Local nursing‑home proposes subsidized short‑term housing to recruit staff and cut costly travel contracts
May 20, 2026 | Madison County , Montana
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Madison Valley Manor (the county’s long‑term care facility) presented a staffing proposal during the budget workshop to reduce its reliance on expensive traveling contract nurses and aides.
The director described significant up-front costs for contract staff: “We are spending an average of $3,500 per RN contract prior to them even starting, $3,100 per LPN, and about $2,000 per CNA,” she told the commissioners, citing training and competency expenses. To make in‑county hiring more attractive, the director proposed a lodging program that would charge incoming staff a modest daily rent (her example: $15–$20 per day) for short-term stays while they transition to core employment with the county. The plan would operate outside payroll (treated as lodging revenue to offset facility housing costs) so it does not increase workers’ compensation premiums, staff said.
Why it matters: Long-term reliance on traveling nurses has grown county health-care costs and reduced continuity of care. The lodging-subsidy idea aims to convert contract workers into county employees at lower total cost by removing the barrier of moving or temporary lodging expenses.
Questions and cautions: Commissioners and finance staff flagged the need for a clear administrative trail and a formal policy to ensure the lodging is recorded separately from payroll. Staff also sought written guidance from state auditors on whether lodging revenue would affect work-compensation rates; the MVM director reported having written confirmation that, structured as short-term lodging and not payroll, it would not raise the county’s work-comp premium.
Next steps: The director will return with a formal proposal and recommended contract language. Commissioners asked staff to place a standalone agenda item for the lodging pilot so the board can approve the policy and implementation steps after finance and legal review.
Outcome: Commissioners endorsed further study and asked the director to prepare a formal agenda item and implementation plan for a future meeting.
The director described significant up-front costs for contract staff: “We are spending an average of $3,500 per RN contract prior to them even starting, $3,100 per LPN, and about $2,000 per CNA,” she told the commissioners, citing training and competency expenses. To make in‑county hiring more attractive, the director proposed a lodging program that would charge incoming staff a modest daily rent (her example: $15–$20 per day) for short-term stays while they transition to core employment with the county. The plan would operate outside payroll (treated as lodging revenue to offset facility housing costs) so it does not increase workers’ compensation premiums, staff said.
Why it matters: Long-term reliance on traveling nurses has grown county health-care costs and reduced continuity of care. The lodging-subsidy idea aims to convert contract workers into county employees at lower total cost by removing the barrier of moving or temporary lodging expenses.
Questions and cautions: Commissioners and finance staff flagged the need for a clear administrative trail and a formal policy to ensure the lodging is recorded separately from payroll. Staff also sought written guidance from state auditors on whether lodging revenue would affect work-compensation rates; the MVM director reported having written confirmation that, structured as short-term lodging and not payroll, it would not raise the county’s work-comp premium.
Next steps: The director will return with a formal proposal and recommended contract language. Commissioners asked staff to place a standalone agenda item for the lodging pilot so the board can approve the policy and implementation steps after finance and legal review.
Outcome: Commissioners endorsed further study and asked the director to prepare a formal agenda item and implementation plan for a future meeting.
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