One patient per hospital room is good medicine. Here’s why…
The following article appeared in our 2014 Annual Report.
Semi-private rooms offer little privacy or space for patients, their families and hospital staff. Private patient rooms will alleviate the overcrowding that is typical of shared rooms.
The reality of a shared hospital room is that you don’t get to choose your roommate.
“We do our best to match up personalities and scenarios and illnesses and infection issues,” says Alison White, vice president of the hospital division, “but there are things like having a roommate who is a night owl and you like to be in bed by 7:30. If we need a bed and your room happens to be that one empty bed, you get who you get.”
The new reality at Gifford is that every hospital patient will soon have a room of their own as part of a construction project that received its final okay in October 2013. In spring 2015, when 30-bed Menig Extended Care moves to Randolph Center, the hospital will begin converting the vacated wing. The number of rooms for hospital patients will double while the number of hospital beds—25—remains the same, a ratio that guarantees maximum comfort and safety. The renovations are also an opportunity to open up ceilings, replace old systems, and improve energy efficiency.
“When patients are recovering from surgery or from illness, they want what they want,” says Rebecca O’Berry, vice president of operations and the surgical division.
“Sharing a room with somebody else just doesn’t work for most patients. From the surgeon’s point of view, if I’ve just replaced your total hip, the last thing I want is for you to be in a room with someone who might be brewing an infection.”
White names several other factors, besides the risk of infection, that have helped make private rooms the standard in hospitals today. Among them:
Faster healing: Studies show that patients who are in private rooms need less pain medication because they’re in a more soothing environment. If your roommate has IV pumps that are going off, or the nurse has to check your neighbor every one or two hours—which is very common—the lights go on, the blood pressure machine goes off, the nurse has to speak with the person in the bed next to you. With private rooms, all that is removed.
Ease of movement: Our rooms were built before the current technology existed. IV poles didn’t exist. We now have people with two or three pumps. With today’s technology there’s no room to move around. When you have two of everything—two chairs, two overbed tables, two wastebaskets—it creates an obstacle course.
Better doctor-patient communication: As professionals, we don’t always get the whole story because the patient doesn’t want to be overheard by his neighbor.
Patient satisfaction: Larger rooms, each with a bathroom, will give patients additional privacy and enhance the patient experience. It’s a win-win for everybody.
The following article appeared in our 2014 Annual Report.
Board Chair Gus Meyer
What a momentous year it’s been! Things we had been planning for years came to fruition in 2014. Even as these fundamental changes in our organization have taken place, Gifford has maintained its remarkable fiscal stability and continued our steady growth in the proficiency, professionalism, and breadth of service that we provide.
In 2015, we anticipate completion of the nursing home, renovation of the space that Menig now occupies, expansion of mental health and dental services associated with the FQHC, and full implementation of the EMR, along with ongoing commitment to fiscal responsibility and improvement in quality of care.
These accomplishments are all the more amazing because they have been achieved in a very uncertain health care environment. While Governor Shumlin has suspended planning for single payer health care, many other aspects of health care reform continue. For example, accountable care organizations are now in development, with the goal of changing from fee-for-service to covered lives reimbursement.
How these changes get implemented will have profound impact on how medical decisions are made, as well as how and where care is delivered. In the coming year, as we pursue the internal strands mentioned above, we will also maintain our active involvement in the health care reform planning process, working to ensure that Gifford’s patients continue to have the highest quality, locally provided health care possible.
The following article appeared in our 2014 Annual Report.
A message from Administrator Joe Woodin
FISCAL YEAR 2014 was a transformative one for Gifford as several long-term initiatives came to fruition—efforts that will not only benefit patients but also position Gifford well for the future in an era of health-care reform.
In November 2013, a very excited Senator Bernie Sanders called to say that Gifford had been designated a Federally Qualified Health Center. What we qualified for were federal funds that provide greater access to primary care—including dental and mental-health services—for Medicaid patients and the uninsured. By July, after a lot of hard work by our administrative team, we were ready to start drawing on those funds.
The Gifford Retirement Community now under construction in Randolph Center passed its final regulatory hurdle a month before the senator’s phone call, and ground was broken in the spring. Add to these developments the hospital’s conversion to single-patient rooms and Gifford’s transition to electronic medical records and you can see why we’ve titled this report “Building for the Future.” In the following pages, we discuss the new developments and relate them to the changing health-care landscape.
Last but not least, Gifford “made budget” for the fifteenth year in a row, a feat not replicated by any other hospital in Vermont. Achieving its state-approved operating margin is an indicator of Gifford’s health as a medical center, community organization, and employer, and credit for this achievement goes to the entire staff.
Podiatrist/sports medicine advocate celebrated for His 12 years at Sharon Health Center
Gifford staff gathered on March 25 to celebrate podiatrist Dr. Rob Rinaldi’s 12 years of service to an expanding community of athletes, and to wish him well as he transitions to new roles in the organization.
The party featured a cake shaped like a foot, lots of foot jokes, and heartfelt stories about Rinaldi’s many contributions and roles at Gifford: as generous mentor, sports medicine advocate, surgeon, and the force behind the very successful Sharon Health Center and sports medicine clinic.
“I flunked the first time I retired!” Rinaldi quipped, explaining that he missed seeing patients when he left a thriving Connecticut practice and retired to his farm in Chelsea in 2000. So when Gifford Administrator Joe Woodin approached him about expanding sports medicine at Gifford, he was receptive: “I didn’t want to sound too anxious, so I said yes!”
Rinaldi helped design the first phase of the Sharon Health Center, which opened in 2005. By 2008 a 2,200 square foot expansion was added to accommodate the thriving sports medicine clinic, and a final planned 2,600 square foot expansion was added in 2014.
Today, athletes come from all over the Upper Valley to the center, which includes a physical therapy gym space; x-ray technology and mounted flat screens for reviewing radiological exams; physical therapy treatment rooms; and a state-of- the-art gait analysis system. The sports medicine team includes: Michael Chamberland, DC (chiropractic/sports medicine); Paul Smith, DPM (podiatry/sports medicine); Nat Harlow, DO; and Peter Loescher, MD (sports medicine); and a team of physical therapists.
“Rob brought years of business experience to the creation of Sharon Health Center,” Woodin said. “But he also brought his pride in what he does, and his entrepreneurial spirit to Gifford.”
The stories Rinaldi’s colleagues told described a generous and compassionate mentor: “Rob was the voice of wisdom, the one people came to when facing some sort of challenge,” said Vice President of Surgery Rebecca O’Berry.
Although he will no longer be seeing patients, Rinaldi will continue to serve on administrative committees at Gifford, and will work with residents at the new Menig Nursing Home when it opens this spring in Randolph Center.
109th Annual Meeting celebrates forward-looking growth in programs and facility
Administrator Joe Woodin answers questions during Gifford Medical Center’s 109th Annual Meeting.
Nearly 100 community members gathered Saturday night for “Building for the Future,” Gifford Medical Center’s 109th Annual Corporators Meeting.
Reporting on an exciting and transformative year, administrators and board members highlighted the implementation of several long-term initiatives:
The new Menig Nursing Home, looking out over the green mountains in Randolph Center, will open—on time and on budget—mid-May 2015.
The hospital wing vacated by Menig will be converted into state-of-the-art private patient rooms to offer privacy for provider consultations and family visits, and to accommodate medical technology at the bedside.
A new organizational structure, created to reflect Gifford’s new Federal Qualified Health Center designation, will allow Gifford to offer enhanced preventative, dental, and behavioral health services to our patients.
“It’s been an extraordinary year,” Gifford Administrator Joe Woodin stated. “These initiatives strengthen the services we offer our patients and also position Gifford well for the future in an era of healthcare reform.”
Moving forward while making budget for the 15th consecutive year
After presenting the annual hospital report and a brief update on the uncertain state of Vermont’s healthcare policy, Woodin noted that Gifford has maintained ongoing fiscal stability while pushing ahead with these forward-looking initiatives. For the 15th consecutive year Gifford has made budget and achieved its state-approved operating margin. The culmination of years of research and planning, each of these new projects reflect Gifford’s commitment to providing quality community care for years to come.
New $5 million capital campaign launched Lincoln Clark, board treasurer and co-chair of the “Vision for the Future” campaign, announced the launch of the public phase of the $5 million capital campaign.
“As of tonight this campaign is no longer silent,” Clark told the group. “It has been a remarkable experience—we started two and a half years ago with a vision, research, and a community survey. We decided then to wait until we raised 60 percent before going public, and we’ve exceeded that goal. We hope to reach the campaign’s $5 million goal by December 31st of this year.”
The “Vision for the Future” campaign supports the hospital’s conversion to industry-standard private patient rooms, and the construction of the new Menig Nursing home in Randolph Center. Menig, one of only twelve nursing homes in Vermont to retain a five-star rating from the Centers for Medicare and Medicaid Services, will anchor the new Morgan Orchards Senior Living Community in Randolph Center.
Panel presentation describes a Gifford ready for tomorrow’s healthcare needs
A panel presentation looked at four recently implemented changes that will help Gifford provide for future community healthcare needs:
Dr. Martin Johns, medical director for Gifford’s FQHC and hospital division, talked about building the behind-the-scenes administrative structure now in place that will help Gifford provide expanded preventative, dental, and behavioral health services as a Federally Qualified Health Center.
Dr. Lou DiNicola, pediatrician, described the challenges staff faced while transitioning to a federally mandated Electronic Medical Record system. Now that the transition is complete, the benefits are clear: greater efficiency and improved patient care.
Alison White, vice president of Patient Care Services, talked about how important private patient rooms are for provider consultations, improved patient care, and how they will help bring medical technology to patients’ bedside.
Linda Minsinger, executive director for the Gifford Retirement Community, talked about plans for the new Morgan Orchard Senior Living Community in Randolph Center.
Gifford scholarships and awards presented
Bailey Fay was awarded the Dr. Richard J. Barrett Health Professions Scholarship, a $1,000 award for a Gifford employee or an employee’s child pursuing a health care education. Laura Perez, communications director of the Stagecoach Transportation Services, accepted the $1,000 Philip D. Levesque Memorial Community Award, given annually in recognition of his personal commitment to the White River Valley.
Retiring board member Randy Garner was presented with a gift to honor his 12 years of service at Gifford Medical Center’s 109th Annual Meeting. Vice-President of the board Peter Nowlan looks on.
For the second year of a two-year commitment, the $25,000 William and Mary Markle Community Grant was given to schools in Gifford’s service area to promote exercise and healthy eating and lifestyles.
Board of trustees and directors election and service recognition
During the corporators business meeting, retiring member Randy Garner was presented with a gift to recognize his 12 years of service, and retiring board member Fred Newhall was recognized for his three years of service.
The following slate of new corporators were elected: Brad Atwood (Sharon); Rob and Linda Dimmick (Randolph Center); Dee Montie & Murray Evans (Brookfield); Joan Goldstein (South Royalton); Kelly Green (Randolph); Kate Kennedy (Braintree); Doreen Allen Lane (Berlin); Larry and Susan Trottier (South Royalton); Clay Westbrook (Randolph)
The following were elected officers of the board of directors: Gus Meyer, chair; Peter Nowlan, vice chair; Barbara Rochat, secretary; Lincoln Clark, treasurer.
Menig resident Barbara Wright enjoys a visit from Jasmine, a Vermont Therapy dog.
As the sun was lowering on a cold February afternoon, Gifford volunteer Louise Sjobeck and her dog Jasmine walked down a quiet hall toward two Menig residents who were visiting on a bench.
Before she could reach them, a woman in a wheelchair appeared, stretching out her arms to stroke the brown and white Shih Tzu’s silky fur: “What nice ears you have!”
Within minutes more people appeared, filling the space with smiles and stroking hands and conversations: “I love dogs, we used to have two dogs….” “This little doggie is so soft!” “I hope it won’t leak on me—oh, I wouldn’t mind. I‘d just brush it off!”
The visit marked the beginning of a new role for Sjobeck, who had spent nearly a year training and working with five-year-old Jasmine to prepare her for the Therapy Dogs of Vermont certification test. Dogs that are gentle, enjoy being touched, aren’t fearful, and are able to remain calm in new situations are allowed to take the exam, which tests for 48 criteria.
To celebrate their inaugural visit, Jasmine was dressed in a red ruffled dress decorated with Valentine’s Day hearts, bringing some early holiday spirit to Menig.
“I love to see the residents’ faces light up when the pet visits occur,” said Brooks Chapin, director of nursing at Menig. “There is nothing like the unconditional love of a dog.”
Two organizations solidify commitment
to the care of area seniors
Project Independence executive director Dee Rollins joins ribbons with Linda Minsinger, Executive Director of Gifford Retirement Community.
On September 30th, Project Independence and Gifford Retirement Community, part of Gifford Health Care in Randolph, officially merged in a ceremony and celebration held at the Barre-based adult day program.
The ribbon joining ceremony was attended by representatives from both organizations, participants and their families, dignitaries, and special guests, including Project Independence founder Lindsey Wade.
The merger comes after years of struggle for the independent adult care program, Vermont’s oldest, which faced flood recovery efforts in 2011 in addition to other facility issues and financial woes.
“It is very hard in these changing times in health care for a stand-alone nonprofit to make ends meet,” says Project Independence executive director Dee Rollins. “Merging with Gifford allows us to be off the island with more supports and resources so we can grow our services for our elders and caregivers. Gifford is the right and best partner Project Independence could imagine.”
While still responsible for their own bottom line and fundraising efforts, Project Independence now has the resources and backing of the financially stable Gifford to help maintain ongoing services.
Gifford CEO Joe Woodin officially welcomes Project Independence to the Gifford family, shaking hands with board president Steve Koenemann and executive director Dee Rollins.
And the center is already experiencing the benefits of being part of a larger organization through savings in expenses and access to a wider range of resources.
For example, Project Independence is now able to utilize purchase point buying for a savings on supplies and groceries while also benefiting from the services of established Gifford departments such as billing, payroll, human resources, marketing, and others.
For Gifford, the merge is an opportunity to expand on its commitment to the region’s seniors. Already home to an award-winning nursing home and a successful adult day program located in Bethel, Gifford has a strong foundation in caring for the aging.
It’s a foundation they are building upon with the creation of a senior living community in Randolph Center. This new community will include a nursing home, assisted living and independent living units.
Construction on the campus began this past spring with work focusing on infrastructure and the building of a new Menig Extended Care facility, the 30-bed nursing home currently connected to the main hospital.
Current Menig residents are expected to transition to the new facility when construction is completed in the spring of 2015, a time that will also see the ground breaking of the first independent living facility.
President Joseph Woodin and CFO Jeff Hebert announce via video that Gifford closed the books with a 3.2% margin for the 2014 fiscal year.
In a feat that has not been replicated by any other hospital in Vermont, Gifford Medical Center announced that it has achieved its state-approved operating margin for the 15th straight year, by managing its expenses and the budget process.
In a “reality TV” video announcement sent to staff on Monday, November 3, President Joseph Woodin and CFO Jeff Hebert announced what auditors have confirmed – Gifford closed the books with a 3.2% margin for the 2014 fiscal year.
“This is all thanks to the hard work and dedication of our staff,” said Woodin. “Without their diligent focus, always trying to manage quality and costs, we would not be able to have accomplished this.”
An operating margin is the money the medical center makes above expenses – needed to reinvest in programs, staff and facilities. Sixteen years ago, Gifford ended the fiscal year with a negative 16% margin ($2.9 million loss), after having lost money 4 out of 5 years. At that time, the future of the hospital was uncertain, with some state officials even asking if the hospital should be closed.
Today, Gifford is known as one of the most successful and innovative hospital and health care organizations in New England. They are designated a CAH (Critical Access Hospital), as well as an FQHC (Federally Qualified Health Center); one of only three in the nation to carry that dual designation. They also operate a nursing home (Menig) that is rated one of the top 1% in U.S., and are currently constructing the first phase of a five-phase senior living community in Randolph Center, VT.
Consistently achieving the operating margin can be an indicator of an organization’s success. Despite record shortfalls in revenue for Vermont hospitals, including Gifford, Woodin noted the medical center was able to make up for revenue shortfalls through managing expenses and due to support from federal programs like 340B, a drug pricing program that in part generates revenue when Gifford patients fill non-generic, non-narcotic prescriptions at participating pharmacies.
“This news is exciting for Gifford and for the community,” said Woodin. “It is an indicator of Gifford’s health as a medical center, community organization, and employer. Primarily it means we’re stable, and we’re able to provide consistent care and services without facing cuts and uncertainty.”
The achievement is especially remarkable within the current economic climate and amid so many changes in health care, hospital officials also noted.
This article was published in Gifford’s Fall 2014 Update Community Newsletter.
When Gifford conceptualized and received all necessary permits to construct a senior living facility in Randolph Center, it was certain that local people would benefit. The region’s seniors would have a local place for nursing home care, independent living, and one day assisted living.
What wasn’t necessarily known when the project went out to bid in the spring, however, was how many other locals might benefit.
The crew at W.B. Rogers Inc. is a prime example. The local excavation contractor bid for and won the job to do the site work for the first phase of the project.
The project is the biggest in manager Geoff Gilman’s time with the family business, even trumping the eight miles of Bethel roads the company rebuilt immediately following Tropical Storm Irene.
W.B. Rogers Inc. got its start more than 40 years ago in 1968. Today, three generations work with the company, along with plenty of others. With 16 employees, W.B. Rogers brought on extra staff to work on Gifford’s project, which began in May. “We’ve employed quite a few more people,” Gilman said.
“Everybody who works for us lives in Randolph or a surrounding town, so it’s really keeping the income right here in this area,” added Gilman, whose father Charlie owns the business.
As community members pass by the site on Route 66 in Randolph Center, many have been surprised by the amount of equipment on site. Others have been surprised it’s locally owned. W.B. Rogers, which does jobs from the very small to the very large, owns about two dozen pieces of equipment, from excavators to loaders to backhoes to bulldozers to dump trucks.
With equipment stored in Randolph and an office in Bethel, Gilman notes a local contractor is also the contractor you know. He’s readily available, has built a reputation through his previous work at Gifford and many other local projects, and works hard to do a good job for his community.
“I take pride in my work. I like to see everything look nice. I treat these jobs like they are my own,” Gilman said.
After a long summer in the sun, he’ll also be glad to be done with it. “I was glad to get it. I’ll be glad to finish it,” he said.
W.B. Rogers will be on-site on the property until the ground freezes, finishing some grading and building an access road and then return in the spring for final grading and seeding.
The first phase of the project, which is the reconstruction of Gifford’s 30-bed Menig Extended Care Facility nursing home on the site, is expected to be done by May 2015.
The project began this May. Since then, water and sewer lines, drainage pipes, fire hydrants, light pole bases, and power have all gone in. Concrete has been placed, walls have gone up, and the site is getting ready for a winter of interior work.
Once complete, nursing home residents will move from their current home at Gifford to the new nursing home. The current facility will then be renovated into new industry-standard private inpatient rooms.
Later phases of the senior living community call for first 40 independent living units and then more independent living units and assisted living units to follow.
For Gifford, employing local contractors like W.B. Rogers means supporting not just seniors but the local workforce.
“Gifford is successful when our community is successful. It’s a partnership, and we do try very hard to be a good community partner,” said Gifford Director of Facilities Doug Pfohl.
Sue Schoolcraft poses outside of her Randolph Center home with her latest Menig quilt and her sewing machine, which she even packs on vacations so Menig Extended Care Facility residents get their quilts as soon as possible. It takes her between two days to a month to create each quilt.
The Last Mile Ride this Friday and Saturday at Gifford Medical Center in Randolph is a lot of things to a lot of people.
For the residents of the Menig Extended Care Facility, it is a splash of color and warmth during the last years of life.
Sue Schoolcraft’s mother always sewed. She made Schoolcraft and her twin brothers’ clothes and winter wear on a tiny, portable General Electric machine. “Until I was married, she made clothes for me,” says Schoolcraft, who was born at the start of World War II and amid the Great Depression.
Sue Schoolcraft, who makes quilts for Menig residents thanks to funds raised each year at the Last Mile Ride, demonstrates a stitch.
Schoolcraft’s interest in quilting was born in high school in her native New York.
“I started probably right after high school. We had a history teacher and he would take us to museums and living history museums, and I saw all these quilts,” she says, recalling watching women quilting and then seeing a striking image of a Baltimore Album quilt in a magazine.
“It was beautiful. It just appealed to me,” says Schoolcraft.
A quilting book tops a small stack of reading materials in Sue Schoolcraft’s living room.
Her mom helped her get started and she worked on that quilt, her first, for years – through marriage, children and moves to Swanton, Vt., Sheldon Springs, Randolph, Fairfax and Braintree Hill before finally moving to Randolph Center more than 40 years ago.
In Vermont, Schoolcraft found a quilting community. She joined an East Bethel hand crafters group, made a second quilt for her daughter and eventually sold at craft fairs.
Menig resident Barb Reynolds’ quilt features bright greens. “I like the color of it and all the hard work that’s in it.” It is Barb’s first ever quilt, she says.
She was teaching a quilting class at her church in Randolph Center, the First Congregational Church of Randolph, when she saw an ad in the paper from the Menig Extended Care Facility in Randolph looking for quilts for its 30 nursing home residents.
Schoolcraft, a stay-at-home mom and avid sewer, responded and put her four students to work.
“They had just opened up the new Menig center,” Schoolcraft recalls. “We suddenly needed 30 quilts. I was teaching a quilt class at the time and we started making quilts.
“And I just loved it and kept on.”
Menig resident Jean “Terry” Wilson loves her quilt’s colors, particularly the pink.
Today when a new resident moves in to Menig, 75-year-old Schoolcraft talks to the resident about his or her interests and likes, or receives this information from Menig staff, and gets to work herself making a personalized quilt.
One such quilt stands out in Schoolcraft’s memory. Her mother – that mother who taught her to sew – Dorothy Morack, lived at Menig during her final years.
“She wanted butterflies. So I found material,” Schoolcraft says. “It just made me happy to know that I was able to do something special for her after all the things she had done for me.”
A more recent quilt featured tractors, trees and a gambrel roof barn for a male resident.
Mertie Seymour likes flowers, so that is what her quilt at Menig features.
While each is different – be it butterflies or barns – there is one constant to the quilts that neatly adorn each resident’s bed. “I try to do quilts in bright and cheerful colors, especially with our long winters,” says Schoolcraft, who hopes to uplift the residents during what for most are their final years.
The work is supported by the Last Mile Ride, Gifford’s annual charity motorcycle ride, cycle ride, 5K and 1-mile walk, which raises money for free services for people in advanced illness or at the end-of-life.
For Schoolcraft, the work is “a labor of love.” Occasionally, she gets thank you notes and relishes in residents’ reactions. “’Look what I got! Look what I got!’” said one. “’This is for me?’ Did you make this for me?’” inquired another.
“It just brings me happiness and joy to do this. It has many different aspects. It’s giving back to the community that has been so good to us,” she says of herself and husband Ron. “It connects us to people.”
The Last Mile Ride 5K run and one-mile walk is Friday. A 38-mile cycle ride and 79-mile motorcycle ride is being held on Saturday. The events raise money for special services for those in life’s last mile. Those services include alternative therapies such as massage and music therapy; food for families staying in Gifford’s Garden Room for end-of-life patients; professional family photos; family grants; gas cards to doctors’ appointments; and special family requests, such as a family trip to a Red Sox game, a flight to be at a loved one’s side, a handicapped ramp, or other small home improvements.
Log on to www.giffordmed.org or call 728-2284 to learn more. Participants can register on the day of the event.