A staple in New Hampshire’s substance use treatment landscape is preparing to close its doors. Easterseals NH & VT announced this week that it will shut down the inpatient operations of the Farnum Center, a long-standing recovery facility in Manchester, citing mounting financial pressures and a shifting treatment landscape.
“It’s a sad day for the recovery community,” says Maureen Beauregard, CEO of Easterseals NH & VT. “As a person in long-term recovery, it’s always hard to lose a legacy organization that has helped so many people.”
The decision follows a years-long evaluation by Easterseals, which included an unsuccessful search for a buyer or another provider to take over the center’s inpatient services. The final blow came after a potential sale of the program and building recently fell through. “Since that time the dominos started falling,” Beauregard says. “When we look at our fiscal year which runs from September 1 to August 31, we’re underwater $1 million and next year $2 million.”
Farnum will continue accepting new patients through July 20, allowing those entering the program to complete the typical 28-day residential treatment and detox services. The outpatient program at Easterseals’ Lake Avenue location will remain open.
A Changing Landscape
The closure highlights broader challenges facing mission-based, Medicaid-funded treatment providers in a rapidly evolving substance use disorder (SUD) landscape. Over the last five years, Beauregard says, larger for-profit and national recovery organizations—many serving privately insured clients and —have expanded into New Hampshire, creating financial strain for providers like Farnum that primarily serve Medicaid recipients and the uninsured.
“There’s been a proliferation of sober homes and over 1,000 recovery beds in the state now,” Beauregard said. “For-profit centers have outpatient services and can better manage costs. We’re a mission-based organization—we’ve always focused on those who need care the most, regardless of their ability to pay.”
In 2023 the average cost for a residential in-treatment program in New Hampshire was $42,500, according to Zinnia Health, a national behavioral health treatment provider with locations across the U.S.. The average cost of sober homes—without treatment— was $1,500 to $2,000.
While the growth of sober homes and recovery beds has increased access for some, it has created a gap for individuals without insurance or on Medicaid—populations Farnum has long served. For-profit entities, Beauregard noted, often avoid these groups due to lower reimbursement rates and administrative hurdles.
Economic Pressures and Pandemic Fallout
Beauregard says the financial imbalance worsened with the end of federal COVID relief funding, which had helped bridge budget gaps. “Without that support, we simply can’t continue on our own. Running this program in its current form puts the rest of our organization at risk.”
The Farnum Center, located on Queen City Avenue, currently serves about 43 individuals daily in its detox and residential program. At full capacity, the facility employed 75 staff. Beauregard says Easterseals is working with local treatment providers to find jobs for affected workers.
A Statewide Response
To ensure continued access to care, Easterseals is coordinating with The Doorway, New Hampshire’s statewide system of nine regional hubs for substance use services. Created with federal SAMHSA funding, The Doorway offers 24/7 screening, assessment, referrals, and care coordination.
“They will be an integral part of defining care moving forward,” Beauregard says, noting that talks with other providers are underway to assess what services might be preserved or redistributed.
According to the New Hampshire Department of Health and Human Services, 8,645 individuals accessed substance use treatment through the state’s Medicaid expansion program—Granite Advantage—in Fiscal Year 2022. Nationally, an estimated 15,400 people in New Hampshire were engaged in treatment for substance use disorders in 2021, according to SAMHSA, though only about half of low-income individuals with SUDs receive any care annually.
Looking Ahead
Beauregard says Easterseals is assessing the future of the Farnum facility, whether through repurposing or eventual sale. She emphasized the organization's commitment to ensuring continuity of care for current patients and respect for a program that’s served the community for over four decades.
“My biggest concern remains for the staff and the people we serve,” she says. “We want them to know how much we care. Our staff has been unbelievable for more than 40 years.”
While the inpatient closure marks a significant loss, Beauregard expressed hope that partnerships with The Doorway and other community-based providers will help the state continue to serve those most in need.
“We’ve always worked in concert with others in this field,” she says. “And we’ll keep doing that.”