Personalized Care, a Healing Space Near Home

Vision for the Future co-chair experiences first-hand the importance of quality local care

This article was published in our Fall 2015 Update.

Lincoln ClarkLincoln Clark, Gifford trustee and co-chair of the Vision for the Future campaign, has been actively raising funds for the new Menig Nursing home and the subsequent private patient
room conversion at the hospital.

In an odd twist of fate, the Royalton resident recently experienced first-hand just how important quality local care and private patient rooms can be to both the patient and their family.

While on an annual fishing trip with his son in northern Maine, Clark fell and broke his hip as they were taking their boat to get the motor serviced. After a 178-mile ambulance ride to Portland, ME, he found himself facing surgery by a surgeon he’d never met.

“I spent approximately four minutes with him prior to the operation. I was doped up to the gills, and I couldn’t understand his precise and very technical description of the procedure,” Clark said. “The next day he was off-duty so his partner, a hand surgeon, looked at my wound.”

That same day a care management representative visited to say that he would be released the following morning—they were looking for a rehabilitation facility that could take him.

Clark asked if he could go home to his local hospital, and was told that Medicare would only pay for an ambulance to the closest facility (to pay for an ambulance to Vermont, would cost him thousands of dollars). He was transferred to a facility in Portland the following morning.

“The new room was sectioned off with brown curtains, the bed pushed up against a wall, and there was a 3-foot space at the bottom of the bed for my wife, Louise, to sit,” he said. “It was smaller than most prison cells! My roommate’s family (six of them) was visiting, and they were watching a quiz show on TV at full volume.” This was the low point.

Overwhelmed, the Clarks struggled to figure out the logistics of a long stretch in rehab for Lincoln, and the hours-long commute for Louise, who had to maintain their house in Royalton.

After an unimpressive start in the rehab physical therapy department, they made an unusual but obvious choice: Louise packed Lincoln into the car and they made the 4-hour drive to Randolph.

“I wanted to be at Gifford. I knew the physical therapy team was first rate, and I was confident I would get the kind of therapy I needed to get me out of the hospital,” Clark said.

Fortunately, a room was open and he spent ten days at Gifford this summer. He worked on his laptop in the Auxiliary Garden, met with people in his room, and was even wheeled to the conference center to attend board and committee meetings. Once discharged, he was able to continue his therapy as an outpatient.

“After this experience I really can see how important a private patient room is,” he said. “And I can attest that the letters to the board, the positive comments patients make on surveys, and the occasional letters to the editor don’t begin to describe all that it means to be cared for by Gifford’s staff. This is just a great hospital!”

The “Preventable Cancer:” Spreading the Word about Colorectal Screening

This article was published in our Cancer Program 2014 Annual Report.

preventing colon cancer

The providers in Gifford’s Cancer Program regularly visit senior centers, nursing homes, church meetings, and other community gatherings to offer skin cancer screenings, give free talks on cancer prevention and the importance of early detection, and host educational discussions of breast, bladder, prostate, and colorectal cancer.

In talks like “Everyone’s Got One: A Discussion of the Colon and How to Keep it Healthy,” surgeon Dr. Olveto Ciccarelli uses humor to help people learn about the importance of colorectal cancer prevention and screening.

“Everyone has these organs, but people are reluctant to talk about problems with their colon or their rectum,” said Ciccarelli. “Men especially find it difficult to discuss these matters, but this is one area where medical science has proven that cancer can be avoided, lives extended, and quality of life improved.”

This is especially true with colorectal cancer, which was a program focus for 2014. Colorectal cancer is called the only “preventable cancer” because it is the one cancer where regular screenings can help to keep cancer from forming. A colonoscopy detects any slow-growing polyps that may form in the colon so they can be removed before becoming cancerous. Because early colorectal cancer often has no symptoms, screening is even more important because it can detect existing cancer when treatment is most effective.

Still, colorectal cancer is the third most common type of cancer in men and women in the United States. The good news is that deaths from colorectal cancer have decreased as more people take advantage of screening tests like colonoscopies, specialized X-rays, and tests that check for cancer in the stool.

So far, Gifford has had significant success with our efforts to increase colorectal screening rates for our target age group of 50-75 (an increase to 90 percent in 2014 from 59 percent in 2013).

We will continue to spread the word in our community. With colon cancer, it is simple: Regular screening could save your life.

Click here to read our full Cancer Program 2014 Annual Report.

Project Independence

The following article appeared in our 2014 Annual Report.

Project Independence

Adult Day participants at both of Gifford’s locations enjoy many activities: sing-alongs, live performances, arts and crafts, exercise, games — even visits from a therapy dog!

Another senior-health initiative came to fruition in 2014 when the boards of Gifford and Project Independence, an adult day center located in Barre, unanimously
agreed to a merger in May after studying the relationship for more than a year.

The merger took place at the conclusion of Gifford’s fiscal year on September 30.

Project Independence got its start in 1975 when a nursing home activity director, Lindsey Wade, encountered residents who didn’t seem to medically belong there. Wade envisioned a social adult day program, a new concept at the time. An active board and an interested city brought to life Project Independence on Washington Street, and in the decades since, its model has expanded statewide. There are currently 14 adult day programs in Vermont.

Today’s Project Independence serves 23 towns in Washington and northern Orange counties, welcoming an average 38 seniors and the disabled each weekday. The project includes meals, showers, medication management, and ample activities, providing participants with a fun and safe day care experience while also allowing them to stay at home—a far more affordable model than nursing-home care.

But an ongoing struggle for funding—combined with property damage caused by flooding in 2011 and a sewer issue during Barre’s “Big Dig”—prompted small, standalone Project Independence to seek help in the form of a partner. The board was drawn to Gifford because of the adult day program in Bethel, the medical center’s mission of supporting seniors, and its commitment to community.

Under the full-asset merger, Project Independence retains its name, location, and fund-raising dollars. Its board will become an advisory board to provide local perspective and experience, and employees will become part of Gifford, opening the door to enhanced benefits. Project Independence will be helped by Gifford’s staff, from financial to billing to nursing help, as well as its buying power as a larger organization.

“When someone has a humble request for help as it relates to the delivery of health care services, we take that seriously,” said Gifford Administrator Joe Woodin, praising Project Independence’s board, values, volunteers, and hardworking team. “For us, that’s extraordinarily appealing and we’re thankful that they’ve asked us.”

Joining with Project Independence is in keeping with Gifford’s mission and provides support to a needed service that will no doubt grow as the state looks for more affordable ways to care for a growing senior population, said Gifford Board Chair Gus Meyer.

Gifford Cancer Program Overview

Gifford's cancer program

This article was published in our Cancer Program 2014 Annual Report.

Gifford cancer committeeEstablished in 1959, Gifford’s Cancer Program is accredited by the American College of Surgeons Commission on Cancer.

A dedicated cancer committee meets regularly to provide leadership for the program, including setting program goals and objectives, driving quality improvements and best outcomes for patients, and coordinating Gifford’s multidisciplinary approach to cancer treatment.

Operating out of our relaxing Ambulatory Care Unit, Gifford’s Oncology Department includes:

  • Cancer care from an experienced oncologist
  • Specially certified oncology nurses
  • Planning options for cancer treatment following a diagnosis
  • Outpatient chemotherapy
  • Treatments for some hematology conditions

The medical center is home to advanced diagnostic technology, including stereotactic breast biopsies; a breast care coordinator providing education and outreach; a patient care navigator; many surgical offerings; data management and quality oversight; and cancer prevention programs, including a “Prevention into Practice” model that works with patients and their health care providers to bring screenings to the forefront.

Click here to read our full Cancer Program 2014 Annual Report.

A Message from the Medical Director of the Hospital and Medicine Divisions, Dr. Martin Johns

The following article appeared in our 2014 Annual Report.

Dr. Martin Johns

Dr. Martin Johns

One evening when I was on duty, a 911-call patient was brought into the emergency room. The patient was unresponsive and unable to communicate.

I pulled up the electronic medical record and was able to see that he had been given a new medication when seen at a Gifford clinic earlier that day.

Clearly he was having a delayed allergic reaction, and because I could see exactly what medication he was given, I could immediately give him the appropriate antidote. If I had not had access to the information in EMR, I would have had to guess and start trying different medicines to counteract the reaction.

When another patient was confused about what medications they were taking, I pulled up their most immediate office note on EMR and made adjustments based on what had been done within the previous 24-hour period.

An important aspect of the new EMR system is that it allows medical information to follow the patient through transitions of care across all Gifford platforms: inpatient care, outpatient care in community clinics, radiology, and emergency room visits.

In the past, important information could be unavailable or even lost during these transitions—a clinic might be closed for the day, or important information not yet added to a patient’s record. Now, anyone caring for a patient can view important information and also update the record (adding a newly developed allergy or immunization) or note changes in clinical status.

Gifford’s New Single Occupancy Rooms

The following article appeared in our 2014 Annual Report.

new private patient rooms at Gifford

Detail of the new private patient rooms, including two hospice (garden room) suites.

Jack Cowdrey“When you’re sick, you really want to be alone. And when you share a room it can be difficult to sleep when the other patient has visitors. When I was a patient in August I noticed that by the time a nurse rolled in the computer cart there was little room for anything else. It will be so nice to have the privacy and the extra space in the new rooms.”     ~ Jack Cowdrey, Former Board Member Dessa Rogers

“Single occupancy rooms will make it easier for us to get patients more involved in their care. The increased privacy will allow nurses to “sign off” to the next nurse coming on right in the room with the patient, so they can be informed and involved in the process.” ~ Dessa Rogers, RN, Nurse Manager, Medical Surgical & Rehab Unit Ben Cronan

“We bring radiology technology to the patients. It can be a challenge to navigate around beds, wheelchairs, walkers, and other equipment in the room, especially if the room is being shared. Sometimes we will wheel the portable x-ray in multiple times a day, and it can be disruptive to others in the room. The patients and family I talk with often share their difficulties with having two patients in one room. The new private rooms will really help with patient comfort, privacy issues, and visiting family and friends.” ~ Ben Cronan, Radiology Technologist

A Message from the Executive Director of Gifford Retirement Community Linda Minsinger

The following article appeared in our 2014 Annual Report.

Executive Director of Gifford Retirement Community Linda Minsinger

Executive Director of Gifford Retirement Community Linda Minsinger

Vermont has a huge need to figure out how to care for its seniors. Isolation is one of the biggest problems of aging in a rural area. Humans are meant to be with humankind. We proved that years ago when we tried to understand how much touch people need as a baby; when you don’t get it, you fail.

It’s the same with seniors. We want everyone to treasure our seniors as much as we treasure our babies.

Adult day care is a cost-effective way to help seniors age. Yet it has been underdiscussed and underplanned. The state of Vermont only wants one adult day-care center per county. That doesn’t make sense. Orange County has two sets of mountains. It takes me an hour and a half to get from Bradford to Randolph—that’s still in my county. It’s unfair to ask fragile seniors to sit on the bus for an hour and a half.

The state puts a lot of money into nursing homes, so there isn’t much left over for other programs. Adult day gets what we call “budget dust.” We should be trying to figure out how to have fewer people in nursing homes. Let’s tip this pyramid upside-down.

When someone is diagnosed with early-stage Alzheimers, that’s the time to start. The earlier you get them into social situations, the better it will be for them and for their caregivers in the long run.

Enhanced Response to Community Need

The following article appeared in our 2014 Annual Report.

Randolph VT hospitalAs many community hospitals find themselves contracting—or even closing—because of external pressures, Gifford is developing models that will expand services to respond to community needs.

“FQHC resources allow us to expand existing medical services and to create new paths to help patients with behavioral health and dental issues,” says Dr. Martin Johns, medical director of the hospital and medicine divisions. “These areas can impact a patient’s general health, and need to be part of standard primary care.”

Integrating behavioral and dental health into primary care
A special behavioral care team (a psychiatrist, psychologists, social workers, and care managers) has been created to help link access to behavioral health services to primary care. This group will work directly in concert with primary care providers in their offices, so services can be seamlessly added to a patient’s care plan as needed. The new enhanced behavioral health services model will be offered at Gifford’s Randolph campus early in 2015, and will then expand to the community clinics.

Gifford has established relationships with local dentists so that people coming to primary care providers with unmet dental conditions can receive care. This program will hopefully expand to include additional dental providers and other FQHC and federal programs services.

Rising to the challenge of increased substance abuse
Medical centers across the country are struggling to meet the needs of people with alcohol and substance dependency problems. FQHC funding is allowing Gifford to expand existing Vermont Blueprint for Health services so providers can better address the special needs of those who are opiate dependent and want to avoid substance abuse.

The Garden Room

The following article appeared in our 2014 Annual Report.

The Garden Room

Legacy photos (right) are one service the Last Mile Ride funds provide. These photographs, taken by a professional photographer, offer the family an opportunity to capture a few of those last few precious moments at the end of life.

The new private patient room conversion project will allow Gifford to create a second Garden Room suite for end-of-life patients.

This patient room, with French doors that open onto a courtyard garden, has an attached larger room where families can gather to support and comfort the patient and each other in this period of transition.

“A second garden room will double our capacity to care for end-of-life patients and their loved ones,” said John Young, Palliative Care certified nurse. “The Garden Room suite creates a space where families and loved ones can visit, share, interact, or just be present with each other at a time when that is needed. A dying loved one can rest, listen to music, be quiet or visit with loved ones in the attached less noisy and congested space.”

Last Mile Ride (LMR) funds support special services for patients in advanced illness and at the end of life, whether they are at home or staying in the Garden Room suite. These services include massage, acupuncture and Reiki for pain management, music therapy, and help with special wishes and one-time gifts. LMR funds also help make it possible for families and friends to focus on their loved one, providing food, transportation funds if needed, bereavement help, and professional photographs of this special time together.

For patients in this time of transition, the Garden Room adds an option to dying at home or in a nursing home. Dr. Cristine Maloney, lead provider for Gifford’s Palliative Care Program, notes that when families are caring for a loved one at home, the Garden Room can offer a comforting back-up option if things become too difficult.

“This chapter of a patient’s life has great power and poignancy, and surviving family and friends remember vividly how a death is handled,” said Maloney. “We want to help this go as well as possible and in keeping with a person’s goals and wishes.”

Gifford’s 2014 Highlights: October – December

The following article appeared in our 2014 Annual Report.


Gifford completes its upgrade to electronic medical records (EMR). Throughout the year, Gifford primary care and specialty care outpatient practices moved from paper to candidates' debateelectronic records as part of a federal initiative.

Gifford and the White River Valley Chamber of Commerce collaborate to hold the only local candidates’ debate for Senate and House of Representatives candidates.

Gifford's Woman to Woman FundGifford employee Teresa Bradley and her niece, Krista Warner, once again hold a bowling tournament in memory of Teresa’s mom and Krista’s grandmother, Ruth Brown. Money raised supports Gifford’s Woman to Woman Fund and brings awareness to the importance of mammograms.

Gifford announces it has met its state-approved operating margin for the 15th consecutive year.

Gifford meets operating margin


Major Melvin McLaughlin

Gifford loses one of the greatest heroes of our time, Major Melvin McLaughlin. Affectionately known as “the Major” and “Major Mac,” he spent the last 40 years volunteering at the hospital, encouraging staff and patients with words of love and friendship. He will be greatly missed, but never forgotten.

Hannaford gift certificate for Project IndependenceHannaford Supermarket in South Barre presented Project Independence with a gift certificate worth $1,500. The gift is used to offset the cost of groceries for the program which provides a daily breakfast, lunch, and snack for roughly 38 participants. When the store manager asked staff which nonprofit they should contribute to, the adult day program was at the top of their list.

Dr. Lou DiNicolaPediatrician Dr. Lou DiNicola receives the Green Mountain Pediatrician Award from the American Academy of Pediatrics Vermont Chapter. He was acknowledged for over 38 years of service as a Gifford pediatrician. Along with a plaque, Dr. DiNicola was presented a 7-foot-long handwritten scroll describing what makes him special.


Gifford once again invests $40,000 into the regional economy through the Gifford Gift Certificate program.