Cheshire Medical Center 2021-2022 Report to the Community

A Source of Hope and Healing ...

2021–2022

Report to the Community

On the cover: Muthutantrige Cooray, MD, one of Cheshire’s new primary care providers.

Quality Care Pages 2–7

Clinical Excellence Pages 8–11

Team Cheshire Pages 12–15

Community Commitment Pages 16–23

Generosity and Giving Pages 24–33

A year of perseverance and gratitude Our 2021–2022 Report to the Community is an opportunity to pause and reflect on the past fiscal year at Cheshire Medical Center. It’s a time to celebrate what we’ve accomplished, recognize the challenges we faced amidst another year of the pandemic, and show gratitude to everyone who went above and beyond in order to keep our community safe.

Our mission to advance the health and wellness of the Monadnock Region by delivering outstanding care and exceptional service to the individuals and communities we serve shows up in both big and small ways, day in and day out. We’ve selected just a few stories about people in our community who relied on us when they needed care. Here, we look to highlight the unique and essential role Cheshire plays in the Monadnock Region.

As a proud member of the Dartmouth Health system, we work seamlessly with our colleagues to bring a combination of state-of-the-art science and compassionate individual attention to every patient interaction. By serving our neighbors responsibly and compassionately, we honor our legacy every day.

During a year when many communities faced a shortage of primary care providers, Cheshire has increased the number of providers and expanded our

Don Caruso, MD, MPH President and CEO, Cheshire Medical Center

geographical reach in order to welcome new patients across the Monadnock Region and southeastern Vermont.

We’ve also achieved milestones as we work to launch our community-based Family Medicine Residency program. Pending Accreditation Council for Graduate Medical Education (ACGME) approval in spring 2023, we plan to welcome our first six residents in 2024 for a total of 18 residents by 2027.

When faced with challenges, we’ve persevered as we continue to make significant progress in the essential work of strengthening our controlled substance policies and practices. Since the theft of the controlled substance that we discovered and reported earlier this year, we have been intensely focused on taking steps to prevent future occurrences. These steps include extensive training and education of clinical staff, hiring specialized drug diversion specialists, and implementing new practices for oversight, among other beneficial changes.

These ongoing efforts are focused on maximizing patient and staff safety, and we are committed to delivering high-quality care in a safe environment.

We’re grateful to our staff and our community for their shared commitment to the success of this critical work,

Susan Abert Chair, Cheshire Medical Center Board of Trustees

Rob Therrien Chair, Cheshire Health Foundation Board of Trustees

and we are confident that these are the right steps to prevent future incidents.

Cheshire’s ability to prepare for and respond to the COVID-19 crisis demonstrates our dedication to the safety of our patients, their families, and our staff. Our practitioners do whatever it takes to help those who depend on us. The quest to do our best links several essential elements: ongoing training, best practices in healthcare, and an atmosphere of mutual support.

On behalf of the Cheshire Medical Center Board of Trustees and executive team and the Cheshire Health Foundation Board of Trustees, we send our heartfelt appreciation to our employees for the work they do and to you, our community, for the trust you’ve given us to care for you and those you love.

Cheshire Medical Center Board of Trustees Susan Abert, Chair Robert Mitchell, Treasurer Mark Bodin Gina O’Brien, MD Betsy Cotter, RN Maria Padin, MD Barbara Duckett, Andrew Tremblay, MD Secretary Michael Waters Michael Farhm Ex Officio members Mark Gavin, Vice Chair Nathalie Houder Don Caruso, MD, MPH Susan Howard Cherie Holmes, MD, MSc Michael Kapiloff Claire Fabian, MD Stephen LeBlanc Cheshire Health Foundation Board of Trustees Rob Therrien, Chair Hélène Mogridge Trish Campbell, DO Patti Seymour Bill Chase, MD Katherine Snow Betsy Cotter, RN Alan Stroshine Robert Englund, MD Julie Tewksbury Ceil Goff Cindy Westover Topher Hamblet Ex Officio member Aalok Khole, MD Heather Minkler Don Caruso, MD, MPH 2021–2022 Report to the Community 1

Quality Care

Jenna Clark, MSN, APRN 2 2021–2022 Report to the Community

Growing access to preventative care builds a foundation of health Primary care at Cheshire is expanding to serve more patients and evolving to meet their changing needs.

Cheshire is well known for providing quality, compassionate primary care.

Recently, we welcomed more primary care providers (PCPs), allowing us to expand our patientcentered, team-based care to even more people. Welcoming new patients from across the Monadnock Region and southeastern Vermont ensures more of our neighbors live long, good-quality lives.

“Primary care is the keystone in our patients’ care here,” says Andrew Tremblay, MD, chair of the Family Medicine department and a PCP for more than 20 years. “It’s our goal to have a positive impact on our local community’s health and wellness. That may begin with one patient at a time, but it can spread to other family members as well.”

Tremblay says having a PCP allows people to take care of health problems before they become severe. Preventative care from a provider who knows you and a healthcare team that works closely together can significantly improve a patient’s health and well-being.

“Preventative care is the bread and butter of what we do,” says Muthutantrige Cooray, MD, one of the new PCPs at Cheshire. “We try to keep patients from ending up at the hospital with more serious conditions. We also educate our patients about healthy lifestyles so that they do not succumb to chronic diseases such as diabetes.”

In addition to attracting talented new providers, Cheshire took the opportunity offered by the pandemic to improve how patients receive care. For example, most PCPs now work in patient-centered partnerships, embedded in a Cheshire’s Family Medicine department “home team” of support staff. offers primary care to 45,000 patients This offers people more consistent in a county of 70,000 people and care and stronger relationships plans to grow 15 percent in the with their providers. They also coming year. Many new patients may receive more timely responses to have received care from Cheshire’s myDH messages, prescription refills, Specialty Medicine or Emergency appointment requests, and all the Medicine departments but do not other care moments between visits. have a PCP within Dartmouth Health.

“By far, the best part of being a PCP is the relationships we get to build with our patients,” says Sharon Ferguson, DO, an experienced provider working in partnership with Laura Reyor, MSN, APRN. “We get to be involved in their entire healthcare picture through the years, instead of certain aspects only when people are sick. We really get to know people that way.”

“There’s much more than the support of your provider when it comes to primary care, as other members of your healthcare team also help deliver holistic and accessible care,” Tremblay says.

For example, collaborative care nurses support people with ways to manage chronic diseases and maintain a good quality of life.

Behavioral health specialists offer short-term tools for people dealing with troubles such as substance use disorders, insomnia, or thoughts of self-harm. Nurse care coordinators manage patients’ care transitions, such as going home after a hospital stay. And as part of the Dartmouth Health system, Cheshire PCPs also have seamless access to consult with highly qualified specialists across the health system on their patients’ behalf.

“Our primary care patients value the consistency of care they receive, our

reliability, well-educated providers, and evidenced-based medicine,” says Julie Cookish, MSN, APRN, an associate care provider. “There is constant communication between the leadership and providers to enhance the quality of care we give.”

Care also has become more accessible for primary care patients at Cheshire.

Nurses are available by phone 24 hours every day and Virtual Visits mean people can see their provider at home, using their computer or smartphone. For patients with acute symptoms or minor injuries, the Urgent Primary Care Visits team is now located in the Medical Center.

The team works with PCPs and offers better access to diagnostic testing and other services. Via myDH.org or the MyChart app, patients can also self-schedule appointments, message their primary care team, read visit notes, get test results, and more.

With all of these improvements, there are so many reasons for Cheshire patients, new or existing, to be more proactive about their own healthcare.

“Medical concerns are usually much easier to address—and often fix—when caught early, before symptoms are even present,” Ferguson says. “The work you put

2021–2022 Report to the Community 3

Sharon Ferguson, DO

into taking care of yourself every day pays off in the long run.”

As Ben Franklin said, an ounce of prevention is worth a pound of cure.

“I am passionate about helping people live long and high-quality lives free of diseases and medical conditions.

My patients laugh because even though they are here for knee pain, I will be telling them to put sunscreen on their nose and to schedule their mammogram,” says Jenna Clark, MSN, APRN, an associate care provider partnered with Cooray. “It has been a scary couple of years in healthcare due to the pandemic.

But even skipping only one or two years of preventative visits—I have seen damaging results. Preventative healthcare really can save your life.”

4 2021–2022 Report to the Community

“I remind my patients that they are in the driver’s seat. My goal is not to force people to get caught up on the screenings—it’s to help them make informed decisions.” says Roz Vara-Good, MSN, APRN, an associate care provider at Cheshire. “If you come in and don’t have any concerns, and I don’t have any concerns, then we are doing our jobs.”

“My patients laugh because even though they are here for knee pain, I will be telling them to put sunscreen on their nose and to schedule their mammogram.”

To learn more, visit cheshiremed.org/primary-care or choose a new provider at cheshiremed.org/primary-care/choosing-new-provider to get started becoming a primary care patient with us today.

Jenna Clark, MSN, APRN

Program Director Karl Dietrich, MD, MPH, and Christopher LaRocca, MD, director of graduate medical education and Family Medicine Residency development at Cheshire, stand in front of the new facility on Maple Avenue in Keene.

Federal grant will help support start-up costs for Family Medicine Residency program Cheshire recently celebrated the award of a Rural Residency Planning and Development grant from the Health Resources and Services Administration (HRSA) to support the start-up of the Family Medicine Residency program at our West Campus on Maple Avenue in Keene. The grant, one of only 11 nationwide, specifically supports the development of rural residency programs.

Training physicians in rural areas increases the likelihood that they will practice in a rural community. The grant—$750,000 over three years—will help to support start-up costs to establish this new residency program. Grantees may use the funding to cover accreditation costs, faculty development, and resident recruitment.

The opportunity to add a Family Medicine Residency program at Cheshire comes at a critical time, when community health needs require the training of more family physicians. Currently, only 2% of residency training occurs in rural areas. In response, HRSA aims to improve access to healthcare by funding programs to train more physicians in rural communities through the Federal Office of Rural Health Policy and the Bureau of Health Workforce.

To become a family physician, students must first complete medical school, earning a degree as a Doctor of Medicine (MD) or a Doctor of Osteopathic Medicine (DO).

After earning a degree, aspiring family physicians need to complete a three-year

residency in family medicine, during which they continue their clinical education under a training license, diagnosing and treating patients under the supervision of established faculty doctors. Upon completing the three-year residency program, applicants are able to practice as independent family physicians.

Pending approval from Accreditation Council for Graduate Medical Education (ACGME), Cheshire’s program will welcome its first six residents in 2024 for a total of 18 residents by 2027.

2021–2022 Report to the Community 5

Musical medicine helps soothe patients, visitors, and staff Emily Mills uses her fingers and hands to relax, soothe, and offer care to patients in Cheshire’s Inpatient Rehabilitation department. But, unlike the other therapists and nurses who work on the fifth floor, the only thing she ever touches are the black and white keys of her keyboard.

Mills is a certified music practitioner, trained by the national Music for Healing and Transition Program (MHTP). She has been volunteering on Wednesdays and Thursdays since 2020 to play spontaneous, therapeutic music to help patients with relaxation, reduction of blood pressure, relief from anxiety, enhancement of memory, and transition at the end of their lives.

Emily Mills performs in Cheshire’s Inpatient Rehabilitation department.

Clinical staff and visitors, who Mills says also benefit from the music, hear the twinkling of her keys in the hallway and will often step inside the room to comment on her playing.

“Many times, they express thanks and tell me they feel more relaxed,” she says. “Sometimes, patients surprise me with their descriptions. A couple examples are: ‘You played to my spirit,’ and, ‘The music touched my soul.’”

6 2021–2022 Report to the Community

Left to right: Meagan Dame, OT; Donald Hashem, patient; Meredith Matuszewski, CCC-SLP; Kara Stoning, MSPT

Inpatient Rehabilitation services build vital link for COVID survivors During the devastating COVID-19 surge in the winter of 2021–2022, departments across Cheshire persevered, despite being stressed well beyond their normal limits. Nowhere was that more exemplified than the Inpatient Rehabilitation department, which specializes in getting people back on their feet and living their lives.

“COVID has certainly changed all of our lives in many ways,” says Elizabeth Olmstead, business development manager for rehabilitation services at Cheshire. “Our staff were amazing in their commitment, working with all the PPE (personal protective equipment), which is not an easy task when rehab patients needed hands-on care to promote their recovery.”

One of the 18 COVID recovery patients seen from July 2021 to June 2022 was Kathy Tremblay, an insurance billing representative and Keene resident for 20 years. She caught the virus around Thanksgiving of 2021 from a family member while unvaccinated, and by December, was put on a ventilator for 21 days. She was admitted to the Inpatient Rehabilitation unit on Jan. 7 and was able to go home after a week and a half of caring treatment there.

“Getting to go to rehab was a big relief because I knew I was going to be OK,” Kathy says. “Everyone in Inpatient Rehab was amazing. They made me feel welcome and special, and the treatment I received while there was exceptional.”

“What I remember most about Kathy is her quiet, unwavering resilience,” says Meredith Matuszewski, CCC-SLP, a speech-language pathologist who worked with Kathy. “She fought hard to walk, speak, swallow, and take care of herself again. The gains she made were truly remarkable, as she went from extreme illness to returning home in just a few weeks with the help of her rehabilitation team.”

Standing left to right: Elisabeth Dignitti, RN-BC; John Ditri, MD; Cynthia Zipoli, OT; Meredith Matuszewski, CCC-SLP Sitting left to right: Kathy Tremblay, patient; Tricia Toomey, PT

pastor in nearby Townsend. He was also diagnosed with COVID while unvaccinated in December of 2021 and had been on a ventilator in the Intensive Care Unit (ICU) before being moved to Inpatient Rehabilitation for almost six weeks, starting in February.

Cynthia Zipoli, OT, the occupational therapist on Kathy’s team, says, “Inpatient Rehab is always a team effort, and Kathy was certainly a big part of the team. She always dressed in her tie-dye shirts and had a positive outlook, which is often 50 percent of the battle here.”

“Don came to us from the ICU, unable to move his arms or legs,” says Kara Stoning, MSPT, the physical therapist on his team. “He struggled to breathe even sitting up on the edge of the bed, and it took weeks for him to be able to stand. Being a part of Don’s rehabilitation and seeing his accomplishments every day was truly an amazing experience that I will never forget.”

Another inspiring recovery was that of Donald Hashem, who runs a facility maintenance business in Bellows Falls, Vermont, and serves as interim

“Everyone at Inpatient Rehab was awesome,” Don says. “They were very compassionate, very kind and encouraging, cheering on my every

accomplishment. I was called ‘the walking miracle.’ The Bible says that both life and death are in the power of the tongue, and the staff were all full of life. I’ll always be grateful to the hospital—also to all the people praying for me all over the world, from Canada to India.”

The Inpatient Rehabilitation department has seen both triumphs and sadness through the pandemic, including a short closure when the space was converted to a temporary ICU to care for a surge in COVID-19 cases.

“Our rehab staff had to step into roles that they were not accustomed to, but did so without hesitation” Olmstead says. “The silver lining of the COVID experience for me was witnessing the strength and resilience of our staff and feeling very proud of what we all do.”

2021–2022 Report to the Community 7

Clinical Excellence

Kate Ingram, MSN, APRN, and Bob Pavia reunite outside of Cheshire’s Emergency Department 8 2021–2022 Report to the Community

Gratitude for overnight surgery and compassionate follow-up care Bob Pavia had no idea what to expect when he was admitted to Cheshire in the middle of the night with abdominal pain, but he found a caring team of medical professionals who he credits for saving his life.

It was 4 am on Feb. 21, 2021, when Bob Pavia found himself staring up at an unfamiliar face, that of the doctor who performed emergency, life-saving surgery on the 75-year-old retiree.

He performs everything from appendectomies to breast cancer procedures. The doctor recalls that Pavia was suffering from a rupture to one of the pouches outside his colon, which meant that infected fluid was leaking into his abdomen. The situation quickly became urgent.

“The infection was worsening and Bob was getting sicker. We had to remove the portion of the colon with the hole in it,” Burman says. “We were When he was transferred from Grace able to wash out the infection and Cottage Hospital near his home in West reconnect the remaining colon. In order Dover, Vermont, to Cheshire, Pavia was to protect that new connection, we in rough shape. A particularly serious brought out a loop of small intestine case of diverticulitis (the inflammation of so the colon would remain at rest.” small, bulging pouches in the digestive During the nine days Pavia spent in tract) was not responding to antibiotics, the hospital following the procedure, and Pavia was told that surgery was his including care of his temporary only option. When he emerged from ileostomy bag, he was the beneficiary the anesthesia, Pavia learned that he of kindness and care from not only had undergone five hours of intensive Burman, but Kate Ingram, MSN, APRN, surgical intervention under the careful and a team of other professional hands of H. E. Guy Burman, MD. caregivers who counseled and “In recovery, I found out it was quite nurtured him in preparation for serious,” Pavia recalls. “Usually, you discharge.

With her extensive have a problem and you ask a friend experience managing hospitalized who’s the best cardiologist or who’s the patients, Ingram is “supremely best back surgeon. I didn’t have that attentive, making sure surgical patients luxury. I ended up on an operating table are getting everything they need and was operated on by a stranger. to heal properly, ” Burman says.

I was struck by his commitment to coming in during the middle of the night to save a stranger’s life.”

Burman is a general surgeon who joined Cheshire’s team in 2011.

Pavia noted the same thing. “I remember her coming into the room and taking right over,” he says of Ingram. “We talked about what

my diet would be going forward. It was a pleasure to deal with her and everyone else. They were all so caring.”

In recognition of that care, Pavia recently recognized Ingram and Burman by donating to Cheshire Health Foundation’s Circle of Gratitude (see more honorees on page 26). This special recognition offers grateful patients a way to honor an employee, and the gift goes toward supporting exceptional medical care for others.

“After 18 months of being Dr. Burman’s best friend, I’ve resumed my life,” Pavia says. “I feel great and I’m very grateful. I wanted to thank them for being there for me and help them be there for other people. You know good care is important, but you

really don’t know how important it is until it happens to you.”

Since that night in the Emergency Department, Burman has performed two follow-up surgeries on Pavia, one to reverse the ileostomy from the initial procedure and a second to fix a hernia. The doctor is proud of the work he has done to improve Pavia’s condition, and he and Ingram also credit their patient for making healthy dietary and lifestyle changes.

“It actually was a joy to work with (Bob),” says Burman, who, along with Ingram, is now a five-time recipient of Circle of Gratitude honors. “He was so dedicated to doing the right thing, which makes his recovery so extraordinary—and our job much easier.”

H. E. Guy Burman, MD

2021–2022 Report to the Community 9

Awards honor Cheshire providers and staff Cheshire physicians, providers, and staff have once again been recognized for their personal care and commitment.

Seventeen Cheshire physicians, five more than last year, have been named among the best doctors in New Hampshire, according to New Hampshire Magazine’s annual “Top Doctor” survey conducted by the national research firm Castle Connolly.

The following Cheshire physicians were named “Top Docs” in 2022: •

Barbara A. Bates, MD (Family Medicine)

•

Paul C. Bettinger, MD (Hand Surgery)

•

H.E. Guy Burman, MD (Surgery)

•

Todd F. Dombrowski, MD, MS (Rheumatology)

•

Sherry A. Guardiano, DO (Rheumatology)

•

Cherie A. Holmes, MD, MSc (Orthopaedic Surgery)

•

Michael F. Kasschau, MD (Family Medicine)

•

Nicola Kreglinger, MD (Endocrinology, Diabetes & Metabolism)

•

Gregory Leather, MD (Orthopaedic Surgery)

•

Lisa A. Leinau, MD (Hospice & Palliative Medicine)

•

Jessica S. Payton, MD (Pediatrics)

•

Matthew J. Rockacy, MD (Gastroenterology)

•

Anthony H. Presutti, MD (Orthopaedic Surgery)

•

Gregory P. Seymour, MD (Dermatology)

•

Mark B. Silbey, MD (Orthopaedic Surgery)

•

Marni A. Silverstein, MD (Pediatrics)

•

Andrew G. Tremblay, MD (Family Medicine)

10 2021–2022 Report to the Community

“Everything we do at Cheshire is fueled by our commitment to deliver excellent, compassionate care in a safe, well-run environment,” says Cheshire President and CEO Don Caruso, MD, MPH. “This type of recognition highlights our longstanding commitment to advance the health and wellness of the patients and families we serve. Congratulations to the providers recognized this year.”

A total of 154 Dartmouth Health physicians were named among the best doctors in New Hampshire in New Hampshire Magazine’s annual survey.

The Keene Sentinel released its “2022 Choice Awards” in which Cheshire staff and departments garnered awards: BEST NURSE Lori Guyette, RN (Gold) Alaina Snide, BSN, RN (Silver) FAMILY DOCTOR/PROVIDER Lisa Profetto, MSN, APRN (Gold) Suzanne Nabi-Tremblay, MD (Silver) Katelyn Ahern, APRN (Bronze) EYE DOCTOR Lawrence Jaeger, MD (Silver) PHYSICAL THERAPIST/SPORTS MEDICINE James Hall, PT, DPT, OCS, COMT (Silver) URGENT CARE CENTER Urgent Primary Care Visits (Gold) HEARING CARE CENTER Audiology (Gold) VISION CARE CENTER Ophthalmology and the Optical Shop (Silver) FUNDRAISING EVENT Bald is Beautiful (Bronze)

Growing up at Cheshire to ‘provide care for my community’ Coming from a family of nurses, Tanis Ferreira always seemed destined for the medical field.

But it wasn’t until a pair of trips to work in a medical clinic in Haiti—one after an earthquake in 2011, the other following a hurricane a few years later—that she found her calling.

“I felt in those moments that I couldn’t help them as much as I wanted to,” Ferreira, MSN, APRN, says. “I wanted to learn more and expand my skill set, and the only way to do that was to go back to school and become a nurse practitioner.”

So that’s exactly what she did.

Already toting a Bachelor of Science in Nursing degree from Colby-Sawyer College, Ferreira had spent six years combined in the hematologyoncology units at Dartmouth Hitchcock Medical Center in Lebanon and then at Cheshire.

“I transitioned to the inpatient step-down telemetry unit while I did my master’s program,” says Ferreira, who received financial assistance from Cheshire. “I studied at Rivier University and graduated in December 2021. I was fortunate to do all my clinicals at Cheshire, so it was an easy decision when they asked me to work here after graduation.”

A decision made even easier because Ferreira grew up in Cheshire—personally and professionally. Raised in Walpole, she now lives in Westmoreland with her husband and their 2-year-old son.

The Doorway earns national acclaim, receiving the 2022 American Hospital Association Dick Davidson NOVA Award

Tanis Ferreira, MSN, APRN

“And now I have the opportunity to provide care to my community,” she says.

There are still humbling days. “Coming from being an experienced registered nurse with 10 years of experience to a novice provider is hard, but I have a great team and feel supported every day,” she says.

Ferreira is hitting her stride in her new role as an APRN in Family Medicine’s Team A, where she’s partnered in a teamlet with Teresa Woodside, MSN, APRN. “My advice would be to keep going,” she says. “It gets hard, and there are days you want to quit, but now that I’ve earned my degree, I see those hard days are worth it to be where I am now.”

The Doorway at Cheshire Medical Center was honored with a 2022 American Hospital Association (AHA) Dick Davidson NOVA Award on July 18, during the AHA Leadership Summit in San Diego. The award recognizes The Doorway’s hospital-led collaborative efforts that improve community health. Vice President of Population Health Shawn LaFrance and Nelson Hayden, director of the program, accepted the 2022 NOVA Award on behalf of The Doorway.

“It was an honor to be recognized with an AHA Dick Davidson NOVA award for the innovative work The Doorway has accomplished for this region,” LaFrance says. “The dedicated work of The Doorway team has made a significant impact.

After two years of operations, Cheshire County has gone from having the second-highest drug death rate to having New Hampshire’s secondlowest drug death rate. Working together has helped us to create a healthier community and increase well-being for our neighbors.”

The Doorway is a free service available to all New Hampshire residents and Cheshire’s is one of nine Doorway locations across New Hampshire.

The Doorway at Cheshire provides screening, evaluation, treatment, and peer recovery support services for those with a substance use disorder (SUD). It also offers information about SUDs, prevention resources, and supportive services to assist in long-term recovery and advocates for treatment and services for people with SUDs.

Whether you are seeking help for yourself or a loved one or simply looking for information and resources related to drugs or alcohol, The Doorway will connect you to the support and services and the level of care that’s right for you.

For more information, visit cheshiremed.org/doorway.

Vice President of Population Health Shawn LaFrance and Nelson Hayden, director of The Doorway at Cheshire Medical Center, accept the AHA Dick Davidson NOVA award.

2021–2022 Report to the Community 11

Team Cheshire

Mashwani and his son 12 2021–2022 Report to the Community

Afghan family finds healthcare, employment, and community When Mashwani and his wife and son first came to Keene in March of 2022 as part of the national Afghan refugee resettlement effort, it was the end of a months-long journey that had taken them to Qatar, Spain, Virginia, and Concord, New Hampshire.

It was also a new beginning that held great promise, including access to quality healthcare at Cheshire.

Mashwani, as he is known by neighbors and coworkers, even embraced the opportunity for a job at the Medical Center.

“The reception has been wonderful and the people of the community are very nice,” Mashwani says, speaking through an interpreter. He and his family previously lived in a small village in Afghanistan.

“The people here helped provide any assistance we needed, and they are still helping us whenever we need a ride to an appointment. We are very happy with the community.”

The warm welcome given to Mashwani’s family, the first Afghan family to be resettled in Keene, is a shining example of Cheshire’s impact on the community through its Diversity, Equity, Inclusion, and Belonging (DEIB) program and goals adopted this year (see related story on page 15). These goals include cultivating inclusivity at the Medical Center for diverse staff and potential hires, as well as community engagement aimed at fostering a welcoming environment for people with diverse backgrounds.

“I knew some people in the area interested in having Keene designated as an Afghan refugee resettlement community,” says Shawn LaFrance, vice

president for Cheshire’s Center of Population Health, who has also worked as a volunteer with new refugee families in Concord. “I advocated with people I’ve worked with at Ascentria, one of the two resettlement agencies in New Hampshire, for Keene to be a resettlement community. The Neighborhood Support Team (NST) group doing this work here is excellent.”

Eric Swope, an NST co-leader and member of the Keene Immigrant and Refugee Partnership, explains, “We saw a big problem at the end of US involvement in Afghanistan and people wanted to offer help.”

Dozens of people collaborated to raise funds, find housing, and work with Ascentria to welcome the new family. Swope describes the effort as “extremely rewarding … enriching the community and its understanding of the world.”

In April, Mashwani’s family registered for primary care with the assistance of online interpreter services to address the language barrier. LaFrance knew that Mashwani also needed a job, so he arranged for him to meet with Cheshire’s human resources staff on the same day. Although his limited English prevented him from working in his prior profession of safety in Afghanistan, he was grateful for the opportunity to find employment.

“We worked to identify positions Mashwani could do at this time and determined he could work in Environmental Services with his current English skills,” LaFrance says. “He wanted to work nights so he could be home during the day to take English classes with his wife and be available when his son is not in school. We were able to translate into Pashto the

necessary information for cleaning supplies he uses.

We needed to be flexible in our hiring, as stated in Cheshire’s DEIB goals, but now Mashwani is on staff here and working well.”

Mashwani is already making an impression among his new co-workers. “Many people have mentioned how helpful Mashwani is, how communicative he is, even with having limited English,” says Curtis Fortune, director of Environmental Services and Mashwani’s supervisor.

“I am happy with this job right now,” says Mashwani, although he is hopeful that as his English improves, he may be eligible to work in safety. “My goal is to help people in the hospital. That’s why I like this job.”

“The people here helped provide any assistance we needed, and they are still helping us whenever we need a ride to an appointment.

We are very happy with the community.”

Mashwani

2021–2022 Report to the Community 13

Taking steps to ensure patient safety Woven into the fabric of our community Nearly three years ago, the Dartmouth-Hitchcock Health system—of which Cheshire Medical Center is a member— initiated a strategic effort to update its brand identity, and in April of 2022, one of the nation’s premier academic health systems announced its new brand and name: Dartmouth Health.

The new name and logo reflect Dartmouth Health’s focus on strengthening its relationships with the patients it serves in communities throughout northern New England. It also serves to increase awareness of the academic health system; to affirm its position as the healthcare provider and employer of choice in the region; to elevate the system’s reputation nationally; and to better articulate the strengths and benefits of the growing and increasingly integrated system in a dynamic and competitive healthcare environment.

14 2021–2022 Report to the Community

Cheshire strives to pursue and achieve measurable, continuous improvement across every aspect of our organization and continues to make significant progress in the essential work of strengthening our controlled substance policies and practices. Since the theft of the controlled substance that we discovered and reported earlier this year, we have been intensely focused on taking steps to prevent future occurrences. These steps include extensive training and education of clinical staff, hiring specialized drug diversion specialists, and implementing new practices for oversight, among other beneficial changes.

Our clinical practice is distinguished by a deep commitment to safety and quality, and a culture that values the contribution of every staff member. The quest to do our best links several essential elements: ongoing training, best practices in healthcare, and an atmosphere of mutual support. In a hospital environment, “quality” isn’t an abstract notion.

To ensure patient safety and improve treatment outcomes, we engage in activities ranging from preparedness drills and certification programs to third-party accreditation programs and professional development.

“Every regulation, every rule, is grounded in evidence and best practice,” says Angie LeFebvre, MSN, BSN, RN, Cheshire’s senior director of Quality and Patient Safety. “By assuring adherence to these rules, we can confidently say that we are giving the best possible care. It’s nice to know that my work is directly tied to patient outcomes.”

LeFebvre has a Master of Science in Nursing in Quality and Patient Safety from Southern New Hampshire University. While she joined Cheshire as a registered nurse in 2007, LeFebvre also serves as accreditation and regulatory compliance leader at the Medical Center, which she has done since 2016. In this position, one of her primary responsibilities is to identify and resolve patient safety problems.

LeFebvre leads a team of 16 at Cheshire.

Carol L. Barsky, MD, MBA, the chief quality and value officer for the Dartmouth Health system provides system-wide leadership and strategic oversight for all Dartmouth Health quality and safety. Barsky works closely with other Dartmouth Health leaders, including LeFebvre, to develop policies, programs, metrics, reporting and accountability to implement improvement to safety, quality assurance, and operational excellence.

Angie LeFebvre, MSN, BSN, RN

World map highlights cultural diversity— and Cheshire’s growth There’s a little white sticker at the top left corner of the map, which sits on two black easels. On it— written in uppercase letters with a purple marker—it says, “Push pin really hard.”

For Subbareddy Pidaparthi, who works in the laboratory at Cheshire, the significance of the action—sticking a small, colored push pin in his native country of India—was well worth the effort.

Subbareddy Pidaparthi places his pin on the map.

“I always believe, once you understand and appreciate other people’s cultural backgrounds, then you can also connect with them more.”

Subbareddy Pidaparthi

Shawn LaFrance, vice president for Cheshire’s Center of Population Health, who helms the committee.

So, in early 2022, the committee created DEIB Program Goals developed to integrate work with Cheshire’s Three-Year Strategic Plan.

“It didn’t just come out of nowhere,” LaFrance says. “Our board put a mark in the sand and we started doing things that have only now started to bear fruit.”

“I am so happy to be part of this World Map Project,” says Pidaparthi, who was one of the first staff members to place a pin into the cardboard-backed map. “I always believe, once you understand and appreciate other people’s cultural backgrounds, then you can also connect with them more.”

Things like the World Map Project, which was already teeming with pins—proudly pressed into virtually every continent—just a few weeks after it started.

“We said, we have to deal with the pandemic and the surge, but this is, in the long run, important to the health of our community and of the hospital,” says

As the calendar shifts to 2023, it’s clear that the DEIB Committee is committed to making a difference, one pin at a time.

“Although we are tucked in the southwest corner of New Hampshire, it tells the story that the world has found its way to us,” says Sue Maydwell, MS, PA-C, Throughout 2022, the World Map Project invited one of the volunteer members of the committee.

Cheshire staff to place a pin in the country they “Ultimately, this genuine snapshot allows our staff culturally identify with in an effort to learn about and the community we serve to appreciate our and celebrate campus-wide, self-identified cultural organization through a different lens. I had an diversity, as culture shapes our beliefs, values, opportunity to talk with a patient who was looking at norms, and behaviors. the world map as she was casually pointing out the many countries where push pins were placed and It’s one of many initiatives undertaken and sponsored expressing her awe in such a kind and reflective way.”

by Cheshire’s Diversity, Equity, Inclusion, and Belonging (DEIB) Committee. After the Cheshire Other plans for 2022 include sponsoring and Board of Trustees passed a resolution in 2019, exhibiting at the first Keene Pride Festival, showcasing committing to improving DEIB at the Medical staff members’ international cuisine favorites at the Center, an organizational baseline assessment report Art Nichols Café, and engaging with staff in difficultwas completed. The DEIB Committee formed the but-necessary conversations about the hospital’s following year, and, while the pandemic slowed efforts new policy aimed at curbing abusive behavior from slightly in 2020, this important work kept going. patients to staff members with diverse backgrounds.

2021–2022 Report to the Community 15

Community Commitment

Troy woman one of many reunited with their rescuer after heart event Pauline Johansen, RN, remembers raking some leaves in her yard on Sept. 17, 2021, in preparation for hosting a wedding party for her only grandson’s upcoming nuptials. A nurse for more than five decades, her next memory is lying in the Intensive Care Unit (ICU) at Cheshire, recovering from cardiac arrest.

Put simply, Johansen’s heart had stopped. She was unconscious and wasn’t breathing. And if it weren’t for the heroic efforts of her quick-thinking Troy neighbors, she would have died.

“I never thought I’d be on the other side of a defibrillator,” says Johansen, who has worked as a registered nurse in the Cheshire ICU for 43 years.

Sisters Emma and Camryn Carey just happened to be driving by as Johansen lay on the unraked leaves. They quickly called 911. Guided by the dispatcher over the phone, Emma performed chest compressions for more than seven minutes until first responders from the Troy Police Department and Fitzwilliam Fire Department arrived on scene to take over.

“It’s amazing that someone could do that,” says Johansen, whose heart began beating again after several more minutes of CPR and shocks from a defibrillator.

“I never thought I’d be on the other side of a defibrillator.”

Pauline Johansen, RN

Pauline Johansen, RN 16 2021–2022 Report to the Community

“It’s more than just luck. There was some divine intervention.”

In 2021, Johansen was one of 10 people in our community who experienced sudden cardiac arrest (SCA) and were saved by the heroic and lifesaving efforts of 911 telecommunications, dispatchers, bystanders who performed cardiopulmonary resuscitation (CPR), law enforcement officers who used an automated external defibrillator (AED), fire department first responders, and EMS clinicians. To celebrate these lifesaving efforts, the first annual “Rescuers Reuniting with the Rescued: A Celebration of

Definitions Survival” was held at Best Western Plus in Keene on June 2, 2022, bringing together the SCA survivors and the many people involved in their survival.

Joined by her husband of 53 years and two children, Johansen was able to meet both Carey sisters, along with their dad and grandparents.

“I want to thank my guardian angels,” Johansen told The Keene Sentinel.

The event was part of Cheshire’s efforts to highlight the importance of knowing how to perform CPR and use an AED during National CPR and AED Awareness Week, June 1–7.

“We also wanted to take this opportunity to celebrate these remarkable saves and promote awareness,” says Jim Suozzi, DO, associate medical director and EMS medical director for Cheshire Medical Center. “Our region is very fortunate to have high bystander CPR rates, around 70%. This is likely due to telecommunicators at 911 recognizing patients who are in cardiac arrest and directing bystanders to perform CPR.” When someone goes into SCA, every second counts.

Knowing CPR and how to use an AED could save a life.

If SCA occurs outside the hospital, the survival rate is around 10%. When the person receives CPR and shock therapy from an AED, the survival rate is over 50%.

These statistics highlight the importance of knowing how to perform CPR and use an AED. Johansen spent a few hazy days in Cheshire’s ICU and inpatient Thompson Unit. “I kept asking repeatedly what happened to me,” she says.

an electrical impulse or shock to the heart when it senses a life-threatening change in the heart’s rhythm. She then completed almost two months of cardiac rehabilitation at Cheshire.

Johansen says she has a “profound” appreciation for the people who cared for her during her recovery, from those in the ED and ICU to the Thompson Unit and Cardiac Rehabilitation—and everyone in between.

“They call me their star patient,” she says, “but, really, they’re the stars.”

As for that wedding, it went off as planned 15 days after Johansen’s heart attack.

“I was there,” Johansen says, “and I danced my heart out. I don’t remember much. But I danced!”

Johansen, now 72, returned to the ICU several months later—working 24 hours a week caring for other patients. Her blood pressure and cholesterol are “perfect,” she reports after a recent check-up with her cardiologist. She’s able to exercise, using a stationary bike to ride 6 to 7 miles a day.

On the one-year anniversary of her near-death, on Sept. 17, 2022, Johansen hosted a “Rebirth Day” party on her front lawn. She invited the Carey sisters, as well the Fitzwilliam and Troy first responders, who weren’t able to make the June event.

But first, she had to do some raking.

“That work never got done,” she says with a smile and just the hint of a tear.

Cardiopulmonary resuscitation (CPR) is a life-saving technique useful in many emergencies, such as a heart attack or near drowning, in which someone’s breathing or heartbeat has stopped. The American Heart Association recommends starting CPR with hard and fast chest compressions.

An automated external defibrillator (AED) is a medical device designed to analyze the heart rhythm and deliver an electric shock to victims of ventricular fibrillation to restore the heart rhythm to normal.

A heart attack occurs when there is a blockage in an artery that supplies blood to the heart.

Cardiac arrest occurs when the heart stops beating. This is often due to a heart attack, although not all patients who suffer from a heart attack experience cardiac arrest. Patients experiencing a heart attack can suffer from a lethal cardiac arrhythmia called ventricular fibrillation (V-fib), which results in cardiac arrest.

CPR keeps blood and oxygen moving to the heart and brain and prolongs the amount of time people are in V-fib. While in V-fib, patients can be treated with a defibrillation device such as an AED. If you are called on to perform CPR in an emergency, you will most likely be trying to save the life of someone you love: a child, a spouse, a parent, or a friend. Individuals interested in becoming CPR certified should email healthymonadnock@cheshire-med.com for information about upcoming trainings.

Ultimately, her care team placed a stent in one of Johansen’s coronary arteries and fitted her with an automatic implantable cardioverter-defibrillator (AICD), a device that monitors her heartbeat and delivers 2021–2022 Report to the Community 17

Community benefits is an organization-wide responsibility and commitment

 Community Health Services.................................$403,330

The Center for Population Health (CPH) was completing a new Community Health Needs Assessment as this report went to print. Conducted every three years, this assessment helps identify emerging needs and issues affecting the health and well-being of people in the region based on community members’ feedback. Some articles in this year’s Report to the Community illustrate recent efforts to address community health improvement needs. Other important changes in the past year include the following:

 Community Benefit Operations........................$530,544

•

•

•

CPH received a new $826,000 state grant to oversee the Public Health Network and related services in the Monadnock Region. This program supports emergency preparedness activities and many prevention strategies. It is led by the Leadership Council for a Healthy Monadnock, with staff support from CPH. The Doorway expanded services with a new Medication-Assisted Treatment clinic and a closer partnership with Cheshire County Drug Court program, providing treatment support services for their clients.

A partnership between Cheshire’s Diversity, Equity, Inclusion, and Belonging (DEIB) committee and Keene’s Racial Justice and Community Safety committee in 2021 has led to the creation of the new regional Monadnock Diversity, Equity, Inclusion and Belonging Coalition (MDEIB Coalition). Engagement with new stakeholders is increasing awareness of this work. The new MDEIB Coalition was featured at the American Hospital Association’s national conference on Accelerating Health Equity in May.

18 2021–2022 Report to the Community

 Health Professions Education..............................$894,450  Subsidized Health Services.....................................$1,229,469  Financial and In-Kind Contributions.............$345,002  Community-Building Activities...........................$861,803  Charity Care/Financial Assistance...................$1,708,000  Government-Sponsored Healthcare............$16,188,473

Cheshire Provided Community Benefit...$5,972,598 no government-sponsored healthcare

Full Community Benefit.............................. $22,161,071 *preliminary numbers as of October 2022

Programs and partnerships Interpreter Services: 2,573 patient care visits were provided in a language other than English. The top five requested languages are Spanish, American Sign Language, Portuguese (Brazilian), Vietnamese, and Mandarin.

Prescribe for Health Initiative: Fielded 494 referrals, including 321 with complex needs and 173 for Activity is Good Medicine.

Sports Medicine Athletic Trainers: More than 4,500 hours supporting local high schools and community events.

Wellpowered Schools: 16 schools participated.

The Behavioral Health Liaison Team: 2,028 behavioral consults; 1,132 psychiatric consults for a total of 3,160 patient consults.

Family Resource Counseling Assistance: 147 applications for coverage completed, enrolling 216 community members for healthcare coverage.

The Doorway: Served 1,270 unique individuals during 4,279 appointments.

Substance Use Disorder–Medication Assisted Treatment Project: Served 351 unique individuals during 1,371 appointments.

Wellpowered Worksites: 30 organizations participated.

Right This Way: 11 organizations and 331 individual participants.

Mind Full to Mindful: 9 organizations and 149 individual participants.

Run and Read: 5 libraries participated.

Volunteer Support: More than 1,000 hours of volunteer support provided to local nonprofit organizations through presentations, board, and community support.

Community Health Improvement Plan: Allocated more than $55,000 to local nonprofits to implement programs that advance the work of our Community Health Improvement Plan (CHIP), which sets the strategic direction for the Healthy Monadnock Alliance.

Above are many of the friendly faces of the Center for Population Health, shown in a photo taken earlier this year.

The Center for Population Heath at Cheshire Medical Center Cheshire’s Center for Population Health (CPH) works to improve the health and well-being of people in the Monadnock Region. Throughout this Report to the Community, you can find stories of people whose lives have been impacted by CPH’s programs and partnerships.

CPH uses information gathered from a community health needs assessment to guide our work. It measures social factors that influence health. These factors need to be addressed for individuals to achieve optimal health and well-being. We follow evidence-based practices to develop policies, programs, and

initiatives that support an active lifestyle, good nutrition, healthy living conditions, and well-being for all in the community.

We could not do this work alone.

CPH engages and collaborates with community partners to improve the health and wellness of individuals, families, worksites, schools, and more. This work supports access to care, continuum of care facilitation, mental health, obesity prevention, substance use disorder treatment and prevention, and tobacco use prevention.

Healthy Monadnock Alliance The Healthy Monadnock Alliance (HMA) is a regional partnership of community leaders representing municipalities, schools, businesses, nonprofits, coalitions, faith, and civic groups who have joined together around a common purpose. As an alliance, they are dedicated to creating a compassionate community, where health equity and emerging community needs are at the forefront of their work.

The members of the Healthy Monadnock Alliance believe that together they can work to create better health and wellness for everyone in the Monadnock Region. They accomplish this through shared goals, cross-community connection, and collaboration to execute the Community Health Improvement Plan (CHIP). Membership in the Alliance is open to any organization interested in

helping advance health and well-being in this region by doing the following: •

Connect: Members of the HMA realize that together, we are more powerful than we are alone.

Connecting with like-minded organizations expands our reach throughout the region.

•

Advance: Members of the HMA are actively improving health outcomes by advancing one of the five Priority Areas of the Community Health Improvement Plan.

•

Assess: Members of the HMA know that improvement happens through a cycle of data collection, assessment, and evaluation.

Measuring what matters helps others learn from our valuable work.

2021–2022 Report to the Community 19

Monadnock Mobile Food Pantry pop-up

Cheshire Walkers We are pleased to announce that Cheshire Walkers’ long-standing community partner, Monadnock Conservancy, has taken over full stewardship of the program as of June 1, 2022. We’re thrilled that a program founded by a community partnership between Cheshire and the City of Keene Parks and Recreation Department more than 20 years ago will continue to grow stronger today through the efforts of another community partner.

Through Cheshire Walkers, a group of older adults meets to explore the Monadnock Region together every Wednesday in the fall and spring through a series of easy-going hikes. The program helps participants increase their physical activity, foster social connection, and learn about the region’s rich history. The program was on hiatus during the COVID pandemic.

Over the years, the Monadnock Conservancy has planned and guided special walks for Cheshire Walkers. Based on these positive experiences, Executive Director Ryan Owens submitted a proposal on behalf of the Conservancy to expand its support to include oversight and management of Cheshire Walkers. Cheshire Medical Center’s leadership and the Monadnock Conservancy board of trustees approved the proposal, expressing confidence that Monadnock Conservancy will steward this beloved program well.

20 2021–2022 Report to the Community

The Community Kitchen’s Monadnock Mobile Food Pantry program officially launched at the Winchester Senior Living facility on June 11, 2022.

Thirty-four people attended the first of six “popup” events, with an estimated 700 pounds of food distributed. During September and October, five similar events were slated to take place in Fitzwilliam, Gilsum, Antrim, Nelson, and a second event in Winchester.

Kate Leversee, The Community Kitchen’s new pantry manager, oversees distribution, and the Monadnock Food Access Alliance (the work group responsible for last year’s Monadnock Food Access

Analysis) provides on-site support during the events.

Distribution locations are in areas of significant food insecurity, compounded by a lack of transportation.

The Locals’ Local Fund, launched by the Monadnock Farm and Community Coalition, works to support local farmers and get food into the Monadnock Mobile Food pantry by purchasing local farm products at a negotiated price.

Climate and health resilience The health and resilience of the Monadnock Region are impacted by a changing climate, more frequent and severe weather events, and an aging population. In 2022, the Climate and Health Resilience Initiative, a partnership between the Greater Monadnock Public Health Network, Antioch’s Center for Climate Preparedness & Community Resilience, and the NH Department of Health & Human Services, implemented an intervention to measure and strengthen the region’s community resilience.

More than 40 organizations and community leaders participated in online surveys and virtual workshops. Educational topics included climate hazards, related health impacts, and community resilience definitions and metrics.

Two evidence-based resilience tools were

implemented: Assessing Disaster Engagement with Partners Toolkit (ADEPT); and the COPEWELL Toolkit on Social Capital and Cohesion.

The region’s resilience was rated as “Good” using both toolkits. A lack of resources was the biggest challenge for organizations when preparing for or responding to severe weather events. The next steps to strengthen community resilience include identifying resource availability, increasing community partnerships, and building trust between older adults and the organizations that serve them. The intervention strengthened community resilience by increasing participant understanding of resilience; connecting organizations; building new relationships; and starting conversations.

Mind full to Mindful Wellpowered Worksites, a program offered through CPH, has been promoting health and well-being throughout our community for nearly a decade. As the pandemic revealed an even greater need for mental health resources, the Wellpowered team got to work. They quickly realized if they wanted to offer an impactful mindfulness program with in-depth curriculum and professional instruction and make it accessible to worksites, they would need to build it themselves. So, they did!

Throughout the past year and a half, the Wellpowered team has worked hard to create the Mind Full to Mindful program from the ground up, with the help of a trained mindfulness instructor and a professional production company.

Partnering with nine local organizations in 2022, Mind Full to Mindful was successfully piloted, helping bring presence and peace of mind to more than 149 participants.

Local residents assisted the Winchester Fire Department in filling and laying sand bags on the dam to prevent erosion during the severe flood in Cheshire County on July 18, 2021.

Photo by Janine Marr.

Lindsey Cushing, MSN, APRN, SANE-A, and Kelsey Page, BSN, RN, SANE-A

Care for sexual assault survivors Providing healthcare for people who experience sexual violence requires knowledge, experience, and a patient-centered, traumainformed approach. A key element in providing the highest quality care is clinicians specially trained in caring for patients who have experienced this type of trauma, such as Sexual Assault Nurse Examiners (SANEs).

Kelsey Page, BSN, RN, SANE-A, and Lindsey Cushing, MSN, APRN, SANE-A, of Obstetrics and Gynecology, are leading Cheshire’s efforts to improve

and expand care for survivors of sexual violence and related crimes. They are revising and creating policies and procedures for the care of survivors and educating staff in clinical settings on what to do if a patient discloses an assault. In April, they led the Sexual Assault Awareness Month campaign in partnership with the Monadnock Center for Violence Prevention (MCVP), a community organization focused on prevention and responding to survivors in the region.

2021–2022 Report to the Community 21

2021–2022 Year in Numbers 3,641

634,968

237,506

2,758

Admissions

Provider visits

3,829

Surgical cases

Laboratory tests

Pain clinic procedures

19,093

Respiratory therapy treatments

418

6,393

23,867

82,148

12,634

7,651

14,448

65,917

79,468

148,828

16,689

844,727

Newborns

ED visits

Virtual Visits

Urgent Primary Care visits

Imaging Exams

EKG/EEG tests

22 2021–2022 Report to the Community

Endoscopies & colonoscopies

Physical therapy & other outpatient treatments

Volunteer hours

Patient meals

Non-patient meals

Pounds of laundry processed

2021–2022 Financials As the region’s leading care provider, we strive to make Cheshire Medical Center a place that patients choose not just for convenience, but for quality and safety. Our commitment to the Monadnock Region remains strong over the last 130 years of service to the community. We are uncompromising in our pursuit of excellence, and our commitment to providing excellent care to every patient and family member is paramount.

The fiscal year 2021–2022 continued to be a difficult year for our community as we attempted to return to a new normal in the presence of a global pandemic. During the winter months we experienced our most intense wave of COVID so far, forcing the hospital to cancel elective procedures and to re-deploy some staff into the inpatient and ICU settings. As in the past, this took a financial toll. In addition to the pandemic, a nationwide staffing shortage in healthcare is impacting our ability to fully staff all areas, and the cost of staffing is escalating quickly.

Cheshire Medical Center ended fiscal year 2022 with a $10.8M (-4.2%) loss from operations, which includes $13.8M of federal stimulus funding for pandemic relief. Volumes were lower than budgeted in many areas, due both to the COVID wave and to staffing shortages. Patient Revenue ended the year $14.4 million lower than plan.

Operating expenses were generally well managed, with the exception of staff salaries which were $8 million over budget. This result is due to reliance of contract labor to cover open positions at a significant premium over normal wage rates.

It is very important that Cheshire operates at a breakeven or better operating margin in the long run so that we can invest in needed facilities and equipment. Our membership in the Dartmouth Health system provides us with access resources (such as a strong balance sheet and access to low-cost borrowing) that continue to strengthen our ability to ride financial disruptions like these without impacting staffing or the quality of our care. This partnership allows Cheshire to serve patients and families, and colleagues who support our efforts to deliver exceptional care—an essential objective of our mission.

Cheshire Health Foundation fiscal year 2022 report

Statement of operations Twelve Months Ending June 30, 2022 Billed for services to our patients: Care for inpatients..............................................................................$128,278,237 Services for outpatients..............................................................$645,107,786 Received from other sources.................................................$24,852,055

Cheshire Health Foundation cultivates and stewards charitable support to advance Cheshire Medical Center’s health and wellness mission. This includes raising funds for patient care, equipment, programs, nursing scholarships, facilities, and more. We are grateful to our community for supporting all of our strategic fundraising initiatives.

Gifts given between July 1, 2021, and June 30, 2022, totaled more than $6.9 million and represent our community’s commitment to exceptional healthcare close to home.

Your support helps to make Cheshire Medical Center stronger. Thank you for your commitment and all you do to help us care for our community.

(Includes income from incidental services, investments of previous charitable gifts, and unrestricted gifts from hospital donors)

Total from all sources: ......................................... $798,238,078 Amounts billed but not received: Government programs and commercial contractual agreements...........................................................$516,064,998 From patients unable to pay and bad debt.........$20,675,896 Therefore, we actually received revenue from patient care and other services of: ....................$261,497,184 Our costs included amounts: To pay our employees and physicians....................$166,886,244 To pay our suppliers and vendors......................................$78,416,324 To operate the building, depreciation, and pay interest........................................................................................$17,601,840 Resulting in total costs for patient care and other services: ................................... $262,904,408 Residual earnings intended for use to reinvest in our community’s healthcare:.......................................................... ($1,407,224) Payment of the state Medicaid Enhancement Tax....................................................................................................$9,468,525 The excess of amounts received over costs for the year is used to expand services to our community, to improve the facilities, and to pay back debt. ........................................... ($10,875,749)

Fiscal Year 2022 Charitable Contributions by Fund/Need

Fiscal Year 2022 Committed Expenditures

 Ultrasounds Fund.......................................$520,000

 3 Ultrasound Machines.................................$520,000

 Nursing Scholarship Funds................$122,604

 Cancer Care & Patient Relief*.......................$18,468

 Cancer Care & Relief Funds.................$30,043

 COVID-19 Response..............................................$166,043

 Family Medicine

 Patient Financial Assistance*....................$449,870

Residency Fund.........................................$3,031,500  Farnum Rehab & Education Funds................................................. $63,126  Bequests—Patient Care/

Equipment.........................................................$1,893,250  Emergency Medicine...................................$17,000

 Nursing Scholarships/

Education*..........................................................................$131,587

 Cardiac & Pulmonary Rehab.............................$6,174  Women’s Health/WACHU...................................$27,814  Emergency Medicine............................................. $15,883

 Women’s Health/

 Inpatient Care Computer

 Strategic Capital Fund......................$1,000,000

 Family Medicine Residency

WACHU Fund...........................................................$20,172

 Inpatient Care

Computer Equipment................................ $40,079

 Other Funds, including Equipment,

and Patient Care & Assistance.. . . . . . . . $200,536 Total..................................................$6,938,310

Equipment.........................................................................$40,079

Program/Facility....................................................$2,371,079  Other, including Equipment, and Patient Care & Assistance..........................$40,424 Total......................................................... $3,787,421 *Includes FY 2022 income from restricted endowment funds

2021–2022 Report to the Community 23

Generosity and Giving

Evans Juris 24 2021–2022 Report to the Community

Evans Juris chooses to fight cancer close to home At his annual physical in October 2020, Evans Juris mentioned to his primary care provider, Katrina Masure, APRN, that he had some hoarseness he thought might be allergies.

Closer examination didn’t reveal anything, but Masure said if the hoarseness persisted, he should get it checked out further.

“Every single person knows you, and what others really need to know is that the treatment here is truly personalized,” Evans says. “The support at this medical facility is second to none.”

A positive attitude and support from friends and family helped Evans make good progress, even on days when all he could swallow was Jell-O, pudding, meal-replacement shakes, and ice cream. He particularly credits his wife of 40 years for seeing him through his cancer treatments.

Evens and his wife, Lois, headed to their winter home in Florida. But by May 2021, he had returned to the Walpole Family Medicine Clinic, opting to come to Cheshire rather than seeking care in Florida, “where you’re just a number,” Evans says. After a second examination, Masure “Lois,” Evans says, “is my rock.” referred him to Cheshire Medical Center’s Ear, Today, Evans is doing well, and there is no sign Nose, and Throat (ENT) specialists. of his cancer. He is grateful to the Cheshire With Lois by his side, Evans met with Paul staff who helped him during his cancer Righi, MD, and underwent an endoscopy. He journey and has honored many of them knew the results were bad by watching Lois’ through the Circle of Gratitude, including body language. Their worst fears were soon Masure. As Evans says with a smile, “When she confirmed: It was throat cancer. says she’s going to follow through, she follows through!”

Righi said Evans would need surgery immediately. Evans, who was looking forward to summer with his family, asked if it could wait. He was told with certainty that it could not.

On July 15, 2021, 40 percent of Evans’ tumor was surgically removed. The remainder, which was twined around his larynx and vocal cords, was targeted through seven weeks of grueling daily radiation treatments and medication. Although he was given options to have his treatments elsewhere, Evans again chose to stay close to home and receive his care at Cheshire.

“Every single person knows you, and what others really need to know is that the treatment here is truly personalized.”

Caring for her community: Katrina Masure, MSN, APRN When Katrina Masure, MSN, APRN, was asked if she would accept a panel of patients at Walpole Family Medicine, she jumped at the chance to work in the same community where she lives. That was seven years ago, and Masure’s impact on patients has been significant.

Evans Juris knows this firsthand: It was Masure’s intervention that led to his throat cancer being detected and treated. He recently honored her and others involved in his cancer care through the Circle of Gratitude (COG), Cheshire’s grateful patient program.

“It’s beyond words,” Masure says about her COG recognition.

“It was extremely meaningful to be honored and a reminder that the work I do in the community is impactful and sometimes life-saving.”

Masure says living and working in the same community means she has a personal stake in patient outcomes. Her skill and expertise got Evans Juris where he needed to be, and for that, he will always be grateful.

Evans Juris 2021–2022 Report to the Community 25

Has someone at Cheshire Medical Center made a difference in your visit or stay?

Make their day with your appreciation. Our Circle of Gratitude is a special way for you to honor a provider, nurse, dietary aide or any employee.

Learn more at cheshirehealthfoundation.org/circle-of-gratitude

Karen Morris, RN, amazed by Circle of Gratitude honors

Lindsey Cushing, APRN, beloved by her patients

Calvin Seppala, RN, truly touched

by COG recognition

Karen Morris, RN, has worked at Cheshire for 22 years, most of that time caring for patients in the Post Anesthesiology Care Unit (PACU). On a typical day, she may care for as many as 10 patients, each of whom has had a procedure or surgery.

Lindsey Cushing, APRN, is a multiple-time Circle of Gratitude honoree for her care of Obstetrics and Gynecology patients. Her confident, caring manner makes all the difference, reassuring patients and easing the experience of vulnerable circumstances and uncomfortable procedures.

As an inpatient nurse on the Thompson Unit, Calvin Seppala, RN, says that no two days are ever alike. He enjoys the diversity of the patients he cares for and the challenges that naturally present themselves.

She belongs to an elite group of Cheshire employees who have been honored two or more times by patients in the Circle of Gratitude (COG). Morris’ COG honors are from patients she cared for following their colonoscopies.

“Often, we care for the same patients again and again,” Morris says. “It’s extremely gratifying to know that I have made such a positive impact in someone’s life, but also amazing that they think so highly of the nurses and the hospital. It’s not just a thank you—those patients also gave a gift, and that’s BIG.” 26 2021–2022 Report to the Community

“To have patients let you know that what was a brief part of your day was a big or memorable part of theirs is truly gratifying,” Cushing says. “It’s a good reminder that short interactions can still be impactful and that sometimes the extra minutes you spend with a patient are really meaningful.”

It is clear that the grace and respect she extends to patients is returned in spades.

Cheshire is fortunate to have such a devoted care provider.

Seppala is a two-time honoree in the Circle of Gratitude, and each time he was recognized, he was caught by surprise. And, after two years of difficult COVID-related care for hospitalized patients, those honors also elicited some strong emotions.

“Receiving a handwritten note from a patient was really touching,” Seppala says. “We don’t normally get that kind of feedback, so it is extremely validating to know that our hard work is recognized and valued.”

Left to right: Don Wilson, MD; Don Caruso, MD, MPH, Cheshire president and CEO; and John Gove with a photo of Bernadette Quinn and a dedication plaque, both of which are hung near the new testing booth.

Raette Trombly (center) with the Frazier & Son crew, Tonya Wilder, Jacquelyn Trombly, Christie Wilder, and Emily Cook.

Donors hear the call, help purchase new audiology booth

Frazier & Son Furniture: giving back for a healthy community

In November of 2021, Cheshire expanded patient care in the Audiology department, thanks to the generosity of donors who helped fund a new audio testing booth. Their gifts, which were made during the New Hampshire Gives fundraiser, enabled the Medical Center to purchase and install a second soundproof audio booth and testing equipment.

Founded nearly 75 years ago, Frazier & Son Furniture is tightly woven into the fabric of the Greater Monadnock community. For Raette Trombly, the second-generation owner of the business, supporting Cheshire and other local nonprofit organizations has long been a priority, both personally and professionally.

In our community, the need for audiology testing services is considerable and only continues to grow. With the addition of the second audio booth, Cheshire has been able to increase the number of available testing appointments for patients.

This has included newborn hearing screenings, testing for children with speech and language delays, and appointments for adults experiencing hearing loss.

During a special ribbon-cutting ceremony, the new booth was dedicated in memory of audiologist Bernadette Quinn, MS, CCC-A. Bernadette was a long-time employee of Cheshire Medical Center and is affectionately remembered by many for her dedication to and compassion for patients.

In particular, she is remembered by her former colleague, Don Wilson, MD (retired), whose generous gift to the Audiology Fund in her memory helped make the expansion of these services possible. “She was loved by everyone,” Wilson says.

It is wonderful that the generosity of our community results in more patients receiving care due to this new equipment and that its use is in memory of someone who cared so deeply for others.

“I had my two babies at Cheshire, and most of our grandchildren were born there,” Trombly says. She adds that, in 2021, she had both of her knees replaced and rotator cuff surgery at Cheshire, and that her husband, Arthur, has had two hip replacements here.

She understands—from first-hand experience as a patient and from her perspective as a local business owner—the importance of keeping exceptional care close to home and what a thriving medical center means for the community at large.

Today, she continues a tradition of charitable giving that began with her mother. “We didn’t always have the money to give, but once we did, it became a priority to support Cheshire because everyone needs healthcare,” Trombly says.

We are grateful to have the support of Frazier & Son Furniture.

2021–2022 Report to the Community 27

The health and wellness of our community is supported by the kindness and generosity of Cheshire Health Foundation’s donors. We are grateful to be able to acknowledge those who supported Cheshire Medical Center’s health and wellness mission by making a gift from July 1, 2021 through June 30, 2022.

Every effort has been made to publish an accurate list. Please bring any errors to our attention by calling 603-354-6800.

Cheshire Health Society ($25,000 and up)

Monadnock ($2,500–$4,999)

Anonymous (1) Bill and Kathy Baldasaro Estate of John Bradshaw* Donald and Jill Brehm Jan and Rick Cohen Linda Guinane Richard P. High, PhD and Joyce Clark* Estate of John Palkowski* Jarrett and Ann Scott Estate of Marabel P. Snyder*

Anonymous (2) Friends of Jenna & Patrick Lisa and George Foote, Jr. Yvonne Goldsberry, PhD and Cherie Holmes, MD Daniel Gross Nancy and Roger Hansen, MD Nathalie B. Houder Ruth and Carl Jacobs, Jr. Amy and Keith Matthews Jennie Norman and William Walker Robert and Judith Perry Sandie Phipps James E. Robertson Patti and Gregory Seymour, MD Katherine Snow and Paul Ledell Eleanor and James Stack Barbara Taft Robert and Lianne Therrien Kathryn and John Willbarger

1802 Founders ($10,000–$24,999) Anonymous (1) Stephanie and *Joseph Baute SB Legacy Fund Barbara Coburn JoAnn and William Fenton John and Jean Hoffman Geof and Donna Molina Jim and Judy Putnam Elliot ($5,000–$9,999) Anonymous (2) Eleanor Ball Edward and Mable Bergeron Don Caruso, MD and Nancy E. Johnson, MD Christine and Thomas Doane Mark and Kathy Gross Eileen and Michael Sarson, MD

Granite ($1,000–$2,499) Anonymous (10) Susan Abert, Esq. and Thomas Abert Nathan Alexander, CPA Jill Batty and Daryl Stutes Mark Bodin and Madeline P. Bodin Jane and John Bridges Megan Burke Kidder Cynthia Caddell Mary Lou Caffrey and Kenneth Stewart Louise and Edouard Carignan, PsyD Leslie and James Casey

28 2021–2022 Report to the Community

Dan Chalifour Barbara and William Chase, MD Elizabeth B. Cotter Michael and Theresa Desilets, APRN Kimberly DeVore, DO Linda and Robert DiLuzio, Sr. Barbara Dowd Alfrieda and Robert J. Englund, MD Claire Fabian, MD and Jack Fabian, PhD Ian and Maryanne Ferguson Marcia French Cecile Goff Mitch and Erika Greenwald Robert Guardiano, DO and Sherry Guardiano, DO Christopher Hamblet Donall and Joyce Healy Kerry Henegan and Marika Henegan, MD Paul and Sussan Henkel Eric and Dottie Herr, MD Larry and Ashton Kane, DVM Michael and Tricia Kapiloff Richard and Diana Kasper Liam Kelly and Lesley Loke Jennifer and Gerard Kiernan, MD Norman Kristoff David P. LaCoste and Patricia I. Campbell, DO Mary Ann Lancey Martha M. Landry Jane and Steven Larmon, MD Carolyn Loos George D. Maydwell Timothy and Ann McCann Jennifer Michelson, RN Robert and Kim Mitchell Hélène and Chris Mogridge

Anne and Bill Moyle, MD Robert and Mary Jane Nardone Maria Padin, MD Lisa A. Profetto, APRN and Eric M. Goodman, APRN Louise and Dan Rath, MD Reinette and Brian Reilly, MD Katherine Richardson Richard Scaramelli Connie and John Schlegelmilch, MD Rev. and Mrs. Charles Shook, Jr. Jane P. Skofield* Jane and David Stabler Valerie and Jonathan Starbuck Alan and Melissa Stroshine Sandra L. Swinburne Jeanie M. Sy Julie and Gregg Tewksbury Bayard Tracy Jeanne Williams Bruce Williamson Kathy and Donald Wilson, MD Martha J. Zimmerman Susan Zimmerman Ashuelot ($500–$999) Anonymous (11) Patrick and Katelyn Ahern, APRN Honey Aho Genny Alexander Mary Annear Dorothy Arwe Cynthia Baute Robert Baute, Jr. Tracy and Mike Beam David and Patricia Beffa-Negrini Paul and Elaine Bieber Jim and Bev Boden Suzette Borden Peter and Maria Bradshaw Hilary Brown Jessica Bullock John Bunce John and Catherine Byrnes Emmy and Jerry Chamberlin Katherine Clarke and Lily DeYoung Joseph and Marina Coneeny Alison Cuomo-Nason and Donald Nason

Mark and Phoebe Danahy Irene and David Davis Allison Deen Elisabeth M. Dignitti Susan C. Doyle Jennifer and Shawn Doyle The night crew - the “stars” that come out at night Sean Drower Richard and Patricia Dugger Susan and John Eastwood Jacquelyn and Paul Ethier Marla and Todd Evans Brad and Sharon E. Ferguson, DO Kevin and Dawn Forrest Tiffany French, RN Mark and Amanda Fryberger Mark and Barbara Gavin Mindy Glasschroeder Brenda and James Glinka Julie and Doug Green Marian Gunnell Charlotte Guyer Lori A. Guyette Audrey L. Hadcock Gail Hale Joseph Higgins Carrie and Steve Hoffman, DMD Dennis and Evelyn Huston Charles T. Jackson, RN Karen P. Johnson Jay and Cheryl Kahn Judy and Rich Kalich Alison P. Kapadia, MD and Nirav Kapadia, MD Margaret Kasschau and Donald Gillis* Kerry Kelley Neha and Aalok Khole, MD Erika Kleczek Shawn LaFrance and Rebecca Farver Gail Laraba Nora G. Larsen Victor Lawrence Stephen and Leslie LeBlanc Joanne LeRoy Steven R. Levene, MD and Susan W. Peters Jeannine Lucius * Deceased

Jessica and Donald Lussier Charlton and Diana MacVeagh Michelle and Carl Majewski Billie Marks Jodi Mattson Laura May-Scott Sylvia and Craig McBeth, DMD Susan H. and John H. McGinnis Sandra and Robert Miller Jeffrey B. Miller and Carol MacKinnon Michelle A. Miner Heather and Thomas Minkler Charles and Mary Lou Montgomery Bob and Maryann Mucha Alisa and David Nash, MD Tina Needham D. and A. Nichols Michael L. Ormont, MD Debora Pierce-Settle Jane and Leslie Pitts, MD Rebecca Pratt Wilder David and Susan Quigley Laura Reyor, APRN Larry Robbins, MD Ann* and James Robinson, MD Mary and Bob Rooney Paul Roth Venkat and Brinda Sadasivan Lisa and Eric Sandstrum Cynthia Sieracki Lynn and Arthur Simington, MD Suzanna and Thomas Strempfer Mary and James Suozzi, DO Sarah M. Tatro Maria and Kimball Temple, MD David and Lisa Therrien Mallorie Timon Gary and Susan Tochterman Suzanne F. Tremblay, MD and Andrew G. Tremblay, MD Anthony and Barbara Tremblay Kelsey Trombley Jason and Stephanie Vallee Olivier Van Houtte, MD Panom Voravittayathron Joe and Judith Walier Steve and Leah Walsh Sandra Van De Kauter and John N. Walter, Jr., MD * Deceased

The Honorable Lucy Weber Robert Westlake, MD and Susan Byrne Cynthia and David Westover W. John Whittaker Richard and Sharon Wilson Ellen M. Wright Joseph and Lorraine Youngs Elm ($250–$499) Anonymous (12) Charlotte Alexander Richard Anderson Janet Aug, OD Carol A. and David B. Beal Tracy and Richard Beard Sarah Beckley Gail Bomba Constance J. Bowblis Mara M. Bryand Elaine Carey Don and Heidi Carlisle Lorraine and Gregory Chaffee Heidi G. Clark Rebecca Cleveland Ashley Copeland Moira Croteau and Steve Creamer Jane B. Cunningham Hilda L. de Moya Ashley DeLea Karen E. DeMinico Klaus and Margery Dickinson Thais and Todd Dombrowski, MD Dennis Donegan Tuesday Douglass

Barbara Duckett and John McPeake James P. Duffy Jay Eason Frederick and Else Ernst Caroline and Tom Ewing Susan S. Farrell Catherine Forrest Lucius and Rhonda Fowler Ann Gagnon Dawn A. Gallagher Maich Gardner and Ed Tomey Jennifer and Michael Gomarlo David and Rhunell Gruender Kate Guyette Gail Hamblet Parker and Sally Hansel Debora Haskel Coby and Katherine Hauser Sharon Helie Kelsie and Stephen Hennessey Christine Hrynowski and Ockle Johnson Valerie D. and Frank Jenkins Carol and *Ken Jue Lauri and Basilio Kalpakian, MD Robin Kelly April M. Kerylow Robert and Lynn Kimball Joslin Kimball Frank Suzanne and Paul Krautmann, DDS Robert and *Loretta Lariviere Sara LaShay Marcia Legru Deborah Malila Maura McQueeney Allen and Ellen Mendelson Laura Merrifield

Kathleen and John Moyer Margaret M. Murtha Kristen Nadeau Meena and Addison Neva Michael and Beth Newbold John H. Newman, MD and Rebecca Lyford Lisa Nuttall Kalie Randlett Rachael Richardson Hila Robinson Mircea Rusu, MD and Raluca Rusu, MD Sara Sargent Judy and Anton Schoolwerth, MD Marcy and Charles Southgate Debra Stallings Deb and John Starkey Maria Stewart Kecia Stone Christine Symonds Wendy Tenney Nancy P. Thompson Deborah Timon Robin Topper Dorrie and Donald Upton Nancy and Paul Vincent Gina Warner M. Denise Wissell Philip Wyzik Louise Zerba Stone Arch ($100–$249) Anonymous (47) Michael A. Ahern

“Cheshire Medical Center has always been here for us—something a lot of people might take for granted. Judith and I both realize how lucky we are to have a medical center of this caliber and size and are proud to have supported Cheshire for more than 40 years.”

Joe and Judith Walier

Janice and Louis Albano Elizabeth and Brewster Ames Jr David Arakelian Robert Baldrian Michael Ball David and Fay Barden Gary and Susan Bascom Cecily Bastedo Roland J. Beauchemin Cheryl Belair and Stephen B. Bragdon Deanne and Paul Belanger Thomas Bergin, Jr. Alyse and Paul Bettinger, MD James and Lauris Bissell Michael and Kathryn Blair Holley Allen and Jacques Blanchet, MD Donna and Joseph Calabro Susan Carlson Harriette H. Carter Shauna Chamberlain Paul G. Chamberlin Mike and Kathy Chelstowski Elizabeth and Michael Christiansen John C. Clark and Judy Unger-Clark William and Jacqueline Cleary Ellen and Bruce Clement Bob Cochran, MD Ross and Carrie Cocklin, MD Bob and Kathy Collinsworth June and William Congdon Andrew and Pamela Cooke Cynthia Copeland and Wayne Woolridge Cindi and Rich Coughlin Susan and Michael Cox Mark Cross-Powers Richard Crowe, Jr. Shirley and Wayne Crowell Heidi Cushing Linda Daniel Joseph Darby Ann B. Day Norman Dean Rosemary Dettelback Nancy E. Dimauro Jean and Tom Dobson John R. and Edith C. Drinkwater Mark and Julie Drury 2021–2022 Report to the Community 29

Cheryl and Richard Durkee III Tammy Dwyer Eliza Eager Karlene Embler Laura Eno-Kennell Kathleen and Paul Fagley Michael and Julie Farhm Kim and Chris Farris Margaret and Richard Fellenz Donald and Paula Flemming Margaret and Arthur Flick Chris Fortier Barry Fowler Janet Fox Marilyn D. Freeman Richard W. Freeman George and Jane Freund Kevin and Susan Frewert Alice and Gilbert Fuld, MD Alice and Mark Funk, MD Carol and George Gage David and Jo Anne Gale Thomas Galloway Charles and Liz Anderson

Kathryn P. Gibson Barbara Giles Anthony and Maria Glimenakis Jane Goodband Susan Goodrich Nancy S. Graham Lynch and John O. Lynch Jennifer and Mark Guest Anita Hall Richard and Marian Hamilton Marianne and Doug Hamshaw Joy and Richard Hanrahan Peter and Bridget Hansel Colleen Harper Joanne Hayward Melissa and Ken Herman Jeanie Hickox Leonard and Frances Himmelberg Mark Hinrichs J. Robert and Joann Hof Kate and John Hoffman, III Susan Hoffmann Susan and David Howell Barbara and Paul Hudgik

“Quality medical care in our community has always been important to me as a family man and an employer. It’s even more important to me now that I have three active grandsons.

Every year, my wife and I identify a need at Cheshire Medical and help make it a reality by contributing a pre-tax gift from my IRA.” Bill Walker

30 2021–2022 Report to the Community

Paula and William Hudon Terri Hudson Judy and Phil Hueber Peter and Cornelia Jenness Carroll Johnson Evans E. and Lois Juris Kimberly Keating Risa and Douglas Keene, MD Sandra Kingsbury Anne and Eugene Klein, DDS Gregory Kleiner Dennis and Patricia Koch Douglas and Pauline LaBree Thomas and Linda Lacey Maurice and Susan Lafreniere Cynthia J. Lamoureux Judith Landry Phyllis and Howard C. Lane Elizabeth LaRose Kim Lauer Patrick Leary and Stephanie Burns Leary Marion Lefrancois Bob and Linda Lester

Cindy and John Letendre William and Barbara Lindsey Ellen Loughney Robert and Mary Jane Lupien Anne Lydon Louise G. Malcolm Peter and Sharon Mangan Sue and Jim Margraf, MD Millicent Martineau Kimberly Mastrianni Wade and Katrina Masure, APRN Meredith Matuszewski Greg and Susan McConahey Mary A. Mello Mike and Diane Metell Faith Miller Herbert and Paula Miller James and Deborah Miller William L. Miner Randall Morse Howard and Martha Mortenson Steven Myre Susan and Jeffrey Newcomer, MD Dean and Katherine Ogelby David and Susan Olson Peter Olsson, MD and Pamela Olsson, MD Alan R. Opsahl, MD Theodore H. Parent Robert J. Pavia Edward and Dawn Phippard Katherine Piispanen Norma Pinney David Pittman Charlie Plunkett Christopher and Michelle Pong Linda Price Joy and Karl Putnam Tom and Barbara Putnam Ann E. Quirk and James P. Phippard Sandra and Jeff Richardson Karen Rider Donna S. Robbins Amoriel Robinson Nellie and David Robinson Janet and Vincent Roche Justin Rosini Greg W. Rothman, MD and Linda B. Singer, MD Jim and Sharon Rousmaniere, Jr.

Beverly Schmidt Patti and Mike Schuman Karen L. Sebastian Rose and Dhanwant S. Sethi Jane and Gary M. Shapiro, MD Helen and Harry Shaw Margaret Sheldon Carol A. Shelley Mary A. Sherwin Elizabeth Shields Lucy Shonk Stella S. Sise Winifred J. Skeates and John Kerrick Steven and Sharon Skinner Pamela Slack Rosemary and Robert Smith William Starkey, Sr. Thomas Stearns, PhD Terry and Steve Stepenuck David and Cynthia Stinson Patricia and Michael Stoudt Paul J. Sullivan Roger and Ann Sweet Ann and Carl Szot, MD Cameron Tease and Dixie Gurian Eustace and Carol Theodore Mitchell and Cindy Thomashow Lisa Tkal and *Christopher Tkal David Todd Elsie L. Tretler Janice Walker Norma Walker Ernest J. Walsh George T. and Judith R Walton Michael J. and Cynthia Waters William and Judy Waterston Jeffrey Whitcomb Peter and Suzanne Whittemore Elaine Winzheim Rita Wirth Mary Ann Wisell Barbara Woodward Donna and Ernest Wright Patricia B. Wright Sarah Wright John and Gail Wrigley Jessanne Wyman Tricia Zahn Elizabeth Zimmerli William and Ruth Zimmerman * Deceased

Community (to $99) Anonymous (68) Joy W. Ackerman Ellen and David Adams Tim Ahern Marylouise Alther and Glenn Davis William and Mary Arnott Russ and Carol Austin Mary L. Bakalar Yvonne and Michael Ball Lin Banek Jill Beam Charles T. and Gail E. Bell Craig and Jenifer Bell David and Judith Bell Nancy and Thomas Best Christine M. Betts Mary Beverly Brandi Bills Barbara Binkowski Manaswini Bokka Pierre Bonneau Barbara A. Boulton Gretchen Bowman Kathy R. and Francis X. Breen June C. Brening Karen Brook Sarah Brubaker Marcia L. Buckman Sarah M. Bulger Marilyn Burday Rory Burke Richard and Jane Butler Josephine G. Butts Shirley Byczkowski Francis Caffrey Richard and Frances Cappucio Dana and James Carley Maria Castellano Freda Chabot Wanda Chabott Colette C. Chaput Joanne Charest Lillian and Michael Chirichella Catherine Chrost Dewitt S. Clark William K. Clark Patricia Consigny * Deceased

Sharon K. and Kenneth H. Cook Elizabeth Coors Sharon and Dale Courtney Dorothy L. Cripps Joan and Roger Crooker Christopher F. Curran Kathy Dalzell Leanne D. Daniels Julie Davenson Fatima Sol Davis Keith C. Davis Cynthia J. Day Louise A. Degrenier Dieneba Diallo Jean and John Diemond Frank Dobisky Diantha Dorman Julie and John Drake Caroline E. Driscoll Parke E. Duing, Jr. Kristen Earle Robin Eichert Elaine C. Ellis Victoria Farrell

Joel Feldmann Alexandra and Daniel Fernandez David and Betty Ferner Janice Fiandaca and Leo Rheaume Gina Fifield Gordon M. Fisher Betsy R. Follansbee Lois J. Ford Darren Forrett George Foskett and Mary Delisle Gretchen Fowler Marian O. Franklin Carlene Frazier Jill French Herbert and Kathy Frink Mary and *Rufus Frost Tracy Funk Glenn Galloway, CPA Nancy and Jerome Galloway Holly Gambone Isabelle Gander Patricia Garnis Simon Gascoyne Ross* and Sherry Gauthier

Sara Germain Graham and Virginia Gitchell Carol and Bernard Glabach Fotini and Christopher Glimenakis Ruth Goldstein Shae Goodell Elizabeth R. Gowen Sally and William Graf Barbara Grande Steve Grande Zaiga Greenhalgh Elizabeth Gunnerson Jacob and Henryka Haberman Frank Hale Nancy and James Hall Rev. Robert and Sandra Hamm John C. Hanrahan Rachel R. Hanson Diane Harris Donald P. Hart Kathleen M. Hart Wendell Harty Richard E. Hastings, Sr. Francesca Heap

Ann Heffernon Stephen H. Hellus Judith Henderson Ralph Herrmann Donald and Jane Hienkle Rita R. Hinds Nancy E. Hitchner Bentti Hoiska Gerald W. Holcomb Joan Horskin Abrahm and Tisha Howe Debra and Scott Hunter James and Caroline Huntley Stephen Ide Cecille Ingalls Kate Ingram, APRN Margaret Ioannou Michelle and Rob Jackson Cherryl Jensen David E. Jewett Meghan John David and Andrea Johnson H. Gregory and Jane Johnson Mary Jane Jones

“Having combined experience of more than 25 years in the Dartmouth Health system is the foundation for why we feel so strongly about giving to Cheshire Medical Center.

Being part of a place where we are able to care for the community we live in, the community where we are raising our family, and where our family and friends are taken care of is so important to us. Contributing to Cheshire comes from a place of knowing that the money is going to better the care that is given to the community we live in, and for that we are grateful.”

Katelyn Ahern, MSN, APRN and Patrick Ahern, LPN 2021–2022 Report to the Community 31

“The greatest gift to anyone is good health.

Every day, Cheshire Medical Center and its nurses, doctors, and staff make a real difference, caring for our community close to home. That’s a blessing and a mission we want to support well into the future and why we have included a gift for Cheshire in our wills.”

Rob and Lianne Therrien

Marjorie and Thomas Judge The Morrison Family Karl and Roxanne Karter Karen Kay Charlene Keith Linda Keniston Susan and Robert Kessler Allen Kiblin Deb and Ronnie Kilyanczik Anita and Marc Koolen Susan Krebs Ilona Kwiecien Suzanne M LaCroix Karen A. and Paul J. Laffond Barbara and Randal Lake Ruth Lambert Miriam Lanata Drew P. and Carol Landry Michael and Diane Langlois Pamela and David Laporte Marcy Larmon Gail P. Lawrence Dorothy Ledwith Daria F. Levy

Charlotte Lewis Roy Lightfoot Aaron Lipsky John and Joan Little Lisa M. Llera Timothy J. Lord Carol Lorente Caroll Lothrop Evan Lowy, MD Virginia D. Ludeman Richard A. and Claudia J. Lusky Erin Lynch Meredith A. MacDonald Karen J. and J. Patrick MacQueen Normand Madore Patricia and Gary Marcus Scott Marquis and Susan Belgard Marquis Roger and *Judith Martin Barbara Massicotte Mary Mathias William and Joan Maxwell Susan McMillan Maureen Means Patricia and Richard Mellen

32 2021–2022 Report to the Community

Alan H. Merrill, Jr. Paul and Kathy Miller Kully Mindemann Cynthia and William Moffitt Kathaleen E. and Phillip S. Morales Stephanie Morgan Walter and Elisa Neglia Art and Patricia Nichols Alvah W. Niemela James and Melissa Nikiforakis Kathy Nikiforakis Earl and Esther Norris Scott and Judith Northcott Sue Norton Poplin James J. O’Brien Thomas and Marianne O’Brien Bryant Oja Kelly L. J. Omu Christopher Osgood Ryan Owens Judith Palmer Atchar and Roy Patno Carol Patten Paul and Celia Pearson Neil Pelsue, Jr. Michele and Richard Penna Janice Perry Ralph Petti Stephen F. and Carol L. Pfistner Merope and Panos Pitsas Jill Plavnick Dennis Poirier Jack Pratt Nicole T. Prescott Mark and Jeanne Pride Erika Radich and Leonard Fleischer Joan Reilly Clare Richard Carla Richardson and Timothy Mowry Frank and Barbara Richter Andrew and Vicky Riggio Eli and Jen Rivera Louise Robbins Cindy Robichaud Marjorie Ann Rogers Philip Rogers and Sally Brooks Cammie Royce Derek Savory Catherine H. Schlichting

Kathryn and Stephen Schnyer Therese Seibert Ernest and June Severance James A. Shanks Walter and Carolyn Shelley Carl and Marjorie Shepardson Valerie Sherwood Kimberly Shonbeck Janine Short Marni A. Silverstein, MD Rebecca Simpson Annette M. Skoog Joseph N. Slater Lynda F. and Douglas Smith Melinda Smith Virginia M. Smith Richard H. Spaulding Dawn St. Luce Patricia B. Steeves Nicole Stefanowicz Sally Stockwell Nat and Sharon Stout Charles G. Street IV Elisabeth Street William Stroup and Amy McIntyre Mandy Summers Arnold and Leannette Suokko Robert and Elizabeth Sweet Nora and Henry Swierczynski Vamsi Krishna Syamala Kim Tann Mark M. Tanzer Curtis S. Tarlton, Jr. Thomas H. and Geraldine Taylor Lynn Tenney Martha J. Tenney Daniel Tewksbury Steven Tewksbury Lori Thoin Francis V. Thompson, Jr. Judith Tobin Stephen and Crystal Toegel Max Tolle Jill Tomlin and Jeffry Clifton Karen and Robert Tortolani Constance Tremblay Sheila and Robert Twombly Alei Verdi Courtney Vicaire Tyler Walters

Ruth O. Warren Martha and Larry Waters Susan and Thomas Weller Patricia Wheeler Paula Wheeler Kevin Whitfield Nancy and Doug Whitney Mary Whittle Rebecca C. Wilber Frederick and Janet Wilkinson Gareth Williams Alfred Lewandowski and Kathryn Williamson Clifford and Fay Wilson Craig and Susan Wilson Julie D. Wolf Guy A. Wood Patricia Woodward Sherry Wright Joan Wydo Norma A. Wyman Yvette Yeager and Thomas Bassarear Jonathan Young Gifts Made in Tribute and Memory

Every year individuals and businesses recognize, pay tribute to, and memorialize their family, friends, and co-workers with gifts to Cheshire Health Foundation. We are honored to be the beneficiary of so many meaningful sentiments.

In Honor of All cancer patients Genny Alexander Patricia Campbell, DO Don Caruso, MD Cheshire Medical - Winchester Clinic Carl DeMatteo, MD Annie Disilva Mary Jane Doody Jennifer Doyle Hala El Chami, MD Wayne A. Fowler Erin Jablonski * Deceased

Aalok Khole, MD Patrick Leary Donald Mazanowski, MD Stephanie K. Miller, CMA My patients and friends who struggle valiantly Joyce Paquette Paul Piispanen Dale Pollack, MD Lisa in Radiology Katherine Richardson Philip W. Rogers Pam Russell Gregg Tewksbury The dedicated staff at the Cheshire Health Foundation Rob Therrien Arthur Kelley Cooke Thomson Margaux Van Houtte Mark Verdi Wonderful people at CMC John Wood In Memory of Wendy Abbott Bonnie Aiken Kenneth J. Arwe Alice Kingsbury Bakemeier Loretta T. Ball Bill Ball Walt Banek Elijah Barrett Bill Barrett Peter Barrett Martha Ann Bauman Richard Bauries Joseph Baute Margaret Beauchemin D. Stuart Blakely Ann Bunce Cheryl Burrows Rosemarie T. Carroll Frank H. Carter, MD Joan Casey Tom Casey Barbara Chamberlin Kathleen Chertok Karen Clay * Deceased

Bill Cotter Linda Crump John J. Cunningham Leon Daniels II Jean Donegan Peter Doyle Sharon Eason Bill Ellis David A. Eno Maria Pinto Eufemia E. Paul Fachada, DPM Mark P. Fachada, DPM Louis Favreau Pauline Fish Richard Follansbee Peter James Fournier Allan G. Freeman, MD Annette Gagne George C. Gallagher Nancy Ganley Linda Graves Leland Gray Stanley Gunnerson Dexter Guyette Gale Hamlin Margaret Hanrahan Charles Hartmann Marilyn S. Hastings David (Mike) Helie Barbara Henault Richard Henault Jean Hudgik Frank Hudgik Christopher Hulsizer Mary E. Ide George H. Kay Dr. (Mrs.) Vrinda Vijay Khole Marie M. Kiblin Larry Lanata Loretta Lariviere Robert C. Larson Bret Clay Leighton Alfred P. Lewandowski Charles B. Loos Anne Matuszewski Annie May Sally May Donna Tewksbury McNeil Jane Menehini Harry E. Miller Robert Anderson Miller IV

Janice Miner Audrey Carey O’Brien Joan Pappas Terry Phipps Jody Poirier Wendell Pollock Alice Porter Vanessa D. Prigge Roz Putnam Cliff Reese Lee Robbins Kenneth B. Robertson Norris H. Robertson J.P. Roche Elizabeth Roche Peggy Roth Nancy Rowe Harriet Saal Judith Sargent James L. Schumann James G. Sise, MD Betty Slater Walter Smith, Sr. Judy Stadig Barbara Stampalia Linda Stone Virginia Street Cheryl Sullivan Jeanne Symonds Raymond Tewksbury Hattie Todd Donald C. Tretler Todd Walier Barbara Wardell George Warner, Jr. Robert S. Wesley Walter Whitfield Charles Winzheim Norman E. Woodward Iris N. Wright Douglas Wright Walter F. Wydo, Sr. Amy Zaluki-Stone, RN Edward Zimmerli The Green Family The William G. Zimmerman Family My Mom, Sandra Paul and Vinnie Christopher

Business and Foundation Giving AGM Landscaping Alexander’s Sheet Metal, Inc. American House Keene Arzol Chemical Company Barclays Bellows Falls Country Club Bensonwood & Unity Homes Bergeron Construction Company, Inc. Best Western Sovereign Hotel Borns Group BR+A Consulting Engineers Brady Sullivan Properties, LLC Brattleboro Country Club C&S Wholesale Grocers, Inc. Chesterfield Inn Clark-Mortenson Insurance CMH Foundation Colby-Sawyer College Conifer Health Solutions Crown Uniform and Linen Service Dartmouth-Hitchcock Medical Center Davis Oil Delta Kappa Gamma DEW Construction DiLuzio Ambulance Service Dunkin’ Donuts e4h - Environments for Health Architecture Eastern Architectural Representatives Eastman’s Fishing Fleet Edward Jones - Keene Branch Fairfield Inn & Suites Fenton Family Dealerships Fifth Generation, Inc. FirstLight Flaggs Window Cleaning Service FM Global - Boston Operations Frazier & Son Furniture Galloway Real Estate LLC

Geiger GemGraphics Hamblet Electric Harvard Pilgrim Health Care of New England Health Plans, Inc. Home Healthcare, Hospice and Community Service (HCS) Hooper Golf Club Johnson & Johnson Johnson Controls K. E. Bergeron Mechanical Systems Kapiloff Insurance Agency, Inc. Keene Country Club Keene Family YMCA Keene State College Ken Wright Construction Kurtz Family Foundation Lavallee Brensinger Architects Life Safety Fire Protection, Inc Limerick Charitable Trust Longhorn Steakhouse Marsh Risk & Insurance Services Inc. Mascoma Bank Merrimack County Savings Bank Microcatheter Components, LLC MINT Premium Car Wash Monadnock Community Hospital Monadnock Family Services Mount Snow New Hampshire Charitable Foundation New Hampshire Mutual Bancorp NG Advantage, LLC Norm’s Ski and Bike Shop Northeast Delta Dental Norton and Abert, PC

Orthocare Medical Equipment, LLC Papagallos Restaurant Pepsi Beverages Company Powers Guaranteed Services Putnam Foundation Raynor Dental RE/MAX Town & Country Red River Computers Ricoh RiverMead Runnings Savings Bank of Walpole Service Credit Union - Keene Branch SERVPRO Shattuck Golf Club Squam Lakes Natural Science Center Stanley Elevator Sterling National Bank Charitable Foundation TD Bank The Common Man Inn The Hoffman Family Foundation The Home Depot The Keene Swamp Bats The Melanson Company, Inc. The New Hampshire Trust Company The Richards Group Transamerica Retirement Solutions True North Networks, LLC United Church of Christ UnitedHealth Group Upper Valley Produce VFW Post 799/Men’s and Women’s Auxiliaries Vocera Communications W.S. Badger Company, Inc. Westside Animal Hospital ZOLL Medical Corporation

Thank you!

Cheshire Medical Center 580 Court Street, Keene, NH 03431

... Cheshire is Committed to Our Community.

Cheshire Medical Center 2021–2022 Report to the Community