Cheshire Medical Center 2019-2020 Report to the Community

Cheshire Medical Center

Working together during defining times.

2019-2020 REPORT TO THE COMMUNITY

Each and every day, It would be an understatement to suggest that the first six months of this year—the second half of our fiscal year 2020— were challenging for Cheshire Medical Center, our staff, the wider Monadnock community, and the entire country as we faced a global pandemic known simply as COVID-19.

These difficult times have reminded us all that it is not just the moments that define us, but how we respond to them.

We are so proud of the fact that our organization was well prepared to face the virus by quickly mobilizing our emergency response teams, partnering with state and local officials, and joining with our neighbors who supported us throughout the crisis with financial and tangible gifts. We are grateful for the hundreds of Cheshire doctors, nurses, and staff who put in countless hours of their time to prepare and respond to the pandemic we continue to face.

Everything we do at Cheshire is fueled by our commitment to deliver excellent, compassionate care in a safe, well-run environment. Throughout the pandemic response, we have remained committed to helping you and your loved ones stay healthy. We’ve enhanced measures throughout all of our locations to keep you safe and to provide the in-person medical care and services you need. At the same time, we have improved our ability to offer convenient virtual visits from the comfort of your own home. Speaking directly with your doctor face-to-face has never been easier.

Cheshire remains uncompromising in our pursuit of excellence and our commitment to provide outstanding care to every patient and family is first and foremost. While we stand by these commitments in the midst of the present challenges, we know that we must also be looking toward our future—which is why Cheshire’s new three-year strategic plan is so essential.

Above: Some of the dedicated staff that make a difference each and every day at Cheshire Medical Center.

On the Cover: Katelyn Ahern, APRN, and Kama Ellnor, LPN, meet with a patient in Family Medicine at Cheshire.

2

Cheshire Medical Center 2019-2020 Report to the Community

we stand committed.

The plan, organized into four main areas of priority, puts our people, our patients, our community, and our organization at the very top with a commitment to quality and safety running throughout all of them.

Our Community: We engage in partnership that improve the health and well-being of the region.

Our People: We work together to create a positive and supportive culture.

 Support access to high-quality services to meet the

 Improve processes and systems to enable everyone

 Advance diversity, equity, and inclusivity within our region

to do their best  Create a culture of mutual respect

 Support community health and wellness through

Population Health initiatives evolving needs of our community

Our Organization: We provide resources for our people, services, and facilities to ensure sustainability.

 Support the safety and wellbeing of everyone

 Achieve and maintain a minimum 3% operating margin

 Advance diversity, equity, and inclusivity within our

 Align operations and processes to reduce cost, improve

organization Our Patients: We provide services that meet our patients’ expectations and needs.  Improve access to care  Design systems of care around patients and families

services, and provide quality care  Continue to integrate and align with the Dartmouth-

Hitchcock Health system as a high-quality regional referral center  Optimize quality performance

With a history extending more than 125 years, Cheshire plays a unique and essential role in the Monadnock Region.

We’ve been a source of hope and healing throughout that time, and we take great pride in knowing that our 1,500 staff members live and volunteer in the same communities we serve.

We are excited to share a few real stories of individual response to these defining times with a commitment to excellence + dedication, care + kindness, trust + connection, and generosity + vision.

On behalf of the Cheshire Medical Center Board of Trustees and executive team, and the Cheshire Health Foundation Board of Trustees, we are pleased to share our annual report updates, community impact, and generous donor information for fiscal year spanning July 1, 2019 through June 30, 2020. We offer our sincere thanks to each and every one of the wonderful people that make a difference in this community. You inspire and encourage us. 

 Create a culture of safety, quality, and service

excellence Don Caruso, MD, MPH President and CEO/CMO, Cheshire Medical Center Nathalie B. Houder Chair, Cheshire Medical Center Board of Trustees

Jane M. Stabler Chair, Cheshire Heath Foundation Board of Trustees

Cheshire Medical Center 2019-2020 Report to the Community

3

“We could not have achieved what we did this past year had it not been for the constant, tireless efforts by all the staff here at Cheshire Medical Center, whatever the role might be.”

—Aalok Khole, MD Infectious Disease Specialist, Cheshire Medical Center Brianna Rennick, RN, and Stephanie Morse, RN, care for patients in Cheshire’s Intensive Care Unit.

Responding to the COVID-19 pandemic

A

s the COVID-19 pandemic swept across the country earlier this year, hospitals were taxed in unprecedented ways. From treating COVID-positive patients, to preventing the spread of the virus in facilities and in communities, medical centers throughout the country faced unique challenges and difficult decisions— Cheshire Medical Center was no exception. In March, Cheshire made the drastic move to temporarily curtail non-urgent care in an effort to focus on safety internally for staff and patients. To do so, nearly every process had to be reviewed in the hospital and ambulatory settings, especially around staff and patient safety.

Mary Pierce, BSN, RV, infection preventionist, and Aalok Khole, MD, infectious disease specialist, have led this incredible work.

Now more than six months into the pandemic, Dr. Khole reflected on our response to COVID-19 and what might be ahead for the still-widespread virus.

4

“We were all battling a thousand unknowns about this virus and the disease itself,” Dr. Khole says. “We were fine-tuning our response with rules, regulations, and protocols changing every day, at times even throughout the day. All in hope of preventing us, and our community, from getting overwhelmed with the disease.”

“It was by no means a simple task. We could not have achieved what we did this past year had it not been for the constant, tireless efforts by all the staff here at Cheshire Medical Center, whatever the role might be.

We can proudly say that we have had no patient-to-staff, staff-to-patient, or staff-to-staff exposures at Cheshire.”

“The community’s support was equally admirable as the local population rapidly adjusted to a ‘new normal’ and helped keep the numbers down in this region thereby allowing us to focus on new safety procedures and caring for those in more urgent need.”

Cheshire Medical Center 2019-2020 Report to the Community

Because Cheshire is the only care facility in this region, there has been a focus on supporting community entities to make sure everyone is doing what they need to do to stay safe.

As schools were preparing to start again, Cheshire reached out to Keene State College, local school districts, and the city of Keene to see if help was needed to fill any knowledge gaps or answer questions those groups had as it relates to preventing the spread of the virus.

However, the virus is still a concern. As we move into autumn and winter, the respiratory virus season awaits. The potential of a “twindemic” with influenza and COVID-19 is a threat that staff at Cheshire have been planning to address for months. Now is the time to be even more cautious with social distancing, hand hygiene, and universal masking. It is a critically important time for everyone, including friends and loved ones, to get the flu vaccination—this year more so than ever before.

Cheshire Medical Center is open for all services with both in-person and Virtual Visit options. We are committed to helping this community stay healthy and safe. 

Cheshire providers and facilities earn recognition for excellence Cheshire Medical Center nationally recognized Cheshire Medical Center achieved Platinum recognition this year from the U.S. Department of Health and Human Services for activities to increase organ, eye, and tissue donors.

Alberta Grunbeck, hospital relations coordinator for New England Donor Service, recognized Pam Merritt, RN, administrative clinical supervisor, and Amy Matthews, DNP, RN, vice president of patient care services and chief nursing officer, for playing an integral role in the development of the “Let Life Bloom” campaign.

She also highlighted our entire staff for cultivating a supportive, donation-friendly culture through direct staff education and involvement, saying “their dedication and commitment to advancing communication, compassion, and understanding of organ and tissue donation to the hospital and community at large is why Cheshire Medical Center continues to be recognized on the national stage.”

“Organ and tissue donation is so important,” says Merritt.

“Organs save lives and a single tissue donation can improve the quality of life for up to 50 people. That is why our staff’s efforts means so much.” 

While there’s no doubt that 2020 was unlike any other, it was similar to past years in one respect: Numerous Cheshire Medical Center providers and facilities were honored for their exemplary care and service.

When NH Magazine named its “Top Doctors” in April, the Orthopaedics Department saw five of its providers win the award for the third year in a row. Honorees included Section Chief Paul Bettinger, MD (Hand Surgery); Cherie Holmes, MD (Sports Medicine); Greg Leather, MD (Sports Medicine); Anthony Presutti, MD (Sports Medicine); and Mark Silbey, MD (Sports Medicine).

“I am very proud of my department for all of our hard work, excellence, and dedication to patient care in the field of orthopaedic surgery,” Dr. Bettinger says. “We are humbled with the honor of Top Docs in NH for three years in a row.”

Other Cheshire providers named to the “Top Docs” list includes Barbara Bates, MD, and Andrew Tremblay, MD, of Family Medicine; Todd Dombrowski, MD, and Sherry Guardiano, MD, of Rheumatology; and Lisa Leinau of Palliative Medicine.

In our local region, several providers also earned recognition from The Keene Sentinel in two different ways.

Amy Matthews, DNP, RN, Cheshire Medical Center’s vice president of patient care services and chief nursing officer, was one of 10 women named to The Sentinel’s “Extraordinary Women” publication, the eighth annual

recognition of women who are making a difference in the Monadnock Region community. The publication was due out in October.

Earlier in the year, The Sentinel released its “2020 Choice Awards”, and Cheshire staff and departments were wellrepresented. Below are the 2020 medal-winners.  Best Local Provider Lisa Profetto, APRN, Primary Care – Gold Donald Mazanowski, MD, Primary Care – Silver Eric Goodman, APRN, Pediatrics – Bronze Best Local Nurse Lori Guyette, RN, Primary Care – Silver Terry L. Clough, RN, Nursing Informatics – Bronze Best Local Eye Doctor Lawrence Jaeger, MD – Silver Best Vision Care Center Cheshire Optical Shop – Silver Best Hearing Center Cheshire Audiology Department – Gold Best Urgent Care Center Cheshire Walk-In Care Clinic – Gold

Cheshire Medical Center 2019-2020 Report to the Community

5

Virtual Visits through myD-H keeps patients connected.

6

Cheshire Medical Center 2019-2020 Report to the Community

The power of Virtual Visits Getting the care you need—from the comfort of home

I

t’s no secret that COVID-19 has greatly impacted our hospitals.

Health care systems across the country have been forced to rethink the way they do business, both in caring for people who have or think they might have the coronavirus and other patients who are trying to get in to safely see their doctors.

But not all of the changes brought on by COVID-19 have been negative. In fact, there is at least one medical practice increasingly used to see and treat patients that will likely be a standard after the pandemic is over: Virtual Visits.

Prior to COVID-19, Cheshire Medical Center was already starting to interact with patients through video conferencing and online health information through the myD-H Patient Portal. But with the heightened emphasis on social distancing, limited travel and access to shared spaces, and the public’s general unease with leaving the safety of their homes, Cheshire has used Virtual Visits to provide the same quality care in less time to more patients—and not just for primary care appointments. Specialty medicines, from cardiology to endocrinology to pediatrics to the Walk-In Care Clinic have taken advantage of the convenience of telemedicine.

“Telehealth has taken off,” says Dr. Todd F. Dombrowski, MD, MS, CCD, FACP, FACR, rheumatologist at Cheshire Medical Center, a member of the Dartmouth-Hitchcock Health system. “Prior to COVID-19, we did not do any Virtual Visits in our department.

But we’re trying to get patients in to be seen with a limited number of in-person visits. This way I can converse with my patients, read their medical record in real time, and the visit flows. I can give them the time and access they need. They have my undivided attention, and they don’t even have to come in.”

Dr. Dombrowski says that this is particularly helpful for patients who live far away from the clinic or hospital. He has patients from Nantucket to Maine to south of New York City (two hours away), who can now get a referral, consultation, diagnosis, and even a prescription from the comfort of their own living room.

“Speaking to the patient and seeing them on screen, you can get about 70 percent of what you need from their medical history and a virtual physical,” Dr. Dombrowski says. “You can assess a patient’s problem during the limited exam, enough to order further tests, medications, and determine whether they need an in-person follow-up.”

Screening patients to see if they require in-person care is a key benefit of Virtual Visits, saving time and resources for both the patients and the caregivers. It has even proven useful for the Cheshire Medical Center’s Walk-In Care Clinic. Whether patients were in the parking lot or at home,

Todd F. Dombrowski, MD, MS, CCD, FACP, FACR

“I can converse with my patients, read their medical record in real time, and the visit flows.

I can give them the time and access they need. They have my undivided attention, and they don’t even have to come in.”

—Todd F. Dombrowski, MD, MS, CCD, FACP, FACR Rheumatologist, Cheshire Medical Center

Continued on page 8.

Cheshire Medical Center 2019-2020 Report to the Community

7

they could talk through their symptoms with the staff and determine if they needed to come in. At first, these conversations happened over the phone, but now the team uses Virtual Visits in the case of rashes, lacerations, or other things that might not require urgent hands-on attention at the clinic.

“If the nature of the visit doesn’t require an in-depth medical exam, you can get right to the point with a telemedicine visit,” says Dr. Michael O’Shea, VP and medical director of Ambulatory Care Services at Cheshire.

“And with the advances in technology, physicians are incorporating more and more things into the Virtual Visit.

You can check a patient’s blood pressure and conduct other elements of the physical exam. There are technologies that allow providers to listen to a patient’s heart through the Virtual Visit. The field with continue to grow.”

And as the field of telemedicine grows, Dr. O’Shea says that it will enable Cheshire to continue to grow as a regional health care provider.

By embracing this technology, Cheshire Medical Center is not only helping patients get the care they need during this unprecedented pandemic, but it’s also paving the way for a more convenient and efficient future of health care. 

There are many advantages to Virtual Visits for patients and their families Shortened wait times for booking appointments: Cheshire is dedicating specific appointment slots in some departments solely to Virtual Visits, which can be booked closer together because there’s less downtime in between. Also, a majority of follow-up appointments with specialists can be done through Virtual Visits.

Quicker referrals: Getting to the specialist is easier, because patients don’t have to wait as long to see the primary care physician and get the referral.

Less time off work or away from home for patients: With no commute to and from the hospital or clinic, not to mention a shorter appointment, patients only have to be away from work for a few minutes instead of half a workday. In fact, office workers can complete the 25-minute Virtual Visit right at their desk.

Everyone can be in communication: Adult children who want to keep up with their parents’ health can patch in from anywhere in the world. Patients can also show a nurse or doctor their prescriptions to ensure everything is as ordered without having to gather and tote a bunch of pill bottles to and from the hospital.

The myD-H Patient Portal keeps patients connected: This electronic platform gives patients easy access to scheduling, after-visit summaries, billing details, and test results, as well as doctor’s notes so there’s complete transparency. They can now also use the portal to log in to their Virtual Visit with the click of a button.

For more information about Virtual Visits at Cheshire, call 603-354-5454 ext. 2446 or visit: cheshiremed.org/patientsvisitors/outpatient-virtual-visits

Lead Retail Pharmacy Tech, Ashley Perham, CPhT.

Cheshire opens on-location pharmacy It’s never been easier to get a prescription filled for Cheshire Medical Center patients. That’s because in October 2020, the hospital celebrated the one-year anniversary of opening its own pharmacy in the area that used to contain the lobby gift shop.

No matter who your prescribing doctor is, if you are a patient or employee of Cheshire or Dartmouth-Hitchcock, Cheshire’s pharmacy can fill your prescription. Often, a prescription can be sent down to the pharmacy and be ready for the patient to pick up on their way out after an appointment or procedure.

The pharmacy also stocks drug-store essentials such as common over-the-counter medications, wound care supplies, an assortment of snacks and refreshments, and more. It also still sells small gifts, flowers, and cards.

The patient-focused pharmacy accepts most prescription insurance plans; please be prepared to present your insurance card when dropping off your prescriptions.  Learn more at: cheshiremed.org/pharmacy.

8

Cheshire Medical Center 2019-2020 Report to the Community

100% Pass Rate on National Exam for Cheshire’s Medical Assistant Training Program Cohort Since 2017, Cheshire Medical Center has partnered with the Dartmouth-Hitchcock Health Workforce Readiness Institute to offer a Medical Assistant Apprenticeship Training Program. Through this innovative recruitment program, Cheshire has trained and hired 27 medical assistants (MA). At Cheshire, MAs take medical histories and record patient vital signs, and other administrative and clinical responsibilities.

MA positions are in demand. It’s a great entrylevel position in health care.

Candidates are selected and hired for the Medical Assistant Apprenticeship Training Program based on assessment test results and interviews.

During the 11-week training period, participants earn college credits and an hourly training wage.

The full-time, hands-on training includes both classroom and clinical training. At the end of the 11-week training, individuals will sit for the Certified Clinical Medical Assistant (CCMA) exam.

Classes offered during the program include Introduction to Anatomy & Physiology, Medical Terminology, Pathophysiology, Pharmacology, Clinical Medical Assisting with Lab, and Health Care Communications.

The most recent cohort included eight individuals, all of whom passed the national exam and are now working as MAs at Cheshire. The next cohort will start in March 2020. 

White Coats for Black Lives As a gesture of solidarity with #WhiteCoatsForBlackLives, a movement with the mission of dismantling racism in medicine, many Cheshire Medical Center staff gathered in early June and knelt silently for 8 minutes and 46 seconds in memory of George Floyd, who had been killed by police the week before.

While deeply meaningful to the participating staff, the gesture also resonated with our community. When a photograph and excerpts of an address given by Rachel I. Lovins, MD, CPE, SFHM, vice president and medical director of Acute Care Services, was posted to Facebook, it reached thousands, with hundreds of community members adding comments of support and appreciation. Below is an excerpt of the address.

“We kneel here together as one community.

We kneel as health care workers dedicated to caring for our community.

We bind ourselves together to fight the deadly virus of COVID-19 and the deadly virus of racism.

We kneel as people of all colors, Christians, Jews, Muslims, Atheists, Buddhists, Hindus, Mormons, and others.

We kneel as humans who are gay, straight, trans, gender noncomforming; republicans, democrats, independents, able bodied and disabled, healthy and sick, both in body and in mind.

We kneel together in solidarity with our black brothers and sisters who have been suffering under the weight of racist oppression in the United States since 1619.

The most recent Medical Assistant Training Program cohort are now all working at Cheshire.

We kneel together as one, demanding what our country has always promised to offer: liberty and justice for all.”

To learn more about the Dartmouth-Hitchcock Health Workforce Readiness Institute, visit: dhwri.org.

Cheshire Medical Center 2019-2020 Report to the Community

9

2019-2020

Community Benefits Community Benefits is an organization-wide responsibility and commitment. As a non-profit hospital, our employees individually make a difference through their volunteer service—giving a talk in our community or serving on a local board of directors, for instance. Each effort impacts the health and well-being of our community.

Community Health Services

$898,123

Health Professions Education

$726,046

Subsidized Health Services

$214,562

Financial Contributions

$514,527

Community Building Activities

$1,772,989

Charity Care/Financial Assistance

$2,017,000

Government-Sponsored Health Care

Cheshire offers financial assistance/ charity care to underinsured patients. More than $2.02 million in free or reduced cost medical care was provided to patients by Cheshire in Fiscal Year 2020.

In total, Cheshire Medical Center provided over $6.2 million in Community Benefit such as unreimbursed charity care, behavioral health services, health professions education, subsidized health services, and community-building activities. These contributions are in addition to the over $23.5 million dollars in unreimbursed Medicaid and Medicare costs absorbed by the medical center.

"I would like to thank you for all your help. I was so worried and scared about losing my house over this medical scare that I am going through. And when you came in to talk to me and told me you could help it was like someone just lifted a ton of bricks off my heart and soul."

10 Cheshire Medical Center 2019-2020 Report to the Community

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 wellbeing 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, etc. This work supports access to care, continuum of care facilitation, mental health, obesity prevention, substance use disorder treatment and prevention, and tobacco prevention.

$23,496,807

Center for Population Health Cheshire’s Center for Population Health (CPH) works to improve the health and well-being of people in the Monadnock Region.

Throughout this Annual Report to the Community, you can find stories of people whose lives have been impacted by CPH’s programs and partnerships.

—Cheshire patient

Healthy Monadnock In 2006, Cheshire Medical Center set a bold goal to work with our community to make Cheshire County the healthiest county in the U.S. by 2020. The commitment, time, and effort from community leaders, and unwavering support from Cheshire Medical Center toward the Healthy Monadnock initiative has produced many success stories over the past 14 years.

In this pivotal year, the Leadership Council for a Healthy Monadnock and Cheshire Medical Center commit to continue this work because a key lesson learned is that community health improvement does not have an end point; it continues and adapts to changing needs and opportunities over time. 

Programs and Partnerships Supporting the health and wellness of our community Health + Wellness Community Education Programs: More than 750 people participated in 71 community health education programs Family Resource Counseling Assistance: provided assistance to 6,592 newborns, children, teens, and adults Advance Care Planning: 300 people visited volunteer-led information table; group education sessions attended by 34 participants Medication Assistance Program: 147 individuals supplied with 77 prescriptions (valued at $31,933) The Doorway: 1,305 individuals served Tobacco Cessation Assistance: 142 program referrals Prescribe for Health Initiative: 392 individuals served Interpreter Services: 1,268 patient care visits provided in a language other than English The Behavioral Health Liaison Team: 3,204 patient consults Sports Medicine Athletic Trainers: 878 local students with new injuries received medical services

Dottie Morris, PhD, associate vice president for diversity and equity at Keene State College.

CPH offers community education classes on a variety of topics. One example is a workshop led by Dottie Morris, PhD, associate vice president for diversity and equity at Keene State College called So You Want to Have a Difficult Dialogue: More Complex Than Rocket Science?

This program taught participants how to create an environment rooted in compassion to help them discuss difficult topics.

“The presentation was wonderful and so very useful in everyday relationships.”

—Workshop participant

Cheshire Smiles Program: 116 children received preventive services, 534 sealants placed Wellpowered Worksites: 45 member organizations Right This Way: 20 organizations and 577 individual participants Volunteer Support: Over 1,000 hours of volunteer support provided to local non-profit organizations through board and committee service Senior Passport Program: 3,982 meals served Cheshire Walkers Program: 24 walks were offered, 800+ participants

Community Health Improvement Plan: Allocated over $50,000 to local non-profits to implement programs to advance the work of our Community Health Improvement Plan (CHIP) which sets the strategic direction for Healthy Monadnock.

“I made the right decision in the first place to quit smoking. I like the counseling because it holds me accountable and gives me encouragement every week to stay quit.”

–Tobacco cessation participant

Each year, about 1,900 Granite Staters die from smoking-related illnesses. During the pandemic, there has been an increased awareness among smokers about the health risks should they be infected by the coronavirus.

Tobacco cessation counseling is provided to people who want to stop smoking. In addition, CPH actively engages in advocating for policies that prevent young people from developing an addiction to tobacco.

Cheshire Medical Center 2019-2020 Report to the Community

11

2019-2020

Year in Numbers

2019-2020

Financials Our commitment to the Monadnock Region is unconditional.

 Admissions: 4,376  Provider Visits: 215,469  Surgical Cases: 4,216  Newborns: 414  ER Visits: 21,518  Walk-In Clinic Visits: 13,286  Imaging Exams: 65,883  EKG/EEG Tests: 14,726  Laboratory Tests: 531,475  Pain Clinic Procedures: 1,319  Respiratory Therapy Treatments: 18,902  Endoscopies & Colonoscopies: 5,643  Physical Therapy & Other Outpatient Treatments: 108,097  Volunteer Hours: 7,327  Meals Served: 174,417  Pounds of Laundry Processed: 588,021  Donations of N95 Masks: 12,000  Donations of Hand-sewn Masks: 4,000  Donations of Gloves: 500,000  Other Donations Include: 1 Respirator, 100 Gowns, 200 Face Shields

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. We are uncompromising in our pursuit of excellence, and our commitment to provide excellent care to every patient and family member is absolute.

The fiscal year 2019-2020 was an unprecedented year for everyone, but a particularly challenging final quarter given the necessary actions Cheshire took to respond to the global pandemic. In fact, prior to the COVID-19 response, Cheshire had a $2.5 million surplus eight months into the fiscal year thanks to strong revenues.

However, like many health care facilities across the country, Cheshire, along with our Dartmouth-Hitchcock Health system partners, were faced with a mandatory realignment of services. In an effort to focus on the potential for a surge of COVID-19 patients, the decision was made to cancel all non-urgent procedures and appointments in mid-March of this year.

Cheshire and subsidiaries finished fiscal year 2020 with an operating loss of $4.5 million (2%), an amount that was $9.1 million behind budget and $10.5 million lower than prior year results. For the last two weeks in March, appointment volumes dropped 45%, surgical cases dropped 75%, and discharges fell 40% behind plan. This drop in volumes resulted in a $3.6 million loss in revenue in the month of March. Gross revenue trailed budget by 50% in April, 30% in May, and 6% in

12 Cheshire Medical Center 2019-2020 Report to the Community

June. System-wide recovery efforts in May and June helped to mitigate a larger potential loss due to COVID. In addition, Cheshire received $12 million in federal stimulus funds in fiscal year 2020, which helped to offset a large portion of the revenue loss.

For the 12 months of the fiscal year, total operating expenses were $507,000 (0.2%) favorable to budget, largely in the categories of medications and purchased services expense. Keeping our expenses under control were critical as our revenue had dropped significantly and we were committed to continuing to pay our employees and physicians even as volumes dropped in half.

Our membership in the Dartmouth-Hitchcock Health system provides us with access to structures and resources 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. 

Statement of Operations

Cheshire Health Foundation Fiscal Year 2020 Report

Unaudited financials 12-months ending June 30, 2020

Received from other sources......................................................... $6,273,927

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, and more. We are grateful to our community for supporting all of our strategic fundraising initiatives. Gifts given between July 1, 2019 and June 30, 2020 totaled $892,006 and represent our community’s commitment to keeping excellent health care close to home.

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

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

Billed for services to our patients: Care for inpatients....................................................................... $126,981,768 Services for outpatients.............................................................. $537,103,570

Total from all sources:................................................... $670,359,265 Amounts billed but not received: Government programs and commercial contractual agreements............................................ $416,443,395 From patients unable to pay and bad debt.................................. $28,222,796

Therefore, we actually received revenue from patient care and other services of:.............................. $225,693,074 Our costs included amounts: To pay our employees and physicians.......................................$142,797,301 To pay our suppliers and vendors............................................... $62,168,462 To operate the building, depreciation, and pay interest............................................................................. $16,748,284

Resulting in total costs for patient care and other services:................................................ $221,714,047

Charitable Contributions

Committed

by Fund

Expenditures

Digital X-ray, Defibrillators & Other Equipment................... $490,648

Digital X-ray, Defibrillators & Other Equipment...................... $490,648

Cancer Care Fund...................... $16,647

Cancer Care Support Services & Equipment*................................ $31,080

Cancer Patient Relief Fund........ $12,296 Coughlin Nursing & Tatro Healthcare Scholarships... $11,303 COVID-19 Response Fund.........$191,151

Cancer Patient Relief...................... $12,876 Nursing Scholarships/ Education*..................................... $84,636

Farnum Rehab & Spine Therapy Funds...................$12,137

Covid-19 Response...................... $191,151

Population Health Fund.............. $92,020

Population Health.......................... $92,020

Payment of the state Medicaid Enhancement Tax.............$8,475,816

Women’s Health Fund................ $10,850

Women’s Health Fund..................... $9,274

Other Patient Care/ Patient Assistance...................... $54,954

Other Patient Care/ Patient Assistance*....................... $66,352

TOTAL........................................... $892,006

TOTAL........................................ $1,647,884

Residual earnings...................................................................$3,979,027

Net loss from operations...................................................... ($4,496,789)

Patient Financial Assistance*..... $669,847

* Includes 2020 income from restricted endowment funds

Cheshire Medical Center 2019-2020 Report to the Community

13

excellence

+ dedication

On the front line of intensive care Eustace Theodore with his wife, Carol.

In March, Eustace was admitted to the ICU at Cheshire Medical Center with COVID-19. They are both grateful for his medical team’s thoughtful approach to patient care.

14 Cheshire Medical Center 2019-2020 Report to the Community

Pulmonologist Hala El Chami, MD, and Hospitalist Evgeny Buharin, MD, led Eustace Theodore’s medical team in the ICU.

Providing skilled care to COVID-19 patients while keeping worried family members in the loop

O

n the evening of Saturday, March 28, Carol Theodore was sitting in her car in the parking lot of Mount Ascutney Hospital in Windsor, Vermont. Inside, doctors had spent eight hours trying to figure out what was wrong with her husband, Eustace. Due to the burgeoning pandemic, Carol was not allowed to be beside her spouse of 57 years. Sitting alone in her car as the rain fell, she had no idea what was ailing Eustace, and she couldn’t be sure she’d ever see him again.

“I cannot emphasize enough how much it mattered to have the family connected to the patient.”

—Carol Theodore

Then she got a phone call from the nurse inside. Tests were still pending, but a chest scan had found pneumonia, a possible indicator of COVID-19. Eustace would be rushed to the Intensive Care Unit (ICU) at Cheshire Medical Center. Carol could still not accompany her husband. But that phone and the nurses and physicians on the other end of the call would be Carol’s lifeline to Eustace during one of the most trying times in their lives.

“During the time he was in the hospital, I was totally isolated at home,” Carol says. “It was very anxiety-provoking for me and our two sons in New Hampshire and California, because no one could travel. They couldn’t visit their father or know if they ever would see him. I cannot emphasize enough how much it mattered to have the family connected to the patient.”

Throughout their marriage, Eustace and Carol had often been physically separated. His work as an education consultant had kept him in Washington D.C. while her jobs as a lawyer and ski instructor had rooted her in Vermont. But the couple had always maintained a close emotional connection strong enough to bridge that distance.

And every March for the past 20 years, the Theodores have traveled together to the United Kingdom, where they shared their love of horses at the annual Cheltenham Festival races.

But when they returned to the U.S. on March 14, they landed in a country just starting to come to grips with the pandemic. The Theodores knew about COVID-19. They knew that it was already in the U.K., where they had just spent four days packed among 60,000 horse-racing fans, and they knew that they should shelter in place for 14 days. They would do so in Vermont, together.

Neither Eustace nor Carol had a fever, shortness of breath, or deep cough—then the only recognized symptoms of the coronavirus.

But after a few days, Eustace lost his appetite. More concerning, he was suddenly having trouble finishing sentences, stopping midstatement to repeat himself over and over. Their two sons thought he was having a stroke and urged him to go to the hospital. That’s when Carol drove him to Mount Ascutney.

Later that night, at about 1:00 am, the nurse in the Cheshire ICU called Carol and told her that Eustace’s condition had worsened and that he would need to be intubated. They said that she could send her husband’s iPhone and iPad, but of course, he’d be unable to speak while on a ventilator. Instead, she arranged for a doctor or nurse to call her every morning to discuss decisions about Eustace’s care, report on his progress from the night before, and inform her of the plan for that day. Then Carol would call back later in the afternoon for an update.

Eventually, she was able to FaceTime in and at least get a sense of her husband’s room and see the masked faces of people caring for him.

“It was important to me to keep Carol in the loop,” says Dr. Hala El Chami, the pulmonologist in charge of Eustace’s care. “I knew she was home worrying and wondering what was going on every minute. People in the ICU can deteriorate quickly. It’s minute-tominute, hour-to-hour. Just having those small conversations were helpful for her and helpful for us—she could help guide us on what sort of care she and Eustace would want him to have.”

Continued on page 16.

Cheshire Medical Center 2019-2020 Report to the Community

15

excellence

+ dedication

Meanwhile, the hospital was also dealing with one of its first COVID-19 patients. Though relatively little was known about the coronavirus and proper treatment, Dr. El Chami and the staff knew that it could cause respiratory symptoms similar to other infections and inflammations, and they had a protocol to manage that.

They quickly implemented safeguards for sanitization, setting up a buddy system to monitor the donning and doffing of protective suits and masks to ensure the containment of infection and the safety of the rest of the hospital’s patients and staff. They also rotated the staff around Eustace so that everyone could gain valuable experience in dealing with this burgeoning pandemic.

After five harrowing days, Carol got the call that Eustace had recovered to the point that he would be taken off the ventilator. He was groggy at first, but after a few more days, he could get up and use the bathroom sink with the help of a nurse.

Carol was able to FaceTime with him through this progress, to see and hear her husband for the first time in more than a week. By April 10, he was off oxygen and ready to go home.

“It was still a couple weeks before I would know for sure if I’d get him back in full mind,” Carol says. “But I was glad to have him back in any form. I thought I might not ever hold him again.”

Today, the Theodores are safe and well and riding out the pandemic at their home in Vermont. After some subsequent testing, Carol says that she also has the antibodies that indicate she’d had COVID-19 as well.

But both are happy to be healthy—and together.

“Cheshire was the perfect environment,” says Eustace via Zoom. “They had plenty of time and attention to give their patients, and it was easy for them to apply their vast medical knowledge.”

“He got great care,” adds Carol, happily sitting right beside her husband on the video call. “We were very lucky.” 

Ashley Thompson, RN, and Chastity Hodgson, RN, stand committed to quality and safety on the front line in the ED.

Keeping patient-centered care front and center in the ED The nurses in Cheshire Medical Center’s Emergency Department (ED) have always taken their job seriously as they care for patients.

“We really care about our patients,” says Chastity Hodgson, RN. “We have family and friends in this community and they could be the ones who need us.”

Though being an ED nurse during a pandemic has some extra challenges, both Hodgson and her fellow RN, Ashley Thompson, are driven by a deep sense of purpose to care for their patients.

“This is the cloth I’m cut from,” Thompson says. “I love my job. I am an ED nurse through and through.”

Thompson says the folks at Cheshire have been overwhelmed by the support they have received from the community.

“People have been incredibly kind,” Thompson says. “We have had so many donations of masks and supplies. People are sending us flowers, food, plants. The community has been amazing.”

Dr. Evgeny Buharin (left) and Dr. Hala El Chami (right) confer with Aalok Khole, MD, infectious disease specialist (center).

16 Cheshire Medical Center 2019-2020 Report to the Community

What’s impressed Hodgson, she says, is how her team has responded to the challenge of working during a pandemic.

“Teamwork is so important,” Hodgson says. “Keeping up the morale and positivity is key, especially in these times when work can be difficult.

I am so thankful for the team we have in the ED and I know each of my coworkers has my back, amidst a pandemic or not!”

ED providers and other front-line staff also recognize that the community has been taking care of them by practicing social distancing, washing their hands frequently and thoroughly, and wearing face masks. This sacrifice is an enormous, meaningful, and deeply appreciated gift for front-line staff like ED nurses, Cheshire staff as a whole, and the health and safety of the Monadnock Region.

“The ED has come together as a team to get through the changes with COVID,” says Emergency Department Clinical Leader Kelly Chamberlain-Warner, RN, BSN. “Staff are keeping a positive attitude. I hear staff say they feel safe with the PPE provided.”

Cheshire staff are fully committed to providing care to every patient that comes to the ED, whether the visit involves COVID-19 or not.

“What we do hasn’t changed,” Thompson says. She notes that, pandemic or not, people still come in for urgent health care, including broken bones, heart attacks, strokes, and diabetic emergencies.

“What has changed is how we approach it.”

Part of that change is wearing personal protective equipment. This includes scrubs, gown, gloves, facemask, and clear plastic shield.

Thompson points out that people are typically stressed when visiting an ED in usual times. The pandemic adds a new layer of anxiety, particularly as families must remain out of the room in order to prevent the potential spread of infection.

Keene City Councilor Philip Jones often uses social media to connect with his community. This April, he gave a thoughtful shout-out to Cheshire Environmental Services that includes Sherry Schuman, pictured right.

“All of the EVS workers work very hard to keep Cheshire clean and safe for everyone. I love dealing with all of the people that come here.”

—Sherry Schuman, Environmental Services

Celebrating those who keep Cheshire spotless and safe Keene City Councilor Philip Jones has spent nearly three decades in the Elm City, actively engaged in community service and family life. A proud husband, father to his three daughters, and grandfather, he uses Facebook as a platform to connect with family, friends, and constituents.

He rarely misses a chance to celebrate a “national day”—from frivolous festivities such as Hug a Cat Day to serious reminders about PTSD Awareness Month (June) or Lung Cancer Awareness Month (November).

He often shares a short anecdote and even wears the cause’s corresponding color—such as a blue tie for PTSD awareness, or gray for lung cancer awareness. Whether it’s bringing attention to specific initiatives or just passing along a note of kindness, Jones tries to use his Facebook posts to lift others up.

So it was perfectly in character that in April, he commented on a post about Cheshire Medical Center’s Environmental Services department. We thank him for the shout-out to the staff who work so diligently to keep the Cheshire facilities spotless and safe. 

The nurses make an extra effort to tend to every patient, and respond to their patients’ emotional needs for safety and connection.

For Thompson and Hodgson, the coronavirus-related precautions are part of the big picture. Hodgson says, “It’s all about safety—for our patients and also for ourselves, so we can continue to come to work and care for our community.”

That commitment to service is a hallmark of the vocation of nursing, and part of the reason the World Health Assembly designated 2020 the International Year of the Nurse and the Midwife.

Thompson and Hodgson are ready for whatever comes their way.

“Even in normal times, we’re always exposed to hazards. It’s the reality of being a nurse. This is part of the job,” Hodgson says. 

Philip Jones For many years I have been representing chemical disinfectant and PPE manufacturers. As part of my job I was certified to teach infection control and prevention. Although Cheshire Medical is not one of my clients, I have to give them an A+ rating. Every time I enter your building, I am amazed at the cleanliness of your facility. All of your efforts are very obvious to my trained eye. As a resident of Keene who often visits your facility, I truly thank the wonderful people of Environmental Services for all that they do.

6

Cheshire Medical Center 2019-2020 Report to the Community

17

care

+ kindness

Restoring strength and independence with expertise, compassion, and encouragement

D

avid Duffy was always a hard worker. As a financial analyst, he worked 12–14 hours a day, six days a week, minding the ledgers and watching the bottom line for Entergy Nuclear Vermont Yankee. On the weekends he maintained a small accounting practice, doing about 70 tax returns each year. He didn’t have time to go to the doctor or exercise or watch what he ate. By age 50, he was 465 pounds and stressed to his limits.

He arrived at that limit at 12:30 am on Dec. 30, 2018. He awoke on his couch and instantly knew something was terribly wrong. There was no pain. But he couldn’t get up.

He noticed his right arm and leg were very weak. He knew he needed help, but there was no one else in the house.

His cellphone was on the kitchen counter, a few yards away. Using the left side of his body, he pulled himself onto the floor and dragged himself to the kitchen, where he was able to reach up, grab the phone, and dial 9-1-1.

After being rushed between several hospitals trying to find an MRI machine that could accommodate his size, Duffy finally received the news that he had suffered a severe stroke. It almost killed him. He couldn’t move the right side of his body, couldn’t walk; his speech was badly slurred.

He faced a long road of recovery. And he was a bachelor who lived by himself. But he was not alone.

Nearly two weeks later, Duffy began his inpatient rehabilitation at Cheshire Medical Center. Here, he would gradually receive physical therapy to help regain strength in his right leg and arm and occupational therapy to help him improve his speech. Perhaps more importantly, Cheshire would also be the place where he received the

moral support and encouragement to change his lifestyle and rebuild his life.

“I was scared, for sure,” Duffy says. “But I remember a nurse at Cheshire coming in and telling me ‘You’re here now, and we’re going to take care of you.’ The staff all reassured me and told me that it was going to take some time, but that I was going to get better.”

While Duffy was uplifted by the rehab team, they were, in return, bolstered by their patient’s resolve—even in the face of some pretty grim circumstances.

“When he first came in, we weren’t sure he was going to even make it,” says Liz Olmstead, inpatient rehabilitation liason at Cheshire. “Statistically, people in his situation don’t always survive. But when he arrived, he jumped in and was very enthusiastic. Our rehab team embraced him because he was young and wanted to change his lifestyle. He’d had the proverbial wake-up call.”

Duffy had received the message loud and clear. Every day, he worked with the staff to get better, and gradually he started seeing improvement. His speech began to clear up.

He gained strength in his right arm. After about a month, he was able to stand up beside his bed, then walking for short stretches with the help of a leg brace and quad cane.

Every step of the way, the Cheshire staff was there to guide him, motivate him, comfort him through the setbacks, and celebrate the small victories. He got to know each of them by first name. He became so comfortable, that when it finally came time for him to return home, he was reluctant to leave his newfound family.

18 Cheshire Medical Center 2019-2020 Report to the Community

Above: David Duffy with Physical Therapist Kelli Abbott during his early rehabilitation in 2019.

Right: Duffy at a recent reunion visit with some of his team.

“I was scared to go home,” he says. “I couldn’t take care of myself and didn’t have the support network. But the staff at Cheshire reassured me that it was OK to be scared.

They made sure I would have the equipment and supplies I would need at home.”

Once home, Duffy continued his recovery. He bought a step machine for exercise and joined the local YMCA, where he could work out in the pool. He taught himself to drive a modified vehicle, with which he could go to the grocery store. He completely revamped his eating habits and stuck to a strict, nutritious diet of fruits, vegetables, and salads. He also never lost touch with his support network at Cheshire, visiting the staff regularly.

“So many patients come back to visit us,” Olmstead says.

“We become a second home. There’s a level of comfort and the fact that they’re in knowledgeable hands. They came here having been robbed of the independent existence they once enjoyed. When they’re here they have that given back to them. A second chance at life.”

David made the most of his second chance. He is now down to 215 pounds from his original 465. He has reclaimed his life. And he’ll never forget the people who helped him get there. 

Inpatient rehabilitation = 24/7 supportive care

“The people at Cheshire helped me

immensely. I don’t know where I would be without them.”

—David Duffy

Cheshire Medical Center 2019-2020 Report to the Community

19

care

+ kindness

Lifting spirits with recognition and gratitude Hospital staff don’t always see the positive impact they make in people’s lives. That’s why, when a patient takes the time to honor a Cheshire Medical Center employee through the Circle of Gratitude program, it is always a particularly meaningful gesture.

After eight years working at Cheshire—first in Environmental Services and currently as a receptionist in Family Medicine—Marion Beverly has seen a lot and is fazed by little. Yet, that wasn’t the case in January, when he was honored by a patient in the Circle of Gratitude—a program that serves as an way for patients to thank hospital staff for going above and beyond—for his friendliness, kindness, and exemplary service.

“I didn’t see it coming,” he said.

This recognition has a positive impact on staff members because it is a concrete action that lets honorees know that they’ve exceeded patient expectations.

“It’s a huge thing to receive that level of acknowledgement and makes you feel like you are really making a difference,” Beverly says.

Erin Petriello, registered dietician and certified diabetes care and education specialist, was recognized by a patient in February and echoes this sentiment.

“I was really honored and it made me feel that what I do every day is worthwhile,” she says. “It means a lot to receive that kind of recognition from a patient, and it encourages and re-energizes me as a provider.”

As both caregivers and our community cope with the effects of the COVID-19 pandemic, the Circle of Gratitude is also a means of fostering connection and building trust. “This year has been so rough, and so many people are burnt out but still trying really hard,” Beverly says. “It would be really uplifting to let the medical center’s staff know that you care and that you see them.” 

HONOREE

Erin Petriello

HONOREE

Registered Dietician and Certified Diabetes Care and Education Specialist

Marion Beverly Receptionist, Family Medicine

For more information about honoring a Cheshire employee in the Circle of Gratitude, please visit CheshireHealthFoundation.org.

20 Cheshire Medical Center 2019-2020 Report to the Community

Offering solace and support with “Tea for the Soul” When folks see Chaplain Winnie wheeling a “Tea for the Soul” cart their way, they know their palates are in for a treat—and their spirits are, too.

“We bring a cart with tea and snacks to clinical and nonclinical areas,” says Cheshire Medical Center’s Chaplain Winifred Skeates. “It helps show the staff we appreciate them and gives them a chance to take a break during a busy day.”

“Tea for the Soul” is a pastoral care tool used by chaplains in health care facilities across the country.

Skeates stocks her cart with items from the cafeteria, and with donations from individuals and companies such as Walmart, which gives her a discount on snack items.

In addition to the treats, she gives staff an opportunity to take a restful pause and talk with someone whose job it is to listen and lend comfort.

“The basic idea behind chaplaincy is helping someone find their own resources for dealing with whatever stress or anxiety they are going through,” she explains. Giving the team members at Cheshire solace and support is crucial as they care for some of the most vulnerable members of the community.

In addition to the treats, “Tea for the Soul” gives staff an opportunity to pause, and talk with someone whose job it is to listen and lend comfort.

Director of Employee Wellness Jennifer Begley and Chaplain Winnie Skeats bring a “Tea for the Soul” cart to various areas of the medical center.

“I get to spend my time with these people, hearing their stories,” she says. “It’s very much ‘heartwork.’”

The program benefits team members like Maureen Bannon, RN Care Coordinator at Cheshire, who had just finished an emotional conversation with an end-of-life cancer patient when she visited by Skeates and her cart. Although the patient was accepting of the diagnosis, Bannon says the interaction was especially trying for her because she had lost her brother to the same diagnosis.

Pitching in to protect lives Earlier this year, with COVID-19 cases rising and shortages of personal protective equipment (PPE) growing, local businesses stepped in to help get masks for Cheshire Medical Center. Calling on diverse resources, these businesses helped protect the lives of Cheshire’s frontline staff and the community.

Peterborough-based SoClean, which specializes in sleep equipment and air purifiers, made use of its supply chain contacts and, in partnership with a group of private donors, quickly ramped up its “Masks for New Hampshire” initiative.

“We saw a need in the marketplace,” says Mark Gavin, SoClean chief financial officer and Cheshire Medical Center trustee. “In some cases, recipients of the masks had nowhere else to turn to get PPE.” Between March 24 and May 1, the consortium had manufactured and donated more than 250,000 N95 and two-ply face masks to 206 health care and public safety organizations in the state. SoClean employees made every delivery in person; Gavin himself delivered masks to Cheshire and elsewhere, noting that “there were often tears” when the safety equipment arrived.

Mark Gavin, CFO of SoClean in Peterborough. SoClean was quick to ramp up its “Masks for New Hampshire” initiative.

Troy-based Surell Accessories believes in supporting neighbors and other small businesses in need, says co-owner Dan Meattey, because doing so is ultimately what makes our community stronger. When Meattey learned about PPE shortages, he immediately began looking at what his company could do.

“I had just hung up the phone when there was a gentle knock on the door with two beautiful smiling faces (under masks), Winnie and Director of Employee Wellness, Jennifer Begley,” Bannon says. “A small, kind gesture can go a very long way. I am very thankful and often share my positive experience with others.”

“We try to do whatever we can to help in situations like this,” Meattey says. “It is incredibly important to support our health care workers.”

“Tea for the Soul can be a time to reinforce and strengthen our fellow team members,” Skeates says. “It’s nice to have a moment of joy.”

Meattey says he encourages others to get involved in any way they can to support Cheshire and the rest of the medical community in the continuing fight against COVID-19.

The visits remind her that her work is important, too.

“To see the instant smile and hear a person say ‘You brought me something when I needed it’... that feeds my own soul,” she says. “The work reinforces that we are committed to the mission of this organization, to serve our patients, whatever role we play.” 

In addition to the masks donated by SoClean and Surell Accessories, Cheshire also received much-needed N95s from Keene-based Bulldog Designs and the Douglas Co., which makes Douglas Cuddle Toys. The medical center is proud to belong to a community that cares for its own and grateful to belong to a community that emphasizes the health and safety of all. 

Dan Meattey of Surrell Accessories drops off PPE donations to Cheshire in the spring of 2020.

Cheshire Medical Center 2019-2020 Report to the Community

21

care

+ kindness

Providing safe and comforting care for moms delivering during a pandemic

B

eth Wood gave birth to her first child, Elliott John Wood, on April 27 at Cheshire Medical Center. The experience wasn’t what she had expected. For months, she and her husband, Matt, had gone to prenatal appointments together. They’d prepared for labor, imagining that Beth’s mother would be with both of them during delivery.

Then COVID-19 hit, and everything changed.

“It was an emotional and scary time,” Beth says. In midMarch, Cheshire, along with many hospitals across the country, limited the number of daily visitors to protect patients and staff from potential exposure to the virus.

For Obstetrics, Gynecology, and Nurse Midwifery, that meant prenatal appointments were limited to the mother only. During labor, only one support person could accompany the mother in the delivery room.

“Elliott is our first child and my husband had been there for everything. All of sudden that was taken away,” Beth remembers. “I had to go on my own.”

“I can’t sing enough praise for all of the staff. We almost forgot COVID was happening while we were there.

Everyone was just awesome.”

—Beth Wood

to me and helped me to not feel I was losing my mind.”

Beth and her husband stayed in the hospital for five days while Elliott learned to latch and nurse. The pandemic-related restrictions meant that both parents had to physically stay on the labor and delivery floor for the duration.

The Cheshire staff enveloped the Wood family in care the entire time. “Without them, it would have been impossible for us to stay in the hospital five days,” Beth says. “But we left thinking we wanted to take all of them home with us.”

Carlye Atkinson, a certified nurse midwife at Cheshire, notes that the care given to Beth Wood is not unusual, though the pandemic meant a change for everyone.

“It’s been really hard for us to have to tell people you can only have one person in the room with you,” she says.

She also had to break the news to her mother, who is a nurse in Georgia, that she wouldn’t be allowed in the delivery room.

Everyone at Cheshire, says Atkinson, is coming through this difficult time by pulling together as a team, and as a family. Together they stay focused on taking exceptional care of the community members they serve.

“That really threw me for a loop,” Beth says. “I pictured my pregnancy and birth a certain way, and then that was gone.”

“You have to be real about the challenges,” Atkinson says. “But you also have to be a real person, which might include crying with them or laughing with them.”

But in place of what Beth and Matt had expected came a strong source of support.

Beth remains grateful for the steady, thoughtful, expert care she and her family received.

“The midwives, doctors, the nurses, our pediatrician, everyone at Cheshire was phenomenal,” Beth says.

“They personalized everything and took the time to talk

“I can’t sing enough praise for all of the staff,” she says.

“We almost forgot COVID was happening while we were there. Everyone was just awesome.” 

22 Cheshire Medical Center 2019-2020 Report to the Community

Paying tribute to some of our local heroes

U

ntil March 2020, photographer Lisa Scoville’s camera captured joyful moments—engagements, weddings, birthdays. But when COVID-19 emerged, her focus changed.

As a mother of five whose husband works as a Boston MedFlight pilot, she experienced first-hand the stress the pandemic caused for essential workers—those in the medical field, delivery drivers, grocery store employees, plumbers, teachers—and their families. She wanted to celebrate and thank them for their selfless dedication. She began photographing them on their front porches and sharing the photos on her Facebook page, causing a local social media buzz.

It did not take long for her project, “Unsung Heroes,” to gain momentum. As the project grew, she began featuring people where they worked—which led her to photograph more then 20 teams at Cheshire Medical Center.

“Lisa’s photos gave the staff a sense of pride and empowerment during a difficult time,” says Jessica Lussier, MSN, director of Critical Care and Emergency Services.

“They lifted our spirits and boosted morale.”

This fall, Lisa plans to publish a book, also called “Unsung Heroes,” a retrospective documenting the project.

Proceeds from book sales will be donated to help small local businesses recover from COVID-19’s financial toll.

“It’s been humbling to meet these people and hear their stories.”

Photographer Lisa Scoville’s project “Unsung Heroes” includes photographs of more than 20 teams at Cheshire Medical Center.

“It’s been humbling to meet these people and hear their stories.” Scoville says, “This book is a tribute to our local heroes and their dedication to our community. It will serve as a time capsule that documents how our community came together during the pandemic.” 

To see more of the “Unsung Heroes” photographs, visit facebook.com/CheshireMed and facebook.com/LisaScovillePhotography.

The Cheshire operating team includes nurses, surgical technologists, and anesthesia technologists.

Celebrating our registration staff who welcome our patients every day.

Cheshire Medical Center 2019-2020 Report to the Community

23

trust

+ connection In fact, this is Max’s journey through addiction and recovery— and Maryann’s story about being a parent to someone with a substance use disorder (SUD). A person with an active SUD misuses substances—such as opioids or alcohol—to the extent that it interferes with their well-being. It’s a treatable illness that can affect anyone, regardless of age, race, gender, employment status, income, or education level.

Opening doorways to recovery

Max and Maryann wanted to share their story to let people know that addiction can happen to anyone—and there is help.

The Doorway at Cheshire Medical Center played a pivotal role to getting Max on the path to recovery. It’s a long journey, but there is support available for both people suffering from addiction and those who love them.

Clinician Laurie Butz-Meyerrose is one of the caring staff members at The Doorway ready to help you get started on the road to recovery.

M

ax went to a sleepaway camp in Upstate New York when he was 6 years old. It marked the first moment Maryann, his mom, had some downtime as a single mother. It all sounds like a normal—albeit exciting—rite of passage for a young boy, except Max was a hemophiliac and his campmates had critical or life-threatening illnesses.

Maryann knew he’d be safe with the extensive medical support of doctors, nurses, and trained camp counselors. It was a moment when she knew letting go would be good for both of them.

Max first told his mom that he was addicted to heroin when he was 21. He told her that he was planning to go to Florida for the winter to get into treatment. It’s common to suffer from denial around a loved one’s addiction; but Maryann believed her son.

“A lot of parents are surprised. Not my kid. My child would not do that. I did not have that element of surprise because he was using opiates for years to relieve the pain caused by hemophilia,” Maryann says. “Addiction can happen to anyone.”

She also knew from her years in recovery and Narcotics Anonymous meetings that she could not make him stop using, unless it was his decision.

“Unless the person is willing to change their lifestyle and seek treatment, all you can do is hope and pray to a higher power—depending on what you believe in—that they stay alive long enough to do that,” Maryann says.“There is a lot of letting go. And you’ve gotta do your best to keep the lines of communication open.”

Hemophilia is a rare but painful chronic illness that affects the way a person’s blood clots. By the time he was 6, Max could find and inject his own veins with an infusion treatment—the standard way to do that at the time. If he had a bad episode, he was prescribed time-released morphine, an opiate. Needles and narcotics were part of his normal from a young age.

Seven months had passed since Max first admitted to using heroin before she saw him again. Instead of going into treatment as he planned, things had gotten so bad that Maryann knew he was going to die if he didn’t get help. He knew it too. He moved back home to New Hampshire and started a methadone maintenance treatment. This is usually a first step toward rehabilitation for someone addicted to opioids. He was on it for five years. He continued to use drugs.

Maryann has told Max, now 28, on more than a few occasions: You’re not supposed to die before me. But it wasn’t his chronic illness that she was worried might kill him.

“Eventually things got really bad again. My mother suggested I call The Doorway. It helps to have someone push you in that direction, but it is up to the addict,” Max says.

24 Cheshire Medical Center 2019-2020 Report to the Community

In March of 2020, Max finally agreed to go to The Doorway with his mom. They met with Clinician Laurie Butz-Meyerrose, MS, LCMHC, MLADC. “I wish The Doorway had existed years ago. It’s here. They can help you. If they cannot physically help you in the moment, they can suggest where you can go,” says Maryann. “There were a few weeks where Laurie was like my best friend.”

Butz-Meyerrose doesn’t follow a cookie-cutter solution when it comes to helping an individual struggling with a substance use disorder. She’s patient-centered, flexible, and creative. And she makes the most of every opportunity. Meeting the patient where they are—sometimes literally, and sometimes metaphorically—is essential.

Butz-Meyerrose has gotten texts in the middle of the night. She’s been called to the Emergency Department (ED) at all hours.

“We try to seize any window of opportunity,” Butz-Meyerrose points out. “In 20 minutes, the person I am meeting with could walk out of here, see a buddy, and they are off and running, and they are all done. But, if I can meet them in a moment of clarity, and if we can move quickly, we can get them into treatment.”

Some people reach out to The Doorway on their own. Others, like Max, come in because a loved one convinced them to talk to someone.

“We’ll have referrals from drug court,” Butz-Meyerrose says. “We’ll have referrals from probation parole. We’ll have referrals from employers. We have family members who come in: wives, husbands, moms, dads, siblings.”

As soon as Butz-Meyerrose determines a patient’s needs and what is available to him or her based on insurance and other factors, she presents and discusses options. The Doorway acts like a central hub that connects different local services, so staff can help people choose the options that suit their unique situations. But, she admits, she is not a miracle worker. The first step is for the person to admit he or she has a problem.

“You can’t force anyone into treatment. It’s their recovery. It’s their choice,” she says. “It goes back to meeting the person where he or she is. Are there options that might work better for them? If not now, maybe sometime soon. I just pray that they live long enough to get to the point when they are ready. And I tell them to call me when they are.”

“I wish The Doorway had existed years ago. It’s here.

They can help you. If they cannot physically help you in the moment, they can suggest where you can go.

There were a few weeks where Laurie was like my best friend.”

—Maryann

Maryann and Max

Butz-Meyerrose recommended a 28-day residential program for Max, but he needed to detox to meet the program’s entry requirement. She got everything lined up.

“I was at rock bottom. I was so miserable. I was looking for somewhere to go. That is what the Doorway did for me,” Max says. “The spiritual change came later.”

After he successfully completed the 28-day residential program, Max moved into sober living and got a job. He works from 10:00 am to 6:00 pm and lives with others who are also in recovery. As part of the requirements to live there, he needs to attend a certain number of meetings and check-ins per week. He knows he needs to do the right thing.

Max’s concept of trust and connection has changed dramatically in the past few months.

The negative attributes of connection that fueled his addiction have been replaced by positive ones. For Max, trusting the process and staying in touch with people who are going through what he’s going through is essential, as is helping others.

And he wants others to know this: “For any addict or alcoholic, There is a solution and you can recover from a hopeless state of mind.”  Turn to page 26 for Laurie Butz-Meyerrose’s tips for loved ones.

Need help for substance misuse?

Open weekdays 8:00 am–5:00 pm at 24 Railroad St., Keene, NH

Call 2-1-1 to talk with someone at The Doorway.

Phone lines are open 24/7, 365 days a year.

Cheshire Medical Center 2019-2020 Report to the Community

25

trust

+ connection

Taking care of yourself “The Doorway has become a vital partner in the fight against substance use disorder in our community.”

—Jim Suozzi, DO Emergency Department Cheshire Medical Center

when a loved one is suffering from substance use disorder “There has to be a boundary, and that is the hardest thing for a loved one of someone suffering from an SUD to do,” Laurie ButzMeyerrose. says “I know. I have been there.”

“There’s a fine line between enabling and helping,” she says. “It’s a problem when help crosses into enabling. And it’s not always a clear line. It’s a very convoluted, gray area.”

She advises standing your ground.

Partnering to meet people where they are Jim Suozzi, DO, has worked in the Emergency Department (ED) at Cheshire Medical Center since 2009. He’s witnessed the increase in patients with addictions over the past decade.

“I have seen first-hand how opioid abuse takes lives and devastates families and loved ones,” Dr. Suozzi says. “It is heartbreaking to see the rise in patients who suffer from opiate addiction.”

When a patient comes to the ED from an overdose or some other SUD-related injury, the treatment is often straightforward: reverse the opiate overdose with medications such as naloxone (Narcan) or treat other SUD-related complaints such as an abscess or infection.

“We are not able to manage the root cause of their addiction. Before The Doorway opened in 2019, we provided patients with handouts containing recovery information,” Dr. Suozzi. says “These patients now have excellent follow-up care to treat their underlying disease. The Doorway has become

a vital partner in the fight against substance use disorder in our community.”

Experts in addiction treatment, staff members at The Doorway know a key to getting people started on their path to recovery is meeting patients where they are psychologically. Not every person with a substance use disorder is at the same point in their journey to recovery. They also quickly learned that they needed to meet people where they were physically—and sometimes that means followingup with a patient in the ED, or inpatient at the hospital, as well as at their office location.

The Doorway develops a connection through these relationships that continue after discharge. It’s a big change. And they aren’t stopping there.

In fact, The Doorway has expanded its level of care from talk therapy to offering medically assisted therapy where a prescriber gives a patient a prescription. Some people stay on medication for a short period; some for years at a time. 

26 Cheshire Medical Center 2019-2020 Report to the Community

“There has to be a time when the loved one says, ‘I have done all that I am prepared to do. I will drive you to treatment; I will drive you to the ends of earth as long as the end game is that you get help,’” she says. “It is essential that the message is not judgmental. ‘I love you. I will never completely leave you, but I can’t stand here and watch this anymore.’”

She also advises taking care of yourself and learning more about the warning signs of addiction and how best to support someone on their journey of recovery.

A good place to start is Al-Anon, a fellowship of friends and families of loved ones who are suffering from an SUD. You’ll find information and resources, as well as a listing of meetings at al-anon.org.

Below are a few resources Butz-Meyerrose recommends.  Codependent No More: How to Stop Controlling Others

and Start Caring for Yourself by Melody Beattie  Chasing the Scream: The Opposite of Addiction by

Johann Hari, as well as his YouTube video: “Everything You Think You Know About Addiction is Wrong”  Applied Recovery by Dr. Kevin McCauley

as well as his collection of videos: “Pleasure Unwoven,” some of which are available on YouTube For guidance, support, or more information about The Doorway, call 2-1-1 or visit thedoorway.nh.gov.

Hughston Chumley and Sue Tempesta developed a friendship as they walked and talked.

Finding friendship along the way There were some days Sue Tempesta just flat-out didn’t feel like walking. Despite needing just a few more strides to meet her daily goal of 10,000 steps as part of the Right This Way wellness challenge, she just couldn’t muster the motivation.

Then she’d hear a familiar voice coming from down the hallway.

“He would knock on my door and say, ‘Let’s go,’ ” Tempesta says. That would be 85-year-old Hughston Chumley, Sue’s upstairs neighbor and walking buddy.

So she’d go. She’d always go.

Tempesta joined the program through her employer, MillisporeSigma in Jaffrey, as part of the Workplace Wellness program offered through the Center for Population Health at Cheshire Medical Center. The challenge gave Tempesta a goal of 10,000 steps a day, so she started walking laps around the apartment complex where she lives.

That’s where Chumley—who had recently lost his wife of 50 years and was maybe a little short on camaraderie—came in. He noticed she was walking a lot and approached her one day. She explained the program, and he was hooked.

“He’d say, ‘Did you get your 10,000 steps?’ and I’d say, ‘No, not yet,’ ” Tempesta says. “And he’d go, ‘One more time around!’ ” They’d walk and talk, and talk and walk. There were almost as many stories as there were steps.

Responding to anxious patients with empathetic and compassionate care When David Segal, PA-C, was informed that an older gentleman—a veteran—was refusing to enter the military-style respiratory treatment tent next to the medical center, he responded with understanding and empathy.

organization who goes above and beyond, it’s him,” says Michelle Stockton.

“I just said, ‘You don’t have to go inside,’” says Segal, a physician assistant in Family Medicine at Cheshire Medical Center. “We can sit right here under the canopy and see what’s going on.”

“This is our job,” he says. “Isn’t this what we’re paid to do?” 

But Segal shrugs that off. In fact, he likened it to being back in the service, when they awarded a medal for saving someone’s life.

So that’s what he did: treated the man where he was, in a folding chair outside the Keene Ambulatory Respiratory Evaluation Service (KARES) tent area where Cheshire provides primary care medical evaluation for patients with upper respiratory symptoms.

“I have a special place in my heart for veterans,” says Segal, who spent 30 years in the U.S. Coast Guard Reserves. “Though I haven’t served in combat, I’m appreciative of those that have.”

Having been deployed by the Coast Guard to the disaster sites of Hurricanes Katrina, Ike, and Sandy, Segal says the intense conditions and military-style accommodations are nothing new to him. When the hospital was looking for providers to see patients in the tent, he volunteered right away. Ever since, he’s been out there in full PPE, four days a week.

When not seeing patients in Family Medicine at Cheshire, David Segal, PA-C, works in the Keene Ambulatory Respiratory Evaluation Service (KARES) unit, providing primary care medical evaluation for patients with upper respiratory symptoms.

Tempesta has since moved to Hinsdale, and Chumley has visited her new place to walk a few times. Saying she knows how hard it is to meet people, Tempesta’s hoping her friend finds a new partner to walk and talk—talk and walk.

Segal’s colleagues commend him on his dedication. “If there’s anyone in this

“It’s just the sweetest story because it kept me on track with the program,” she

Note: With the change of seasons, the KARES unit is now located in a separate building in the corner of Cheshire Medical Center’s rear parking lot. Please follow the signs.

says. “I lost 10 pounds and I developed a wonderful friendship.” 

Cheshire Medical Center 2019-2020 Report to the Community

27

trust

+ connection

Helping worried callers with answers and reassurance

W

hen a call comes in to the telecommunications center at Cheshire Medical Center, it’s most likely a community member asking to be connected to their primary care provider or to a specialized unit.

Now, with COVID-19 on everyone’s minds, the 13 operators have an added extra demand: helping people get the correct answers to the questions about how the pandemic might be affecting their health.

“The call volume increased dramatically in the beginning of the pandemic,” says Maureen Ovitt, telecommunications manager for both Cheshire and Dartmouth-Hitchcock Medical Center in Lebanon. “It was something no one in the community had ever dealt with, and the anxiety was through the roof for everyone.”

Typically, callers are looking for their doctor or an inpatient, Ovitt explains. After normal business hours, callers may be experiencing a medical issue and need a return call from the on-call care provider. Operators do not give medical advice, but they do help callers get connected with the right people at Cheshire, whether

Mary Priest answering phone calls in Cheshire’s telecommunications center.

that’s a specialist, a primary care provider, or the emergency room. The pandemic brought a new level of concern to the telecommunications team.

Catherine Graves, who was hired just before the pandemic hit, witnessed the sharp rise in callers’ anxiety and need for assurance that the hospital was safe.

“It is the nature of this job that some of our callers are in crisis when they call in,” she says, “but the feeling of fear in the community was something we don’t normally encounter. Callers were worried about possible exposure and we had to reassure many of them that it was indeed safe, and important, to still come in for serious medical concerns. Fortunately, we were able to quell most of those concerns, since the hospital was, and is, being exceedingly careful about the safety of patients and staff.”

Ovitt notes that Cheshire’s culture of collaboration supports the team’s efforts to handle challenges.

“Everyone is an equal at the hospital,” she says. “You get a sense of camaraderie the minute you walk through the door.

It’s really important that people talk to each other because that impacts the level of customer service we can provide to our clients.”

“All of us are aware of our roles, and how all of these moving parts serve Cheshire’s common goal of patient care.”

—Maureen Ovitt Telecommunications Manager, Cheshire Medical Center and Dartmouth-Hitchcock Medical Center

28 Cheshire Medical Center 2019-2020 Report to the Community

Because of this collaborative culture, the telecommunications team feels valued.

“While we don’t treat patients, we are still very much a part of the daily function of the hospital,” Ovitt says. “All of us are aware of our roles, and how all of these moving parts serve Cheshire’s goal of patient care.”

Staff members Olivia Stack and Olivia Robbins screening patients and visitors at the front entrance.

Protecting everyone with entrance screenings There’s nothing in Olivia Stack’s job description that required her to don her down jacket and stand outside in the mid-April chill, asking people if they’re feeling sick.

Yet there she was, joining the front entrance screening team. Stack, the community health education coordinator for Cheshire’s Center for Population Health, was one of many selfless Cheshire staff members outside the hospital asking a few simple questions—“Do you have any COVID symptoms?” and “Have you traveled recently?”—to keep everyone inside as safe as possible.

“It was a rewarding experience helping to protect our community during these uncertain times,” Stack says.

“I witnessed many acts of kindness and giving from community members, such as donating handmade masks and other PPE.” The myriad of hospital staff members that have been reassigned to be screeners have been invaluable, says Christine Scheffler, director of Cheshire Volunteer Services, who coordinates the screeners.

“Screening patients before entering the building has been critical in our ongoing efforts to reduce exposure for other patients and helps to ensure personal protective equipment and masks are being used effectively,” Scheffler says. “We are very fortunate to have such dedicated staff.” 

Connecting around healthy food F ood choices may depend on personal health goals, taste buds, family history, cultural background, emotional state, free time, or culinary knowledge. However, some lack the ability to choose what they eat without some financial and logistical help.

That's why the Center for Population Health at Cheshire Medical Center teams up with partners like C&S Grocers, local farmers, and non-profits to offer a range of programs that get healthy food on the plates of those who need it most. One of these partnerships provides farm shares and grocery store gift cards to patients participating in Prescribe For Health, a program helping people of limited means take charge of their own health.

Ashley Rickey-Hale and her sons, Russell and Joshua, pick up a CSA share of fresh vegetables from Tracie’s Community Farm in Fitzwilliam.

“My boys love vegetables,” Ashley Rickey-Hale says of her sons Russell and Joshua, ages 7 and 5. “At the farm, they learn about how different vegetables grow—they always have so many questions.” Ashley’s family is grateful to have received a sponsored CSA share from Tracie’s Community Farm in Fitzwilliam for the last two growing seasons.

“We know these funds make a real difference,” says Tracy Clark, who works at the Center for Population Health.

Clark met Rickey-Hale while working in the hospital’s Women’s Health department when the boys were born.

Her joy is helping patients like Rickey-Hale invest in themselves and their children for better health.

“I can access fresh vegetables that I’ve never really been able to afford, so I can eat healthier,” Rickey-Hale says.

“I’ve been learning how to cook certain types of veggies I’ve never prepared before and it has helped me bond more with my sons.”

Cultivating connection through sharing healthy food can be a powerful driver of positive change in people’s lives.

“Some women receiving these farm shares have even been hosting family-style dinners with their neighbors to pay it forward,” says Clark, who hopes to continue the program, pending funding for next year. 

“I can access fresh vegetables that I’ve never really been able to afford, so I can eat healthier. I’ve been learning how to cook certain types of veggies I’ve never prepared before and it has helped me bond more with my sons.”

—Ashley Rickey-Hale

Cheshire Medical Center 2019-2020 Report to the Community

29

generosity

+ vision

Honoring a history of caring with a gift to support nursing excellence

E

ven in the midst of his own health concerns, Joe Baute has always remained true to one of his defining traits. Joe is a gentleman who has spent much of his life listening to and learning about others. It springs from his inherent inquisitiveness.

Joe considers himself fortunate to have received excellent care under the compassion and skill of the nurses at Cheshire Medical Center during a series of inpatient stays over the years. He has never considered those days of convalescence to be wasted ones—particularly the middle-of-the-night chats when sleep eluded him; they gave him the opportunity to use his trademark inquisitive nature to get to know the nurses as they cared for him, and understand more about their own lives, hopes, and dreams.

“It’s hard for the nurses to get work done,” says Joe’s wife, Stephanie, with a smile. A longtime volunteer in patient care at Cheshire with her service dog, a standard poodle named Charlie, she adds, “Joe has so many questions for them.”

By establishing the Helen Brueckner Baute, RN, Nursing Excellence Funds, Stephanie and Joe Baute continue a family legacy of commitment to care.

Asking those questions and hearing what the nurses had to say led to more conversations, this time with the Philanthropy and Community Relations team at Cheshire. Over time, Joe and Stephanie determined that an ideal way for them to show their gratitude for the care Joe has received was to create a gift to enhance and support the careers of nurses. Just this summer, the Bautes made a gift to establish the Helen Brueckner Baute, RN, Nursing Excellence Funds at Cheshire Medical Center. The gift is named in honor of Joe’s late mother, who was a registered nurse.

“Years ago, I had to go to the Nurse Clinic once a month,” Joe recalls, “and when you’re in there seeing one or more of the same nurses, year after year, you get to know them, how long they’ve been at Cheshire, what they do outside of work, and about their families. That’s where it started.”

Stephanie has made her own observations about the nursing staff at Cheshire during Joe’s many stays, as well as through her volunteerism with Charlie (and three other service dogs before him) to cheer other patients during their own bouts with illness. “The way the nurses have of using humor and compassion and listening were very important during Joe’s stays,” she says. “I felt comfortable when he was there; he was safe and in excellent hands.”

Continued on page 31.

30 Cheshire Medical Center 2019-2020 Report to the Community

The Helen Brueckner Baute, RN, Nursing Excellence Funds honor her years of service to her community by helping future generations of nurses.

“I think it’s the right thing to do in honor of my mother and I think she’d be very pleased.”

—Joe Baute

Cheshire Medical Center 2019-2020 Report to the Community

31

generosity

+ vision

The true spark of Joe’s appreciation for the medical profession began with his family. He grew up on a farm in Rhode Island, drafting detailed phone messages for his father, a doctor, and his RN mother, so they could respond to their patients’ medical concerns armed with adequate information. Young Joe often accompanied his father on rounds at the Homeopathic Hospital of Rhode Island, and came to appreciate the responsibility of medical professionals. His mother was “in command,” Joe recalls, more than capable of caring for her patients and her four children. She also raised goats and made goat milk soap, wrapping the bars carefully in cloth before selling them to locals. Everything she did, he says, was done well and with compassion.

“The discipline was there,” Joe says. “You learned early on to do your job and do it well. Mother was a great inspiration; we learned and learned from her.”

In the conversations he shared with the nurses at Cheshire Medical Center, Joe recognized his own mother not only in their care and competence but also in their family responsibilities. He also determined that many of them hoped to further their careers and professional education, but were limited by time and financial constraints. In his many years as CEO of Markem, a Keene-based manufacturer, Joe prioritized professional development for his employees. He grasped the rapidly moving nature of the field, and the fact that many in the workforce needed continuing education to keep up with the latest technology. To combat the gaps in knowledge, Joe brought in engineering professors from Boston to teach machine shop workers about the nuances of the electronic components they were building.

“That was the way we stayed ahead of the curve,” says Joe, who spent many years on the board of the original Keene Clinic. “The organization was always learn, learn, learn. I got to see what happens when an organization gets help and offers motivation.”

Translating that observation is at the heart of Joe and Stephanie’s gift to support nurses at Cheshire. The couple has gleaned through listening that the motivation—and need— for extended education exists among the staff. The Baute gift provides additional opportunity for professional growth, and will advance the medical center’s efforts to achieve the American Nurses Credentialing Center (ANCC) Pathway to Excellence designation, which recognizes the organization’s commitment to creating a positive practice environment.

With a goal of improving patient outcomes via advanced education, the funds also offers continuing education opportunities for nursing staff. “I think it’s the right thing to do in honor of my mother,” says Joe, “and I think she’d be very pleased.”

The Baute gift allows for flexibility in the long-term, so the team at Cheshire can adapt to the changing circumstances of health care. “I hope the gift enables nurses’ education to be up to speed with what’s going on and what’s needed tomorrow,” says Joe, echoing his vision from Markem.

Perhaps there is no better example of that need to adapt than the current COVID-19 pandemic, which has highlighted a national nursing shortage. That shortage is something of which Chief Nursing Officer Amy Matthews is keenly aware, and why the timing of Joe and Stephanie’s generosity can help Cheshire Medical Center attract and retain a robust and well-qualified nursing staff for years to come.

“It’s such a gift to know we have a couple in our community who would invest in this profession so we can improve the care of patients and the practice of our profession,” says Matthews. “It’s meaningful and touching—of all the things they could support, the Bautes are not only supporting us in health care but investing in nursing itself.” 

32 Cheshire Medical Center 2019-2020 Report to the Community

Supporting a long-term vision for nursing staff By the year 2030, workforce experts predict that U.S. hospitals may face a shortage of a million nurses.

Contributing factors include a decrease in the number of people entering the profession and an aging American population that requires more care than ever.

In a rural setting, such as Cheshire County, the nursing deficit is expected to be significant. That’s why Cheshire Medical Center’s Chief Nursing Officer, Amy Matthews, is planning with a long-term vision.

“Understanding the realities of the shortage, we started talking about what it would take to have a strong workforce in Keene,” says Matthews, who has been a nurse for 35 years, 20 of them at Cheshire. “We talked about how we live our mission, vision, and values with a focus on leadership development to support nurses as foundational to the success of the nursing staff.”

Thanks to Joe and Stephanie Baute’s generous gift, Cheshire Medical Center has been able to establish the Helen Brueckner Baute, RN, Nursing Excellence Funds. The funds will allow the hospital to

Amy Matthews, DNP, MS, RN, CENP Vice President of Patient Care Services and Chief Nursing Officer, Cheshire Medical Center

offer professional advancement opportunities that will make Cheshire an attractive place for nurses to anchor their careers. The vision Matthews has for the program includes offering academic progression for RNs and LNAs to increase the number of baccalaureate-educated nurses.

The Baute gift will facilitate an enhanced peer-reviewed clinical advancement process for nurses at all stages of their careers, recognizing nurses who elect to take on additional volunteer and leadership roles, and make available options for specialized skill training, in areas including wound care, critical care, or medical surgical care.

“It’s important from a recruitment and advancement perspective that nurses on campus are seen as important partners in health care,” Matthews explains.

Initially, the Baute Funds will permit Matthews and the nursing staff to focus on the accreditation process for Pathway to Excellence certification from the American Nurses Credentialing Center (ANCC). The designation, according to the ANCC website, “recognizes healthcare organizations that demonstrate a commitment to establishing the foundation of a healthy workplace for staff.”

“Having a workforce development plan helps build and support the nursing workforce in a way that ensures nurses are empowered to provide high-quality care,” Matthews says. “Being designated as a Pathway to Excellence hospital means something to nurses when they’re considering where to work.”

Matthews, who spent the first half of her career in varied direct patient care roles, has been in her current position for two years. In addition to what she already has outlined, she hopes to expand Cheshire’s onboarding residency program, raise the bar for specialty certification, and encourage nurses to participate in national fellowship programs.

“It’s about meeting motivated people where they are,” she says.“The Baute’s gift will ensure we can continue to support academic progression and education.” 

Sue and Paul Henkel sprang into action with a plan to make masks for their neighbors at Hillside Village and encourage others to support Cheshire Medical Center’s COVID-19 Fund.

Helping keep friends and neighbors safe Paul and Sue Henkel are longtime supporters of Cheshire Medical Center and care deeply for both the greater Keene community and their retirement community at Hillside Village. In early March, prompted by news of other countries requiring face masks to combat the spread of COVID-19, the couple crafted a plan to make masks to keep their friends and neighbors safe.

“We thought masks would be needed in the United States soon, and especially here at Hillside where the residents have greater health concerns,” Paul says.

Wanting to provide masks with an additional layer of protection, Paul researched materials similar to those found in HEPA filters, which were in extremely short supply. The couple placed three separate orders for the material, but only after “ensuring that doing so would not slow the flow of supplies needed by health care providers” at Cheshire and elsewhere.

With the expert help of seamstress Terry Copple, owner of Keene-based TLC Alterations, the Henkels provided

materials, a mask pattern, and a how-to video to 10 Hillside residents with varying degrees of sewing skills.

“I sewed some of the masks,” Sue says with a laugh. “My sewing machine is 60 years old and I learned how to sew back in junior high sewing class.”

In total, the group made more than 200 three-ply cloth masks, provided at no cost to Hillside residents. When anyone asked about payment for their mask, the Henkels continued to invoke the spirit of generosity.

“We suggested that they pay it forward by making a donation to Cheshire,” Paul says.

As a result, Cheshire Health Foundation received a number of gifts from Hillside residents that provided support for the COVID-19 response and directly impacted frontline staff.

All told, the effects of this generosity have been wideranging. The masks helped protect the health of the entire community, while increasing the community’s support of Cheshire Medical Center. 

Cheshire Medical Center 2019-2020 Report to the Community

33

generosity

+ vision

More than anything, Jake Calkins wants cancer patients and their friends and families to know that they “are not in the battle alone—we’re all in this together,” he says.

Going for it for the fifth year and making plans for the next one “Cancer doesn’t cancel, E so why should the fundraising stop?”

—Jake Calkins

very spring for the past five years, 13-year-old Jake Calkins has shaved his head for Bald is Beautiful (BIB), helping raise funds to assist patients in cancer treatment at DartmouthHitchcock’s Norris Cotton Cancer Center in Kingsbury Pavilion at Cheshire. This year was no exception for him, despite BIB’s live shave event being called off due to the coronavirus pandemic.

“Cancer doesn’t cancel, so why should the fundraising stop?”

Jake says.

With only minimal assistance from his mother, Vanessa Calkins, Jake raised an incredible $2,142 this year to support Cheshire’s cancer patients. His enduring love for his “Grammie-Gram,” Rosanne Ciaramella, who sadly lost her breast cancer battle two years ago—coupled with the recent brain cancer diagnosis of a young friend—are what spurred him to action this year.

34 Cheshire Medical Center 2019-2020 Report to the Community

Although his hair has now grown back, Jake is already making plans for next year. He is excited to have his head shaved again while broadcasting live on Facebook, but this time hopes it will be during the actual BIB event.

And more than anything, Jake wants cancer patients and their friends and families to know that they “are not in the battle alone—we’re all in this together,” he says. He hopes to inspire others to get involved with fundraising and continue “what Grammie-Gram would have wanted.”

Cheshire Medical Center thanks you, Jake!  Turn to page 36 to read more about the BIB fundraising event.

Visit cheshirehealthfoundation.org to learn how you can get involved.

Making social connection on the drive to appointments

Most people would consider a cupcake a small gesture of workplace thoughtfulness.

But when it is a piece of artistry made by Daniel Liberatore, it

It’s really dificult to take care of yourself if your day-to-day responsibilities and needs can’t be met because you don’t have transportation.

becomes something much more.

That’s where Community Volunteer Transportation Company (CVTC) comes in. By driving local residents to doctor’s appointments and grocery stores, CVTC’s volunteer drivers offer more than a ride—they give the gifts of independence, connection, and hope.

“I became a volunteer driver for CVTC when I retired in August 2018,” says Joanne Meshna of New Ipswich. “I have gotten to know some of the riders very well. We enjoy each other’s company and our drives are spent chatting about politics, news, family, and life in general, with laughter sprinkled into the seriousness of it all. I’m happy to be part of their lives and help in my small way.”

Without access to reliable transportation, some patients avoid scheduling preventative care or even vital treatments. According to Tricia J. Zahn, MPH, director of community strategic partnerships at Cheshire’s Center for Population Health, CVTC’s service, funded in part through Cheshire to support the Greater Monadnock Community Health Improvement Plan (CHIP), addresses a major barrier—lack of access to transportation—and offers a solution that improves the health and wellbeing of our community.

Beyond rides, CVTC drivers offer genuine connection.

“She is the wonder of my life,” says one of Meshna’s regular passengers. “She makes me so grateful to be alive. I’ve never missed a treatment. I’m so grateful.” 

Joanne Meshna continues to volunteer to help her neighbors get to important appointments and to the store for food.

To keep everyone safe, she always takes the recommended precautions, including wearing a mask.

“I’m happy to be part of their lives and help in my small way.”

Baking in a little kindness Birthdays in the Respiratory Therapy department at Cheshire Medical Center require an extremely difficult decision: Do you go with white chocolate raspberry or the chocolate salted caramel? What about the kahlua chocolate mocha mousse with chocolate ganache? And in the autumn, who can say no to pumpkin spice?

That’s because Respiratory Therapist Daniel Liberatore—who used to own and operate the specialty cake business “MasterPieces Cake Art”— makes it a point to bring in made-from-scratch, gourmet cupcakes for each staff member’s birthday on the unit. The honoree gets a four-pack for themselves, and the rest of the team shares what’s left of the batch.

“It makes people happy,” says Liberatore, who has been full-time at Cheshire since 2018 and has been baking the birthday delicacies since he came aboard as a way to foster a little extra kindness in the unit. “It just gives me a lot of satisfaction to see people enjoy what I do.”

Not a cupcake person? No problem, says Liberatore, who also makes brownies, pies—“just about anything baking-wise,” he says. And if the honoree is not working that day, he’ll leave the sweets in the fridge next to a card with their name on it.

“To top it off, Dan is humble and signs the note of the birthday treats as, ‘Your friends in the Respiratory Department,’” says Eric Lindquist, respiratory therapy manager. 

—Joanne Meshna Cheshire Medical Center 2019-2020 Report to the Community

35

Event highlights Thank you for your support!

Last year, our community stepped forward and generously gave of themselves, donating $892,006 in support of Cheshire Medical Center’s health and wellness mission. Gifts to fund patient care, donated meals, hand-sewn masks, and much more showcased the greater Monadnock Region’s commitment to the health and safety of others.

Cheshire Health Foundation events raised more than $133,000 last year in support of Cheshire Medical Center’s health and wellness mission. In addition to raising funds for new equipment purchases and patient assistance programs, events strengthened the bond between Cheshire and our community.

We are deeply grateful to the many individual donors, volunteers, and businesses who participated in and gave gifts though our events, understanding how important their involvement is in supporting exceptional health care close to home for all of us.

Community support made possible the purchase of a state-of-theart portable digital X-ray machine, 17 advanced defibrillators, and other specialized equipment. More than $191,000 was donated to Cheshire’s COVID-19 Fund, helping to support the medical center’s coronavirus response last spring and directly benefiting our frontline staff.

Other gifts ensured educational opportunities for Cheshire’s nursing staff and area high school seniors pursuing careers in health care. Last year also saw the installation of the medical center’s new CT scanner, the purchase of which would not have been possible without the community’s generous support.

Some of the gifts we received were priceless. These include thousands of handmade cloth face masks for patients donated by community members. It also includes local businesses that sourced N95 masks for our frontline staff when personal protective equipment was in short supply. We are grateful to the restaurants and other small businesses that donated food and meals to help support our employees.

At every turn, the community’s commitment to keeping exceptional care available close to home was evident. Every gift made—regardless of its size—was tangible proof of how impactful community support is to our nonprofit medical center. We are grateful for and humbled by such selfless giving. Thank you.

36 Cheshire Medical Center 2019-2020 Report to the Community

Pictured Front Row L–R: Dr. Carl DeMatteo, Judy Putnam, and Jim Putnam Pictured Back Row L–R: Steve LeBlanc, Chief Strategy Officer, Dartmouth-Hitchcock Health; Don Caruso, President & CEO, Cheshire Medical Center; Jane Stabler, Board Chair, Cheshire Health Foundation

Tribute event raised more than $46,000 Every year at our Caring, Candlelight and Community Tribute event, we honor medical professionals and community members who have demonstrated a commitment to and support of local health care. In December 2019, we recognized Jim and Judy Putnam and Carl S. DeMatteo, MD, for their significant contributions to the greater Keene community and Cheshire Medical Center.

Golf Tournament raised funds for patient care equipment

Pictured: Vicky and Drew Riggio, leaders of the Cue Balls fundraising team

The Cheshire Health Foundation’s 8th Annual Golf Tournament brought 128 golfers together at the Keene Country Club in September 2019. A full and exciting day of camaraderie on and off of the links culminated in more than $65,000 raised to help Cheshire Medical Center purchase a new, state-of-the-art portable digital X-ray machine and 17 advanced defibrillators.

Bald is Beautiful virtual fundraiser brings in $21,000 One of the first Cheshire Health Foundation events to be impacted by the COVID-19 pandemic was Bald is Beautiful. The event, which typically includes a live shave day, transitioned exclusively online where fundraising continued for Cheshire’s Patient Relief and Cancer Care Funds.

Thanks to the dedication and support of individuals, fundraising teams, and local businesses, more than $21,000 was raised this year to benefit the care of local cancer patients at the medical center’s Norris Cotton Cancer Center–Kingsbury Pavilion.

We owe a debt of gratitude to all of our fundraisers, who creatively persevered during difficult circumstances. In particular we thank the Cue Balls, the Monadnock Rugby Football Club, and Jake Calkins for their enthusiastic participation and generosity.

Read Jake’s story of BIB fundraising on page 34.

Pictured L–R: Amelia Carney, Jon Houle, Rich Ouellette, and Jim Greenwood

To get involved or to learn more about how you can support Cheshire Medical Center’s health and wellness mission, please visit cheshirehealthfoundation.org.

Cheshire Medical Center 2019-2020 Report to the Community

37

Gratitude and Inspiration 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 mission by making a gift from July 1, 2019 through June 30, 2020.

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

Cheshire Health Society ($25,000 and up) Don and Jill Brehm Rick and Jan Cohen Jean and John Hoffman Jim and Judy Putnam Jarrett and Ann Scott

Diana and Richard Kasper Amy and Keith Matthews Robert and Judith Perry Sandie Phipps James E. and Gail Robertson Barbara Taft Robert and Lianne Therrien Kathryn and John Willbarger

1802 Founders ($10,000–$24,999)

Granite ($1,000–$2,499)

Bill and Kathy Baldasaro Ashok Bahl Joe and Stephanie Baute Barbara Coburn

Anonymous (10) Genny Alexander Dollie Ash William * and Eleanor Ball Linda B. and P. Russell Bastedo Jill Batty and Daryl Stutes Lucia Bergeron Suzette Borden Judith A. Boule, MD and Scott Lane John Bunce Megan Burke Kidder Mary Lou Caffrey and Kenneth Stewart Dan Chalifour Barbara and William Chase, MD Rosamond and Francois Delori Susan C. Doyle Richard and Patricia Dugger David Elberfeld Alfrieda and Robert J. Englund, MD Cecile Goff Michael and Jennifer Gomarlo Mark and Kathy Gross Sherry A. Guardiano, DO and Robert A. Guardiano, DO Jennifer Hanrahan

Elliot ($5,000–$9,999) Geof and Donna Molina Don Caruso, MD and Nancy E. Johnson, MD Estate of Emily Mason Edward and Mable Bergeron Linda Guinane Monadnock ($2,500—$4,999) Anonymous (2) William and Susan Beauregard Christine and Thomas Doane Claire Fabian, MD and Jack Fabian, PhD Lisa and George Foote, Jr. Nancy and Roger Hansen, MD Cherie A. Holmes, MD and Yvonne Goldsberry, PhD Nathalie B. Houder

Gregory Hansen, MD and Deborah Hansen, MD Kerry Henegan and Marika H. Henegan, MD Paul and Sussan Henkel Eric and Dottie Herr, MD Robert Inman Ruth and Carl Jacobs, Jr. Judy and Rich Kalich Michael and Tricia Kapiloff Liam Kelly and Lesley Loke Jennifer and Gerard Kiernan, MD Norman Kristoff Mary Ann Lancey Martha M. Landry Jane and Steven Larmon, MD Rachel Lovins, MD Charlton and Diana MacVeagh George Maydwell Lisa and Thomas Migneault Jeffrey B. Miller and Carol MacKinnon Heather and Thomas Minkler Helene and Chris Mogridge Anne and Bill Moyle, MD Matthew Murray, MD Alisa and David Nash, MD Jennie Norman and William Walker Donna and Michael O’Shea, MD Maria Padin, MD Susan and Steven Paris, MD Michele and Richard Penna Paul and Sharon Pezone Jim Janetos and Dale Pollack, MD Lisa A. Profetto, APRN and Eric M. Goodman, APRN Katherine Richardson Ann and James Robinson, MD Eileen and Michael F. Sarson, MD

38 Cheshire Medical Center 2019-2020 Report to the Community

Chris and Randall Schon Patti and Gregory Seymour, MD Katherine Snow and Paul Ledell Jane and David Stabler Valerie and Jonathan Starbuck Sandra L. Swinburne Elizabeth and Bruce Tatro Julie and Gregg Tewksbury Sarah Webb Jeanne Williams Thelma Zak Ashuelot ($500–$999) Anonymous (10) Susan Abert, Esq. and Thomas Abert Tracy and Mike Beam David and Patricia Beffa-Negrini Mark and Madeline Bodin Ted and Linda Braun Larry and Suzanne Butcher Louise and Edouard Carignan, PsyD Ross and Carrie Cocklin, MD Ellen Corindia Elizabeth B. Cotter Thomas Crouse and Kay Enokido Alison Cuomo-Nason and Donald Nason Allison Deen Michael and Theresa Desilets, APRN Christine Driscoll-Carignan Frederick and Else Ernst Jacquelyn and Paul Ethier Ian and Maryanne Ferguson Deborah J. Flagg Catherine and William Fletcher Marcia French

Mark and Barbara Gavin James and Brenda J. Glinka Alexander Guida III Lori A. Guyette Audrey L. Hadcock Julius R. Hof, Sr. Carrie and Steve Hoffman, DMD John Hubbard Dennis and Evelyn Huston Ken and Carol Jue Jay and Cheryl Kahn Larry and Ashton Kane Margaret Kasschau and Donald Gillis* Neha and Aalok Khole, MD Barbara and Paul Koutras, MD Shawn LaFrance and Rebecca Farver Stephen and Leslie LeBlanc Charles and Sheila Lennon Malaise Lindenfeld Laura May-Scott Timothy and Ann McCann Jennifer Michelson, RN Charles and Mary Lou Montgomery Bob and Maryann Mucha Michael L. Ormont, MD Debora Pierce-Settle Thomas and Izola Porter Martin Purcell and Barbara Purcell Tom and Barbara Putnam David and Susan Quigley Michael J. Rafferty, CFP Reinette and Brian Reilly, MD Laura Reyor, APRN Robert Rhodes Larry Robbins, MD Mary and Bob Rooney Wendy Rose Lisa and Eric Sandstrum Connie and John Schlegelmilch, MD Cynthia Sieracki Marni A. Silverstein, MD Lynn & Arthur Simington, MD Rev. Winnie Skeates Alan and Melissa Stroshine Jeanie M. Sy Chris Tacy Maria and Kimball Temple, MD

David and Lisa Therrien Bayard Tracy Robert and Margaret Trebilcock Suzanne F. Tremblay, MD and Andrew G. Tremblay, MD Anthony and Barbara Tremblay Nancy and Paul Vincent Joe and Judith Walier Michael J. and Cynthia Waters Robert Westlake, MD and Susan Byrne David and Cynthia Westover Ellen M. Wright Joseph and Lorraine Youngs Elm ($250–$499) Anonymous (9) Stacey and Tim Allen Janet Aug, OD David and Fay Barden Toni Barrett Colleen A. Barry and Stephen Tarbox Gary and Susan Bascom Andrea Bast Susan A. Beringer, MSN Paul Blais Rachel E. Brown Anita Carbone Emmy Chamberlin Elizabeth and Michael Christiansen Moira Croteau and Steve Creamer Kristina Crowley Jane B. Cunningham Dana E. Dash Klaus and Margery Dickinson Tom and Jean Dobson Kate Donath Dennis Donegan Kristen Earle Jay Eason Eileen Fernandes and Carolyn Crane Arthur Foard III and Melany Kahn Mark and Amanda Fryberger Ann Gagnon * Deceased

Maich Gardner and Ed Tomey Sara B. Gilbert Mitch and Erika Greenwald Sarah Handford Parker and Sally Hansel Peter and Bridget Hansel Gregory Hargous Roberta Heinonen Martha and Vaughan Hennum Charles T. Jackson, RN Karen P. Johnson Carroll Johnson Lauri and Basilio Kalpakian, MD Alison P. Kapadia, MD and Nirav Kapadia, MD Risa & Douglas Keene, MD Kathleen A. Kirstein Frances A. LaCoste Harry and Liz Lajoie, RN Cynthia J. Lamoureux Elizabeth and Maurice Landry Nora Larsen Angela Lefebvre Todd Silberstein, DO and Lisa Leinau, MD Steven R. Levene, MD and Susan W. Peters Diane Lupis Michelle and Carl Majewski Deborah Malila Billie Marks Hugh and Maureen Mason Sylvia and Craig McBeth, DMD Sandra and Robert Miller Suzanne and Roland Nadeau James Neilsen Meena and Addison Neva Michael and Beth Newbold Carlene Newell Anne and Roy Piper Jane and Leslie Pitts, MD Marci and Michael Richards Jennifer and Eliezer Rivera Amoriel Robinson Sara Sargent Jane and Gary Shapiro, MD Linda B. Singer, MD and Greg W. Rothman, MD Jane P. Skofield * Deceased

Andree Smith Suzanna and Thomas Strempfer Janice Sundell Noor Tanritanir Cameron Tease and Dixie Gurian Don and Sheila Tisdale Eugenia and Wilhelm Trinkl, MD Jason and Stephanie Vallee Joan and Mark Van Saun Justin Vincel David L. Williams Richard and Sharon Wilson Mark Woods Louise Zerba Stone Arch ($100–$249) Anonymous (45) Michael A. Ahern Sarah Allen June Alonzo Elizabeth and Brewster Ames Jr. Charles and Elizabeth Anderson Donald and Barbara Arguin William Arnott Dorothy Arwe Ricardo Azarcon, Jr. Carmela Azzaro Brie and Adam Bailey Pamela and Mark Balys Mary Ellen and Timothy Barrett Sarah Bast Barbara Bates, MD Gail Battersby Robert Beard Deanne and Paul Belanger Jeanette Bergeron Thomas Bergin, Jr. Beth and Joseph Bergman, MD Paul and Elaine Bieber Pamela and Alan Bielunis Theresa and Michael Blaisdell Holley and Jacques Blanchet, MD Julie M. Boucher Homer and Lucy Bradley Cynthia Brown Jessica Bullock Sara Burbee

John and Cynthia Cantin Susan Carlson Harriette H. Carter Leslie Casey Lorraine and Gregory Chaffee Jerry and Sandie Chaloux Heidi G. Clark Bob Cochran, MD Arthur Cohen, MD Theresa Coll Bob and Kathy Collinsworth Patricia and John J. Colony III June and William Congdon Andrew and Pamela Cooke Cindi and Rich Coughlin Jack and Nancy Crawford Shirley and Wayne Crowell Linda C. Davis Hilda L. de Moya Barbara and Carl DeMatteo, MD Norman Descoteaux Rosemary Dettelback Elisabeth M. Dignitti Frank Dobisky Sarah Downing Arthur Dupuis Tammy Dwyer Susan and John Eastwood Pamela and James Emery Susan Farrell Terry and Jane Fecto Donald and Paula Flemming John and Carole Foley Kevin and Dawn Forrest George Foskett and Mary Delisle David and Robin Fournier Gretchen Fowler Janet Fox Anne Francisco Marilyn D. Freeman Tiffany French, RN George and Jane Freund Kevin and Susan Frewert Alice and Gilbert Fuld, MD Jessica and Patrick Fuller Robert and Christina Furlone Carol and George Gage Glenn Galloway, CPA Thomas Galloway Arthur Gaudio

Rosemary Gianno Carol and Bernard Glabach Jane Goodband Francoise Gooding Willard Goodwin and Barbara Summers Sally and William Graf Julie and Doug Green Torrey Greene Linda and Peter D. Griesbach, DDS Ian Griffin-Bales David and Rhunell Gruender Kate Guyette Peter and Sarah Haaren Helen Hale Anita Hall Gail Hamblet Richard and Marian Hamilton Doug P. and Marianne Hamshaw Wayne Harper Joanne Hayward Stephen and Kelsie Hennessey Samuel T. Hicks III Donald and Jane Hienkle Katie and Robert Hilo, DO

Leonard and Frances Himmelberg J. Robert and Joann Hof Paula and William Hudon Cecille Ingalls Alouette Iselin Virginia* and Richard James, MD* Cherryl Jensen Helen Jesse Gary Jones Richard D. and Maureen A. Jones Marie Juhlin Roxanne and Karl Karter Meredith J. Kennedy April M. Kerylow Ronnie and Deborah Kilyanczik Joslin Kimball Frank Sandra Kingsbury Suzanne and Paul Krautmann, DDS Thomas and Linda Lacey Anna G. Laffond James* and Jean Lake Delores Lake Bruce Lamb Barbara Lammela Loretta and Robert Lariviere

Sara LaShay Marcia Legru Carolyn Lentocha William and Barbara Lindsey Rory and Marlene Longe Ellen Loughney Marc Lubelczyk Robert and Mary Jane Lupien Leesa and Emerson Lyons Malcolm Macdonald Patricia and Bob Maden Peter and Sharon Mangan Sue and Jim Margraf, MD Kelly Massicotte Wade and Katrina Masure, APRN Abigail Mather Meredith Matuszewski Greg and Susan McConahey Susan and John McGinnis Bill McKee Kathaleen McNealy Lisa Meier Allen and Ellen Mendelson Mike and Diane Metell Herbert and Paula Miller

“When my mother was being treated for metastatic breast cancer, we witnessed firsthand the varied struggles that families go through along with their loved one. We strongly believe that even a small donation can go a long way in supporting their fight against this disease.”

Aalok Khole, MD, and Neha Varma

Cheshire Medical Center 2019-2020 Report to the Community

39

“We moved here four years ago so

Beth and Tom Willey Alfred Lewandowski and Kathryn Williamson Janet C. Wilson Kathy & Donald Wilson, MD Norman and Barbara Woodward Donna and Ernest Wright Philip Wyzik Tricia Zahn

Bob could be part of the hospital’s transformation into a regional referral center. We know this growth requires ongoing investment in well-trained and experienced professionals as well as technology. Having felt so welcomed by the community, we decided to make Cheshire Medical Center part of our estate plan to help ensure that the commitments required for this change continue well into the future.”

Robert Westlake, MD, and Susan Byrne James and Deborah Miller Paula and Larry Miller, CRNA Larry and Mary Milliron Bonnie and Ted Moe Kathleen and John Moyer Keaton Murray Michael Murray Alice Nagahiro Patti and Jim Neal Susan and Jeffrey Newcomer, MD John H. Newman, MD Richard and Angela Nicoletti David and Carmelina Nims Scott and Judith Northcott Roger Nyberg R. Dean and Katherine Ogelby Marcia Oster John Palkowski Norman Parkhurst, Sr. Lindsay and Erik Pattison, MD Sue Peaks Andrea L. Pearson, MD Janice Perry Holly and Bradley Piccirillo Katherine Piispanen David Pittman Cheryl K. Price Louise and Dan Rath, MD

Jeff and Sandra Richardson Karen Rider Timothy Ridley Vicky and Andrew Riggio Hila Robinson Nellie and David Robinson Stillman Rogers Paul Roth Lynne and Lynn Rust Sherrie and Joseph Sabolevski Stephen C. Salamin and Abigail R. Mather Richard Scaramelli Peggy G. Schauffler Kurt Schmidt and Shelley Earley Michael and Patti Schuman Joseph and Lorraine Scrivani Jeremy Shand Daniel Shattuck Helen and Harry Shaw Carol and Gale* Shelley Walter and Carolyn Shelley Stella S. Sise Steven and Sharon Skinner Norma Slanetz Christine and Jason Smart Robert and Nancy Smith Karen L. Snyder

Debra Stallings Heidi and James Stanclift Audrey Starkey Thomas Stearns, PhD Craig and Sarah Stockwell Brian Stoning Kara M. Stoning Patricia and James Strickland Barbara Summers and Bill Goodwin Arnold and Leannette Suokko Joan Sylvester Ann and Carl Szot, MD James and Catherine Talbert Wendy Tenney Eustace and Carol Theodore Judith S. Thompson Marc and Sharon Tieger Christopher and Lisa Tkal David Todd John and Sally Wadsworth Janice Walker Sandra Van De Kauter and John N. Walter, Jr., MD Thomas H. Watts The Honorable Lucy Weber Peter and Suzanne Whittemore Samantha and Stefan Wilhelm

40 Cheshire Medical Center 2019-2020 Report to the Community

Kenneth A. and Elizabeth Borchers Helga Bouchard Barbara A. Boulton Barbara Brackett Michael A. Breen June Brening Karen Briere Jeff and Cynthia Brooks Ellen Brouillette Kelly Brown Community Kelsey Brown (to $99) Melanie Brown Sarah Brubaker Anonymous (64) Mara M. Bryand Theresa Acerno Sarah M. Bulger Ellen and David Adams Rochelle and Justin Bunton Tim Ahern Marilyn Burday Thomas and Gail Ainsworth Jane Burr Jessica Alexson Richard and Jane Butler Dean Allen John and Catherine Byrnes William Allen Marylouise Alther and Glenn Davis Francis Caffrey Donna and Joseph Calabro Stephen and Joan Ames Richard and Frances Cappucio Mary Annear Beverly and Fred Carey Michele D. Apkarian Dana Carley David Arakelian David Caron Joyce and Dominick Arceci Galen Carr Shannon Ashburner Jacqueline Caserta Russ and Carol Austin Sara Castro Mary Ann Babic-Keith Nancy and Carl Chaffee Bonnie Bagley Kelly-Jo Chamberlain Mary L. Bakalar Susan Chamberlin Marilyn Baker* Brandi Chambers Natashia Baker Elaine Clark Yvonne and Michael Ball Jennifer Clark Carol and Gary Ballou Wesley and Ruth Cobb Lin Banek Heather L. Colburn Susan G. Barber Cindy Coleman Amy Bast Dwight E. Conklin Jill Beam Marsha Cook Rodney Beauregard Beverly and James Corey Sara Beauregard Michael and Mary Cornog Jennifer and Scott Begley Sharon and Dale Courtney Bruce and Elizabeth Beliveau Susan and Michael Cox David and Judith Bell Sandra Crosby Brenda and Brian Belliveau Leslie A. Crossmon Carol and Richard Benda, MD Ranee Croteau James and Beverly Best Ingrid Crowley Samantha Blanc Robin Bond Denise and Salvatore D’Atri

James and Harriet Davenport Norman Dean Corinne del Perugia-Stoddart, APRN Allison Delair Rosita Deloch Karen E. DeMinico Terri DeMond Thomas Deborah Denby Rebecca and Chad Dermatis Lisa Derosia Carol D. Despres Caroline and Royal Desrosiers Heidi DeWitt Hannah diCicco Terry Dimick Edward and Carolyn Dinnany Pauline Dionne Jennifer and Shawn Doyle Nirva Driscoll Polly* and Robert B. Dugan* Lois Dunham Eleuthera P. DuPont Passigli Harrison Durfee Matthew Durfee Cheryl and Richard Durkee III Larry Eccleston Erin Edge Laurel Edson Carolina Enzler Lori Erbe Tate and Devoney Erickson Marla and Todd Evans Caroline and Tom Ewing Victoria Farrell Joel Feldmann Lewis Feldstein and Mary McGowan Margaret and Richard Fellenz David and Betty Ferner Janice Fiandaca Gina and Sheldon Fifield Logan Fisher Christen FitzGerald Kirsten Fleury Anne Fontaine Catherine Forrest Darren Forrett Erin Foster Barbara and John Fraunfelder, MD Richard W. Freeman * Deceased

Mary and Rufus Frost David and Joanne Gale Barbara Gammon Colleen Garrett Ross and Sherry Gauthier Robert and Diane Gibbs Dona Girvan Lawrence Graves Susan and Arthur Greenbaum Mark and Jennifer Guest Edward C. Gullo Elizabeth and Stanley Gunnerson Jacob and Henryka Haberman Sandra Hamlin Rev. Robert and Sandra Hamm Susan M. Hancock Amy Harrigan Susan and John Harris Laurel and Stephen Harrison Maurice Harty Edith Hasbrouck Deidre Hastings Coby and Katherine Hauser Ann Heffernon Judith Henderson Gary and Charri Henricksen William and Peggy Heyman Carol Hill Robert and Bette Holmes Abrahm and Tisha Howe Rick Howe Terri Hudson Jill Hulslander Debra and Scott Hunter Stanley D. and Deborah Hutchings Stephen Ide Bill Jeffers David E. Jewett Raymond and Dorothy Jobin David and Andrea Johnson Mary Jane Jones The Morrison Family Karen Kay Charlene Keith Patricia and Dennis Kelleher Susan Kershaw Susan and Robert Kessler Allen Kiblin * Deceased

Jean Kilyanczik Susan Kinney Dennis and Patricia Koch Lisa Kopcha Susan Krebs Douglas and Pauline LaBree Janice and Norman LaCoille David P. Lacoste and Patricia I. Campbell, DO Suzanne M LaCroix Kelly LaFalam Norm Lagasse Miriam and Larry Lanata Joseph R. Landry Donald Laporte and Ann Barrett Liz LaRose Paula Lavoie Patrick Leary Suzanne M. Leblanc Dorothy Ledwith Marcia Lee William Lefebvre Marion LeFrancois Raymond LeFrancois Marlene and Mike Lessard Cindy and John Letendre Emerald Levick John and Joan Little Timothy J. Lord Cynthia E. Lovejoy Frances M. Lovejoy Gladys Lucena Carolyn and Jonathan Lumb Jonathan Lumb Joan and Malcolm Luz Heather MacDonald Anne Macharia Leon Macie Sarah Mackos Cynthia H. MacMillin Ann and Ray Mahoney Scott Marquis Roger and Judith Martin Millicent Martineau Barbara Massicotte William and Joan Maxwell Brenda and Steve McCormack Charles and Cecelia McEachern Tina McLaughlin

Deborah and Lewis McMahon Maura McQueeney JoAnne and Curtis Mead Denise Meadows Maureen Means Patricia and Richard Mellen Jennifer Mercer Alan H. Merrill, Jr. Deborah Mess Ruth Mezzetti Nancy Michalov John and Sally Miller Carol and Joe Minichiello Cynthia and William Moffitt Lana Moore, APRN Stephanie Morgan Francis Moriarty Diane Myers-Miller Chelsea J. Nadeau Justine Neely John Nesbitt, MD Melissa Nichols Alvah W. Niemela James and Melissa Nikiforakis Kathy Nikiforakis Louise Nolan Theresa Norman William and Rebecca Noyes Thomas O’Brien Alfalfa Gomarlo Odoardi Bryant Oja Heidi Olean Michael G. Olm, PA-C David and Susan Olson Doug and Laura Palmer Ronald E. Paquette, Jr. Mary Parr Kathra and John Parrott Pam Patnode Paul S. and Celia A. Pearson Nathaniel W. Peirce Nancy A. Pellerin Keith Pepin Kristen Petricola Edward and Dawn Phippard Brian and Kerry Pickering Russell and Phyllis Pickering Sandra Pickering Subbareddy Pidaparthi

Merope and Panos Pitsas Aimee Plude Lori Plungys Dennis Poirier Nicholas Polselli Linda H. Popovac Rebecca Pratt Jay and Joan Punt Judith Putzel Sandra and David Raabe Erika Radich and Leonard Fleischer Wendy Rafford Lisa Ranauro Philip A. Ray Sheryl and Charles Redfern Nicole Regan Regina M. Reil Raymond and Pollard Reynolds Marilyn B. Richardson Carol Riel Kin and Gary Rilling Sally Rinehart and Bertram H. Boyce Robert and Susan Ritchie Louise Robbins Cathy Robinson

David Robinson Marjorie Ann Rogers Philip Rogers and Sally Brooks Jacqueline Ronning Katharina Rooney Cynthia and David Rose Michelle A. Rose Rosemarri and Hans Roth Christine and Stephen Scheffler Paul Scheuring Beverly Schmidt Judy and Anton Schoolwerth, MD Wanda Schumann George W. Scott, Jr. and Charlotte Guyer Jennifer Scott John and Jacqueline Sendrowski Kristin Sergi Kendra D. Severance Patricia Severino James A. Shanks Vanessa Sheehan Mary A. Sherwin Valerie Sherwood Kimberly Shonbeck Michele Short

Mandy Silva Susan H. Silver Sarah Simonetti Julie and Roger Simpson Rebecca Simpson Terri Skantze Jacob F. Skinner Ernestine K. Sloan Anna and William Smith Jack Smith Sally and Raymond Smith Linda Snider Keith Somers The Somerset Family Charles and Marcy B. Southgate Candace St. John Joan G. Stack Pauline Starkey Teresa Starkey William Starkey, Sr. Martha J. Steele Nicole Stefanowicz Joseph Steinfield and Virginia Eskin Catherine Stephens Donna Stevens Sally Stockwell

“Cheshire Medical Center is the nonprofit you know and an integral part of our community. They care for all of us, from the beginning of life until the end. The Kapiloff family has experienced it all; Cheshire’s staff cared for us during challenging and difficult times. We are fortunate to have such an exceptional facility for a small city and the region.

That is why we support our local hospital!

What could be a more worthy cause?”

Tricia and Mike Kapiloff

Cheshire Medical Center 2019-2020 Report to the Community

41

“Hamblet Electric proudly supports Cheshire Medical Center. As a local business owner and member of this community, the decision to do so is an easy one. After all, not only does Cheshire provide excellent care for the people in our area, it also employs many folks who live here in the community it serves. Talk about a win-win! It only makes sense to support an organization making such a positive impact on our community.”

Topher Hamblet, Owner Nat and Sharon Stout Audrey Strickland Jaclynn Stromgren Amanda Swain Nora and Henry Swierczynski Joyce and Dave Sylvester Katherine Sylvester Christine Symonds Kim Tann Sandra Tatham Scott and Gail Taylor Thomas H. and Geraldine Taylor Charles Tenney Martha J. Tenney Mitchell and Cindy Thomashow Brian Thompson Francis V. Thompson, Jr. Nancy P. Thompson Andrew and Vera Thomsen Deborah A. Titcomb Stephen and Crystal Toegel Scott Tolle Pauline Tonsberg Robin Topper Karen and Robert Tortolani Jean Travers Elsie L. Tretler Dena True Heather and Thomas Tullio

Hanneke and Hans Van Riel Norman VanCor and Elaine Dall Stephen and Susan Vekasy Alei Verdi Ronald and Virginia Wallace Diane Wallis Dana Wasserbauer Carrie Waterman Martha and Larry Waters Barbara Watkins Steven Watt Rosemary F. Watton Marcia Weil Patricia and Stephen Weiner Susan and Thomas Weller Sable Westover Kevin Whitfield Mary Whittle Frederick and Janet Wilkinson Lisa and James Wilkinson John A. Willette Clifford Wilson Laura Wilson Elaine Winzheim Rita Wirth Barbara Wixom Dawna W. Woodhull Cheryl Woods Gale Woodward-Miller

Carolyn Wurschmidt Joan Wydo Ann W. Wyman Kathy Yardley Marie R. and Michael R. Young Glenn Younie Debra and John Zilske Elizabeth Zimmerli William and Ruth Zimmerman Honora and Rupert Zinn Corporate and Foundation Giving Cheshire Health Foundation is grateful to the following local businesses, community organizations, vendors, and foundations that generously partner with us to support the health and wellness of the community.

Aetna AGM Landscaping Alan Cantor Consulting, LLC Alexander’s Sheet Metal, Inc. American Endowment Foundation ARC Mechanical Contractors, Inc. Athens Pizza Bergeron Construction Company, Inc. Bellows Falls Country Club Best Western Sovereign Hotel

42 Cheshire Medical Center 2019-2020 Report to the Community

Billings Farm & Museum Borns Group Bulldog Design C&S Wholesale Grocers, Inc. Carbone’s Window Cheshire Medical Center Cheshire Medical Center Optical Shop Chesterfield Inn Cigna Claremont Opera House Clark-Mortenson Insurance CMH Foundation The Common Man Inn Comprehensive Pharmacy Services Conifer Health Solutions Courtyard Marriott Crown Uniform and Linen Service CUSAG Dartmouth-Hitchcock Medical Center DEW Construction DiLuzio Ambulance Service The Douglas Company Dunkin’ Donuts Eastern Architectural Representatives Eastman Community Association Edward Jones - Office of Alan Stroshine Edward Jones - Office of Jessica Fuller Fairfield’s Buick GMC Fenton Family Dealerships FirstLight Flooring Concepts, Inc. FM Global - Boston Operations Fraternal Order of Eagles, Aerie 1413 Frazier & Son Furniture FujiFilm Medical Systems The Gallup Fund Geiger GFA Federal Credit Union Goldman Sachs Philanthropy Fund Gomarlo’s Inc. Grove Street Fiduciary, LLC Hamblet Electric Charitable Foundation

Hannaford Supermarket Hanover Country Club Harvard Pilgrim Health Care of New England Hillside Village Keene The Hoffman Family Foundation The Home Depot Hooper Golf Club IBM Corporation John and Doris Ernst Family Foundation Johnson & Johnson kcs Architects Keene Country Club Keene Family YMCA Keene State College Ken Wright Construction Kmiec’s Garage Kurtz Family Foundation Limerick Charitable Trust Lincoln Financial Foundation, Inc. Main Street America Group Markem-Imaje Mascoma Bank Masiello Insurance Agency TheMcLellan Family Fund Medline Industries, Inc. MilliporeSigma MINT Premium Car Wash Monadnock Community Hospital Monadnock Harley-Davidson Monadnock Rugby Football Club Monadnock Shopper News Mount Snow Mount Sunapee Resort Nelson Congregational Church Network for Good New Hampshire Charitable Foundation The New Hampshire Trust Company Newport Golf Club NGM Charitable Foundation Northeast Delta Dental Norton and Abert PA Papagallos Restaurant Pepsi Beverages Company Putnam Foundation Raynor Dental

RBC Wealth Management, RBC Foundation - USA RE/MAX Town & Country Ricoh River Valley Community College RiverMead Savings Bank of Walpole Service Credit Union - Keene Branch Shattuck Golf Club Six Flags New England Smiths Medical St. James Thrift Shop SoClean StingRay Optics Street & Savory LLC Surell Accessories Surgi-Care, Inc. SymQuest Group Inc. TC’s Pantry TD Bank Teleflex Foundation The Melanson Company, Inc. Transamerica Retirement Solutions United Church of Christ Women’s Fellowship Vermont Mechanical, Inc. Version Six LLC VFW Post 799/Men’s and Women’s Auxiliaries Walier Chevrolet Willis Towers Watson Workplace Benefit Solutions, A HUB International New England W.S. Badger Company, Inc. ZOLL Medical Corporation 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 Memory of Timothy J. Alexander Homer L. Ash, MD * Deceased

Susanna Ayers Bill Ball Walt Banek Warren D. Barrett Rory Barry Ruth B. Beard Sandra Hallquist Bergemann Adam R. Bielunis Mark Billetdeaux Robert B. Bohannon Fred Boron William L. Brackett Frederick Brow, Jr. Cheryl Burrows Evelyn F. Caffrey Irene Carbone Rosemarie T. Carroll Frank H. Carter, MD Thomas J. Casey Denise Castle Carl Chaffee Jean Cheney Karen Clay Bill Cotter John J. Cunningham Joan Donegan Polly Dugan Sharon Eason Lindsey Eyles Ted Fachada, MD Nancy Flory Peter James Fournier Bruin C. French Charles Eithel Galloway Joanne M. Gaudio George and Freda Graves Wayne M. Groat I. William Grossman, MD Dexter Guyette H. William Harris, MD Michael Healy Dianne Hicks Doris M. Hof Eleanor Holmes Glover Howe Norma Hudson Ralph D. Jordan Charlotte Kapiloff Sanderina Kasper * Deceased

William M. and Daniel Kennedy Vrinda Khole, MD Marie M. Kiblin H. Thayer Kingsbury Alice Kingsbury Bakemeier Samuel F. Lacey Roger D. LaCoste Fred Laffond James R. Lake Robert Lammela David Robert Landry Joyce Lavoie Hope and Roaby Lawrence Alfred P. Lewandowski Eric Lewtas Norma Lovins Frank Lupis, Jr. Margaret Lynch Martha Mack Jeanette and Arthur Marrotte Ann Matuszewski Sally May Edward J. McMarten Ronald Menard Florence Nadeau Marie Namiotko Our Dads Our Family (2) David Perea Linda Pidgeon Mariah Pittman Alice N. Porter Vanessa D. Prigge George Rawlings Frederick M. Rhoades Leland Robbins Walter Rohr Walter C, Rose, MD Harriet Saal Gale Shelley Iris Silberstein James Sise, MD John O. Sloan Ellie Smith Mary St. Lawrence Weldon and Eleanor Stanford Joan Starkey Frances Strickland Michael Summers

Walter P. Sy, MD Jeanne Symonds Charles Tatham III Ben Tatro Dale and Doris Thompson Janet Ray Thompson Hattie Todd Arthur and Lucy Tremblay Donald C. Tretler Todd Walier E. Bruce Weber Robert S. Wesley George E. Whittle Jean and Leslie Williams Charles Winzheim Mary Jane Woods Walter F. Wydo, Sr. Albin J. Zak, Jr. In Honor of All members of Cheshire Medical Center Antrim Fire and Rescue David and Carol Beal Barbara E. Bell Alyse and Paul Bettinger, MD Ann Bunce Mary Lou Caffrey and Kenneth Stewart Pat Carolus, CMA and Stephanie Miller, CMA Robert Cochran, MD Arthur Cohen, MD Annie DiSilva Elizabeth Downing Bob Englund, MD Paul, Jackie and Sophie Ethier Ken Gaspard Nancy and Roger Hansen, MD Richard H. James Steve Larmon, MD Anya Lyons Donald M. Mazanowski, MD Craig McBeth, DMD Denise Meadows My Grandchildren Celeste Ponce Jim and Judy Putnam Mary E. Smith Robert Westlake, MD Tracie’s Community Farm

Every dollar of your support stays local.

Nonprofit hospitals like Cheshire Medical Center rely on local support to keep pace with the growing needs of the communities we serve.

Your donations fund key investments in state-of-the-art technologies, health and wellness programs, educational opportunities, and patient financial assistance, ensuring exceptional care for you and your loved ones.

Thank you!

Learn more about how you can support our nonprofit medical center at cheshirehealthfoundation.org/give.

Cheshire Medical Center 2019-2020 REPORT TO THE COMMUNITY

It is not the moments that define us, but how we respond to them.

Cheshire stands committed to our patients, staff, and community, as we meet the challenges of today and build for a stronger tomorrow.

603-354-5400 cheshiremed.org | cheshirehealthfoundation.org Located at 580 Court Street, Keene, NH | With satellite offices in Keene, Walpole, and Winchester