

Given the state’s aging population, Merrimack County wants to come up with a longer-term solution for caring for its residents. The project would add 80 assisted living beds to the county, which currently has 33 beds and a 44-person waiting list. While carrying a hefty price tag, the renovations would be funded by a bond taken out by the county and paid back over the course of several decades.

“We know we have an aging population and that they need this help and support,” said County Commissioner Stephen Shurtleff. “These are the people that have supported our government, have supported our state for all their life. It is now our turn to help support them and give them what they need.”

Assisted living entails residents having trained professionals to manage their medication, provide meals, help with laundry, and offer medical care with staff present to assist with needs around the clock.

The McLeod Building, constructed in 1975, houses Gerrish Manor, the current assisted living facility, along with administrative services, a daycare, the sheriff’s department, and the Navigator Program. When the Merrimack County Nursing Home moved to a new building up the hill in 2008, the fourth and fifth floors of the McLeod building, which have about 64,200 square feet of space, were left empty and have remained that way ever since.

“The water and waste lines were failing, and it was constant maintenance, upkeep, and renovation,” said consulting architect Anthony Mento, who works for SMP Architecture. “It was all for things that were 50 years old. To just patch a little portion is fine, but the rest of the line is past its functional lifespan. If approved, we’re going to renovate the whole structure, systems, electric, data, building envelope.”

Rather than constructing a new building from scratch – a project at least double the price – Mento said the county would update the existing building, make the fourth and fifth floors suitable living spaces, fashion the exterior to evoke the a classic New Hampshire mountain hotel, and create a main entrance so all the building’s services can be accessed from the same starting place, also contributing to the facility’s safety.

The county finished renovating Gerrish Manor, housed on the third floor, in July and now wants to bring the upper floors to that caliber to meet the needs of more residents, according to nursing home administrator Heather Moquin. With the new 80 assisted living beds, the county would turn the third floor into a memory care unit and move existing and new residents to the fourth and fifth floors. The project’s proposed timeline would take place over the next two and a half years. 

“As we age, there’s a higher likelihood of having complications from dementia and having availability sooner could keep people more healthy and able to age in place in an assisted living, whereas right now, waiting in the community can be very difficult, very stressful for families,” Moquin said. “It would provide a great deal more safety and health to be able to age in place at a lower level of care that’s less expensive.”

The county will face a deficit of 503 assisted living facility beds by the year 2035 as a result of the “silver tsunami,” according to a study done for Merrimack County by independent consultant Steve Norton. The study also states that of the 640,000 housing units in New Hampshire, only 1.75%, or 11,200 units, fall into the category of affordable housing for the elderly.

The state’s elderly population needs more Medicaid-funded assisted living beds, Moquin said.

“About half of the residents at Gerrish Manor right now are Medicaid funded, and that’s a much higher percentage than any of the private institutions or facilities provide, because they can’t,” Moquin said. “They just can’t operate that way. We are very lucky with the infrastructure that we have at the county and the support that we can give that we’re able to do more of that, but for a private facility, they just can’t.”

County Commissioner Stuart Trachy said part of the county’s mission includes addressing the needs of the senior population.

“It’s probably the foremost issue, and I can’t think of a better way to follow up on the construction of what we consider the new nursing home, but it’s now 15 years old,” Trachy said. “We have the crown jewel of long-term care, and now what we’re looking at will probably be the crown jewel of assisted living. I think it’s something that people in Merrimack County deserve, and we should be proud of it.”

The expanded assisted living capacity of the county would also mean the creation of around three dozen new positions. Since the requirements for working in assisted living are entry-level, the Merrimack County Nursing Home runs a training program that allows people to obtain certification to work at higher levels of care.

“The whole thing ties into helping our elder care and then providing services and jobs,” Mento added.

On Friday, March 7, the county delegation will vote on the budget, including the proposal for the renovation of the McLeod Building.

Rachel Wachman can be reached at rwachman@cmonitor.com