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Annual Report 2010 - Gifford Medical Center

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contents/board of trustees<br />

Board of Trustees<br />

Board of Trustees<br />

Bob Wright, Chair, Randolph<br />

Sharon Dimmick, Vice Chair, Randolph <strong>Center</strong><br />

Bruce MacDonald, Treasurer, Warren<br />

Karen Gillespie-Korrow, Secretary, Northfield<br />

Joseph Woodin, Chief Executive Officer, Sharon<br />

David Ainsworth, South Royalton<br />

William Baumann, Randolph<br />

Linda Chugkowski, Northfield<br />

Lincoln Clark, Bethel<br />

Jack Cowdrey, Randolph<br />

Randy Garner, Randolph<br />

Barbara Harvey, Rochester<br />

Paul Kendall, Braintree<br />

Richard Mallary, Brookfield<br />

Gus Meyer, Randolph<br />

Dr. Joshua Plavin, Randolph<br />

Barbara Rochat, Chelsea<br />

Introduction<br />

<strong>Gifford</strong> is known for high quality, personalized health<br />

care. Whether it’s a visit with your doctor, or welcoming<br />

a new life into the world in our Birthing <strong>Center</strong>, our<br />

providers and staff are renowned for their care. But there<br />

are probably a few things about us that you don’t know.<br />

For example, did you know that <strong>Gifford</strong> offers diagnostic<br />

imaging comparable to that of larger tertiary care centers<br />

That our Emergency Department wait times are some of<br />

the lowest in the nation Or that the surgical program has<br />

grown to include a variety of world-class surgeons offering<br />

some surgeries you’d have trouble finding elsewhere<br />

In the pages that follow, we describe some of <strong>Gifford</strong>’s<br />

Best Kept Secrets – services you may not know your,<br />

community hospital offers, facts that might surprise you<br />

and a wrap up of <strong>2010</strong>.<br />

Thank you for your interest in <strong>Gifford</strong> <strong>Medical</strong> <strong>Center</strong>.<br />

We hope you enjoy reading this year’s <strong>Annual</strong> <strong>Report</strong>.<br />

Contents<br />

<strong>2010</strong> highlights ............................................................2-3<br />

Administrator’s message .................................................. 1<br />

Auxiliary ........................................................................16<br />

Board Chair’s message ..................................................... 1<br />

Corporators ...................................................................28<br />

Donor profile ................................................................27<br />

Employee awards ...........................................................25<br />

Financial statment ..........................................................21<br />

Giving ..................................................................... 22-27<br />

<strong>Medical</strong> services and Executive Committee ....................19<br />

Statistics ........................................................................20<br />

Volunteer profile ............................................................ 17


Joe Woodin<br />

Administrator<br />

The title for this <strong>Annual</strong> <strong>Report</strong> came from a number<br />

of conversations where members of the public would<br />

comment, “I didn’t know <strong>Gifford</strong> offered that service.”<br />

They became so frequent that Board members would<br />

challenge us to “get the word out” and highlight our<br />

programs and accomplishments. Hopefully after reading<br />

this report, you will have a greater appreciation for some of<br />

the things we do.<br />

We don’t spend a lot on advertising, and hopefully with<br />

your help, we won’t need to. Read about our “secrets” and<br />

pass them along to your friends and neighbors. I’ve learned<br />

that a good personal story about <strong>Gifford</strong> is far more<br />

valuable than a brightly colored advertisement or a radio<br />

campaign.<br />

You will also get a chance to read about the many<br />

volunteers and donors who have given their time and<br />

resources to this organization. They believe in what we<br />

do, and their involvement is a constant encouragement for<br />

our staff. There is no greater compliment than to have<br />

someone invest in your future.<br />

This next year will bring great changes in the Vermont<br />

health care system. The state is proposing that we re-write<br />

laws and regulations, and embrace a single-payer model for<br />

the delivery of care. This is no small feat, and I would only<br />

ask that you – as members of the public – get involved and<br />

help our political leaders work through the details. They<br />

represent our hopes and desires, and will need our feedback<br />

as they begin to make difficult choices for us as providers<br />

and for you as a patient. Your involvement will only make<br />

for a better health care system tomorrow.<br />

Thanks again for taking the time to read this report. We<br />

are thankful for those who entrust us with their health care<br />

needs and will continue to work at improving our quality<br />

and managing our expenses.<br />

<strong>Annual</strong> <strong>Report</strong> <strong>2010</strong><br />

- 1 -<br />

Bob Wright<br />

Chair, Board of Directors<br />

<strong>Gifford</strong> has always meant a lot to me personally. Growing<br />

up in Randolph, the hospital with its skilled staff, doctors<br />

and nurses offered a sense of security to the community<br />

and to me. It is that same sense of community and excellent<br />

care that has become valued by so many in the area.<br />

Today, <strong>Gifford</strong> has integrated clinics and created a<br />

network that is clearly a model of an effective health care<br />

delivery system. Investment in equipment, people and<br />

facilities has kept the hospital and clinics in a position to<br />

provide the quality and consistency that is expected. As a<br />

result, <strong>Gifford</strong> has been able to expand services to meet the<br />

changing needs of people in our communities.<br />

As a member of the Board of Trustees, I have seen what<br />

it takes to keep <strong>Gifford</strong> in-step with the pace of advances<br />

in medicine today. Not only must we keep up with new<br />

research and technology, but also the ever-changing,<br />

complex regulatory requirements that impact health care<br />

providers.<br />

Reimbursement cuts challenge every health care<br />

organization, and <strong>Gifford</strong> is not excluded. The <strong>Gifford</strong><br />

team has achieved solid financial results for a record 11<br />

years. Even though this gets tougher every year, there<br />

is a philosophy and focus throughout all levels of the<br />

organization to operate responsibly and effectively.<br />

New information technology accessible via Internet use<br />

by home computers and smart phones has made the world<br />

smaller. People have lightning fast access to information<br />

that makes for a more informed health care consumer with<br />

much higher expectations from the health care system.<br />

Quality in all aspects of care is that expectation.<br />

Our focus on strategic planning and commitment to<br />

provide high quality services makes <strong>Gifford</strong> a strong and<br />

effective organization. Not only is patient satisfaction<br />

a priority, the health of <strong>Gifford</strong> itself is meaningful and<br />

real. Thanks to the commitment of everyone, <strong>Gifford</strong> will<br />

remain an outstanding asset in our communities for years<br />

to come.<br />

<strong>Gifford</strong>’s Best Kept Secrets<br />

administrator/board chair messages


<strong>2010</strong> timeline<br />

January<br />

The fi rst baby of the New Year is born at <strong>Gifford</strong><br />

to Kristen Bigelow-Talbert and Andy Talbert of<br />

Montpelier. Azrael Matthew Bigelow-Talbert<br />

arrived at 12:15 a.m. on Jan. 1 – a healthy<br />

7-pound, 11-ounce baby boy.<br />

<strong>Gifford</strong> launches a Patient Care Navigator<br />

Program to support breast care patients<br />

through their biopsies and, for the small<br />

percentage diagnosed, through their cancer<br />

treatment.<br />

The fi rst Healthier Living Workshop series<br />

of the year begins. These free workshops<br />

continue to be offered throughout the year for<br />

chronic disease sufferers.<br />

General surgeon Dr. Ovleto<br />

Ciccarelli, who has worked<br />

for <strong>Gifford</strong> providing weekend<br />

on-call emergency coverage<br />

since 2007, makes <strong>Gifford</strong> his<br />

full-time workplace. The skilled<br />

surgeon brings new procedures and much<br />

enthusiasm to the medical center.<br />

<strong>Gifford</strong> is awarded an Avon Foundation for<br />

Women Breast Care Fund grant for the ninth<br />

consecutive year. The only organization in the<br />

state to receive the national award, <strong>Gifford</strong> has<br />

been granted $40,000 for <strong>2010</strong> to increase<br />

awareness of the life-saving benefi ts of early<br />

detection of breast cancer.<br />

February<br />

Dr. Mandeep Hundal joins<br />

<strong>Gifford</strong>’s inpatient hospitalist<br />

team. Born in India, Dr. Hundal<br />

has lived in the United States<br />

since 2005 and was anxious<br />

to make a rural community like<br />

Randolph his home.<br />

Free diabetes education continues at <strong>Gifford</strong><br />

with motivational speaker Dick Smith featured<br />

at the February and March monthly Diabetes<br />

Support Group meetings.<br />

March<br />

<strong>Gifford</strong> celebrates “A Decade of Change”<br />

at its 104 th <strong>Annual</strong> Meeting. The event<br />

highlights <strong>Gifford</strong>’s fi nancial improvement<br />

and growth over the last decade. The hospital<br />

is the only one in Vermont to meet its stateapproved<br />

budget and operating margin for 10<br />

consecutive years.<br />

A North Carolina woman, Marcy Brenner, brings<br />

her powerful documentary, “Dead Girl Walking,”<br />

on surviving breast cancer to <strong>Gifford</strong>. She also<br />

speaks, and her band, “Molasses Creek,”<br />

performs.<br />

A Babysitter’s Training Course is offered in<br />

<strong>Gifford</strong>’s new Family <strong>Center</strong> space beside the<br />

Ob/Gyn and Midwifery building as part of the<br />

medical center’s continued outreach to women<br />

and families.<br />

April<br />

In conjunction with National Healthcare<br />

Decisions Day, <strong>Gifford</strong> provides free booklets<br />

and one-on-one assistance completing Advance<br />

Directives on April 16.<br />

Employees raise nearly $400 for the March of<br />

Dimes by donning “Blue Jeans for Babies.”<br />

A “Home Alone and Safe” course is offered by<br />

wellness educator Jude Powers for children in<br />

The Family <strong>Center</strong> at <strong>Gifford</strong>.<br />

Steve Votey is named Radiology Department<br />

Manager. Steve is an experienced radiology<br />

technologist and diagnostic imaging manager<br />

who comes from Blue Hill Memorial Hospital in<br />

Maine.<br />

Rebecca O’Berry of Brookfi eld<br />

joins <strong>Gifford</strong> as Vice President<br />

of Surgical Services. Rebecca<br />

previously worked at the region’s<br />

tertiary care centers – Fletcher<br />

Allen Health Care in Burlington<br />

and Dartmouth-Hitchcock <strong>Medical</strong> <strong>Center</strong> in<br />

Lebanon, N.H.<br />

A palliative care training for nurses is held in the<br />

conference center, attracting almost 50 <strong>Gifford</strong><br />

nurses who learned techniques on supporting<br />

and treating the dying.<br />

A 1950s-themed Volunteer Appreciation Event<br />

was held in the conference center, recognizing<br />

<strong>Gifford</strong>’s amazing volunteers and their<br />

contributions to the medical center.<br />

May<br />

<strong>Gifford</strong> receives two national honors. It is named<br />

among the nation’s “100 Best Places to Work in<br />

Health Care” by Becker’s ASC Review/Becker’s<br />

Hospital Review. The medical center’s 2009<br />

<strong>Annual</strong> <strong>Report</strong> also earns a <strong>2010</strong> Aster Award for<br />

marketing excellence.<br />

The medical center celebrates National<br />

Hospital and Health Care Week with lots of<br />

good fun.<br />

June<br />

Local teen<br />

Krista Warner<br />

donates more<br />

than $1,000<br />

to <strong>Gifford</strong>’s<br />

Woman-to-<br />

Woman Fund<br />

after making the<br />

cause her senior project. She held a bowling<br />

tournament as a fund-raiser.<br />

Two <strong>Gifford</strong> health care providers – pediatrician<br />

Dr. Lou DiNicola and Emergency Department<br />

nurse Carol Rittenhouse – share their<br />

experiences in Haiti. Both traveled to Haiti to<br />

provide health care following the devastating<br />

7.0 magnitude earthquake that ravaged the<br />

already impoverished country. Carol traveled<br />

to Haiti in January just after the quake. Dr.<br />

DiNicola went in May.<br />

Construction begins<br />

on the fi nal phase<br />

of the ravine fi ll<br />

project. In 2002,<br />

the project began<br />

and involved<br />

fi lling a huge ravine to create more space for<br />

parking and to connect the main hospital to<br />

the neighboring Thrift Shop and day care. This<br />

fi nal phase involves excavating, paving, moving<br />

the hospital’s liquid oxygen tank away from the<br />

roadside, relocating the driveway entrance,<br />

expanding green space and landscaping.<br />

Certifi ed-nurse midwife<br />

Kathryn Saunders of Calais<br />

joins <strong>Gifford</strong>. Kathryn<br />

previously worked at Central<br />

Vermont <strong>Medical</strong> <strong>Center</strong> and<br />

comes to <strong>Gifford</strong> with a strong<br />

commitment to the midwifery philosophy.<br />

Podiatric surgeon Dr. Nicolas Benoit is elected<br />

president of the Vermont Podiatric <strong>Medical</strong><br />

Association.<br />

July<br />

Gov. James<br />

Douglas, along<br />

with other<br />

state offi cials,<br />

presents<br />

<strong>Gifford</strong>’s Best Kept Secrets - 2 -<br />

<strong>Annual</strong> <strong>Report</strong> <strong>2010</strong>


the Menig Extended Care Facility its sixth<br />

consecutive Nursing Home Quality and Gold<br />

Star Employer awards.<br />

Dr. Joshua White joins the<br />

Emergency Department.<br />

Dr. White is an experienced<br />

emergency medicine physician<br />

who comes from Minnesota<br />

and also serves as community<br />

health director for Worldwide Village Inc.<br />

Through this work, Dr. White ran a 50-bed<br />

mobile hospital with two operating rooms and<br />

an emergency department in Léogâne, the<br />

epicenter of Haiti’s devastating earthquake.<br />

Two free programs for parents and early<br />

childhood educators are offered at <strong>Gifford</strong><br />

based on the work of Becky Bailey, Ph.D., who<br />

developed the Conscious Discipline Program.<br />

August<br />

<strong>Gifford</strong> Hospital Division <strong>Medical</strong> Director Dr.<br />

Martin Johns and <strong>Gifford</strong>’s hospitalist program<br />

are once again featured in “Today’s Hospitalist”<br />

magazine.<br />

September<br />

A free Geriatric Health Fair, complete with<br />

health experts and screenings, is held in the<br />

Conference <strong>Center</strong>.<br />

Montpelier’s Laureli Morrow<br />

joins the midwifery team. Laureli<br />

is a former <strong>Gifford</strong> Birthing<br />

<strong>Center</strong> nurse and a past direct<br />

entry (lay) midwife who earned<br />

her certifi ed-nurse midwifery<br />

degree and enthusiastically returned to <strong>Gifford</strong>.<br />

The <strong>Gifford</strong> Adult Day Program in Bethel<br />

celebrates Vermont Adult Day Services Week<br />

with a fall celebration of apple pie, ice cream<br />

and warm cider.<br />

Cardiac<br />

rehabilitation,<br />

overseen<br />

by specially<br />

trained nurses,<br />

begins in a gym<br />

space in the<br />

Cardiopulmonary Department at <strong>Gifford</strong>.<br />

The <strong>Gifford</strong> <strong>Medical</strong> <strong>Center</strong> Auxiliary completes<br />

its $300,000 pledge to the nursing home<br />

expansion project with a fi nal $30,000<br />

payment – delivered ahead of schedule and<br />

with much enthusiasm.<br />

November<br />

Kinney Drugs begins delivering prescription<br />

drugs to patients at the Chelsea Health <strong>Center</strong>.<br />

The Randolph drug store is also delivering<br />

to the Rochester Health <strong>Center</strong> for patients’<br />

convenience. The delivery program is free.<br />

The volunteer<br />

Chaplaincy<br />

Program<br />

celebrates<br />

one decade<br />

at <strong>Gifford</strong> with<br />

an afternoon<br />

celebration that attracts past and present<br />

chaplains and staff and the Rev. Tim Eberhardt,<br />

who is largely credited with leading the effort<br />

to start the program. The chaplains are praised<br />

for helping to provide the compassion for which<br />

<strong>Gifford</strong> is so well known.<br />

<strong>2010</strong> timeline<br />

Adult nurse practitioner<br />

Mary LaBrecque of North<br />

Pomfret brings her 35 years of<br />

experience to <strong>Gifford</strong> Internal<br />

Medicine. Mary had worked at<br />

the Veterans Affairs <strong>Medical</strong><br />

<strong>Center</strong> and also holds a special certifi cation in<br />

geriatric care.<br />

The Robin’s Nest Child Enrichment <strong>Center</strong><br />

earns National Association for Education of<br />

Young Children accreditation for the second<br />

time.<br />

The fi fth<br />

annual Last<br />

Mile Ride<br />

– <strong>Gifford</strong>’s<br />

annual charity<br />

motorcycle<br />

ride – raises a<br />

record $40,000 for end-of-life care.<br />

Chef, author and motivational speaker Wendell<br />

Fowler teams up with his brother, <strong>Gifford</strong><br />

internal medicine physician Dr. Milt Fowler, to<br />

offer a free talk titled “Diabesity: Making Good<br />

Food Choices.”<br />

Theron Manning retires after a remarkable<br />

41 years in the maintenance and facilities<br />

department. His most recent role was as<br />

Director of Strategic Projects.<br />

<strong>Gifford</strong> concludes another fi scal year “in the<br />

black,” achieving its operating margin for an 11 th<br />

consecutive year.<br />

October<br />

Dr. Saul Nurok joins the<br />

Emergency Department. Dr.<br />

Nurok previously worked as an<br />

emergency medicine physician<br />

in New York, Hawaii and New<br />

Jersey.<br />

East Montpelier native and<br />

certifi ed-nurse midwife Donna<br />

Butler returns to Vermont and<br />

joins <strong>Gifford</strong>. She has more than<br />

25 years of experience in Utah<br />

and Oregon.<br />

<strong>Gifford</strong>’s <strong>Annual</strong> Employee Awards Banquet is<br />

held at Vermont Technical College.<br />

Experienced urologist Dr. John<br />

Daly joins the Twin River Health<br />

<strong>Center</strong>, working with urologist<br />

Dr. Michael Curtis and urology<br />

physician assistant Nancy<br />

Blessing.<br />

The <strong>2010</strong> Diabetes Education Expo is held<br />

Nov. 12 and focuses on “Heart Disease and<br />

Diabetes.”<br />

The annual Craft Fair is held throughout<br />

the medical center, benefi ting the Adult Day<br />

program.<br />

December<br />

The Menig Extended Care Facility’s annual<br />

state Quality Indicator Survey fi nds the nursing<br />

home to be “defi ciency-free.”<br />

An indoor walking group for seniors, under the<br />

direction of Neighbor to Neighbor AmeriCorps<br />

and the Central Vermont Council on Aging,<br />

begins at <strong>Gifford</strong>.<br />

<strong>Gifford</strong>’s annual “gift certifi cate” program<br />

invests more than $40,000 in the area<br />

economy. <strong>Gifford</strong> Gift Certifi cates are good at<br />

a host of local stores – a program that rewards<br />

employees while also promoting buying local.<br />

Employees also donate a signifi cant number of<br />

turkeys to area food shelves.<br />

Pediatrician Dr. Pamela<br />

Udomprasert joins <strong>Gifford</strong> in<br />

Randolph as Dr. Louis DiNicola<br />

transitions to the role of<br />

pediatric hospitalist.<br />

<strong>Annual</strong> <strong>Report</strong> <strong>2010</strong><br />

- 3 -<br />

<strong>Gifford</strong>’s Best Kept Secrets


medicine/fi nance division<br />

Health care you can afford<br />

Patients receiving help from Health Connections<br />

caseworker Michele Packard say she is “phenomenal”<br />

at fi nding fi nancial assistance options.<br />

Well, yes.<br />

In many communities, there are free health clinics. If<br />

you don’t have insurance, you can go to those clinics for<br />

primary care from a physician who is often volunteering his<br />

or her time.<br />

The Randolph community does not have such a resource.<br />

There is no standalone free clinic with volunteer doctors.<br />

Years ago, Randolph did have one. It was called the<br />

Neighborhood Health Clinic, but in 1997 the clinic joined<br />

<strong>Gifford</strong> to provide seamless care and remove any stigma<br />

with a free clinic.<br />

Patients now go to any provider at <strong>Gifford</strong> <strong>Medical</strong><br />

<strong>Center</strong> for any needed health service and receive the same<br />

high-quality care as every other patient.<br />

“Our doctors are basically ‘insurance blind,’” notes<br />

<strong>Gifford</strong> Vice President of Finance David Sanville. All<br />

patients receive the same care, regardless of their insurance<br />

coverage or ability to pay.”<br />

Patients can still receive help accessing insurance, social<br />

services and financial assistance<br />

programs that existed<br />

“Anytime I<br />

had insurance<br />

issues, she’s<br />

been there.”<br />

Lisa Sargeant,<br />

Tunbridge<br />

under the free health clinic<br />

model through a continuing<br />

grant-funded program now<br />

called Health Connections.<br />

Championed by caseworker<br />

Michele Packard, Health<br />

Connections is part of the<br />

Vermont Coalition of Clinics<br />

for the Uninsured.<br />

Michele visits patients<br />

at their bedside, in the<br />

Emergency Department, talks to them by phone, meets<br />

with them in her office and reaches out to them before<br />

a bill lands at their feet. She signs them up for insurance<br />

programs, connects them with a dentist, finds help for<br />

prescription drug costs, accesses <strong>Gifford</strong>’s free and reduced<br />

cost assistance program, helps them sign-up for assistance<br />

at other hospitals for their follow-up specialty care, and<br />

sometimes arranges for transportation to appointments.<br />

She sits shoulder to shoulder with each person, filling out<br />

paperwork on their behalf, and bends over backward to<br />

find assistance options.<br />

“Michele can pretty much find anything for anyone,”<br />

says Gail Bourassa, <strong>Gifford</strong>’s Director of Patient Access and<br />

Financial Services.<br />

“The patient is treated as an individual. Every situation is<br />

unique, and we try to work with each patient to the best of<br />

our ability,” Michele explains. “I tell patients that I will do<br />

everything I can to help you. If you work with me, I can<br />

make it better in most circumstances.”<br />

Patients appreciate the financial help and peace of mind<br />

she provides.<br />

Lisa Sargeant, a senior caregiver from Tunbridge,<br />

tells her story. “Once upon a time, I was having trouble<br />

making ends meet.” Michele helped her obtain insurance,<br />

understand her bills and most recently get on a lower cost<br />

medication plan.<br />

“She’s phenomenal. Anytime I’ve had insurance issues,<br />

she’s been there. She’s like a big sister to me. She always<br />

has an answer to everything. I don’t freak out. I have peace<br />

of mind. I consider her part of my family,” says Lisa.<br />

George Rich of Randolph was hospitalized at <strong>Gifford</strong><br />

<strong>Gifford</strong>’s Best Kept Secrets - 4 -<br />

<strong>Annual</strong> <strong>Report</strong> <strong>2010</strong>


FACTOID<br />

During the hospital’s <strong>2010</strong> fiscal year, it provided a<br />

total of $701,280 in discounted and free care to patients<br />

through the <strong>Gifford</strong> Affordable Care Program.<br />

Joshua Plavin<br />

<strong>Medical</strong> Director, Medicine Division<br />

following his third operation. The down time gave him<br />

plenty of opportunity to think – about being out of<br />

work, about his Main Street apartment and commercial<br />

building being gutted by fire, including the loss of his own<br />

apartment, and about the medical bills that must be piling<br />

up.<br />

“I was worried,” he says.<br />

Michele came to his bedside, listened to his concerns and<br />

went away to do a bit of calculating.<br />

“She came back two hours later all smiles. She said you<br />

owe the hospital 40 bucks.” After a summer of turmoil,<br />

George was relieved.<br />

This past year has been one of continued growth in the<br />

Medicine Division. We have been happy to have nurse<br />

practitioner Mary LaBrecque join us in the Randolph<br />

internal medicine clinic, expanding access to care for<br />

patients. Mary has more than 30 years of clinical experience<br />

and is an excellent addition to our team.<br />

Our pediatric team has also grown. Nurse practitioner<br />

Elizabeth Baez is working in our Berlin office, and<br />

pediatrician Dr. Pamela Udomprasert is in our Randolph<br />

office.<br />

Despite ongoing fiscal challenges in primary care, we<br />

are committed to attract and retain high quality providers<br />

to serve patients in our area. Our new medical leadership<br />

team has fostered a sense of collaboration for patients<br />

throughout the continuum of care at <strong>Gifford</strong>, both<br />

inpatient and outpatient.<br />

We will continue to focus on maintaining and improving<br />

our quality of care for our patients. As part of that focus,<br />

we eagerly anticipate the adoption of a new electronic<br />

medical record system for our clinics in the coming year.<br />

Michele Packard, right, works with patient Lisa Sargeant of Tunbridge to<br />

lower her medical costs.<br />

<strong>Annual</strong> <strong>Report</strong> <strong>2010</strong><br />

- 5 -<br />

<strong>Gifford</strong>’s Best Kept Secrets


in the community<br />

Left, volunteer Mickie Richardson assists community<br />

members in preparing their Advance Directives during<br />

National Healthcare Decisions Day.<br />

<strong>Center</strong>, Chef Steve Morgan does a cooking<br />

demonstration at the annual Diabetes Education Expo<br />

which offers a day of free advice on self-management<br />

techniques.<br />

Right, New Parent Group participants, like Clarke<br />

Collins and his daughter Muirin say they get heartfelt,<br />

expert advice.<br />

Free services for diabetics,<br />

moms and the chronically ill, to name but a few<br />

If you have diabetes, chances are you have a lot of<br />

health care appointments to have your eyes, feet, diet and<br />

blood work monitored. Chances are those health care<br />

appointments also add up financially. But for diabetics<br />

visiting <strong>Gifford</strong> <strong>Medical</strong> <strong>Center</strong>, the opportunities for<br />

diabetes education at no cost are pretty remarkable for a<br />

rural community hospital.<br />

Connie DeCoste of Randolph was recently diagnosed<br />

with diabetes and visits <strong>Gifford</strong>’s Diabetes Clinic and<br />

registered dietitian regularly. She also attended the free,<br />

annual Diabetes Education Expo in November, and<br />

couldn’t say enough about it.<br />

“It was amazing,” Connie says. “It was so people-friendly<br />

and educational. We talked about real important stuff in<br />

everyday language. I took a lot more away from it than I<br />

expected.”<br />

<strong>Gifford</strong> chefs gave a talk and cooking demonstration,<br />

and a cardiologist discussed diabetes and heart disease.<br />

Participants peppered him with questions for an hour.<br />

“It was fun. He made it<br />

interesting,” Connie says.<br />

“It’s like<br />

motherly<br />

advice, but it’s<br />

coming from<br />

an expert<br />

source.”<br />

Clare Barnard,<br />

Wilder<br />

For Braintree’s Susan<br />

Moore, it was meeting others<br />

with diabetes that had the<br />

strongest impact.<br />

“I met a lot of people there<br />

who are struggling with my<br />

issues and heard about what<br />

did and didn’t work for them,”<br />

says Susan who was diagnosed<br />

with diabetes several years ago.<br />

“Sometimes just knowing you<br />

are not the only one is the best<br />

thing of all.”<br />

Susan also attended a<br />

presentation in August by Dr.<br />

Milton Fowler and Chef Wendell Fowler on “Diabesity:<br />

Making Good Food Choices.” “It really hit home because<br />

Chef Fowler had once walked in our shoes and had found<br />

a way to turn his health around. I have since taken some of<br />

the ideas he presented to use in my own kitchen.”<br />

The Expo comes but once a year, so many diabetics meet<br />

monthly at the free Diabetes Support Group. It’s led by<br />

trained facilitators and helps attendees keep in touch with<br />

others and receive support throughout the year.<br />

Diabetes education, however, is just one way <strong>Gifford</strong><br />

reaches out to the community. Free six-week classes for the<br />

chronically ill called Healthier Living Workshops are offered<br />

about four times a year through the Vermont Blueprint for<br />

Health. Tobacco cessation help is offered through the Quit<br />

in Person Group. Health fairs and men’s health screenings<br />

are also offered. You can receive free help completing and<br />

filing your Advance Directive. <strong>Gifford</strong>’s chaplain offers oneon-one<br />

grief and loss support. <strong>Gifford</strong> providers frequently<br />

speak at schools and volunteer at regional free clinics as well<br />

as overseas in impoverished nations. You can buy an “at-cost”<br />

bike helmet for your child and have it fitted at the pediatrics<br />

office.<br />

And for new parents, the resources are vast. There’s<br />

lactation support and a free car seat for those giving birth<br />

at <strong>Gifford</strong>, infant CPR, classes on positive parenting and<br />

the New Parents Group, which meets weekly. The group<br />

involves new parents and their babies. Led by Nancy<br />

Clark, a nurse, lactation consultant and certified childbirth<br />

educator, the group members receive loads of information<br />

on topics ranging from diapering to development to infant<br />

massage.<br />

“It’s like motherly advice, but it’s coming from an expert<br />

source,” says New Parent Group participant Clare Barnard<br />

of Wilder. “It’s also up-to-date information.”<br />

There are snacks and baby playtime. Parents, who<br />

may have already met in <strong>Gifford</strong>’s birthing classes or<br />

innovative <strong>Center</strong>ing group for prenatal care, find support<br />

in shared experiences – meaning programs like these are<br />

not only supporting community health, but also creating<br />

communities.<br />

<strong>Gifford</strong>’s Best Kept Secrets - 6 -<br />

<strong>Annual</strong> <strong>Report</strong> <strong>2010</strong>


Left, Joe Chartier, foreground, and Brooke Paige,<br />

background, work out in the Cardiopulmonary<br />

Department as part of <strong>Gifford</strong>’s new<br />

cardiac rehabilitation program. It is one<br />

of several new services at <strong>Gifford</strong>.<br />

Right, Patient Care Navigator<br />

Brittany Ward makes calls to patients.<br />

new programs<br />

New programs<br />

Helping heart, respiratory and breast patients<br />

For Brooke Paige of Washington, a viral infection led to<br />

a scary diagnosis – congestive heart failure combined with<br />

atrial fibrillation, or a rapid heart rhythm.<br />

A visit to <strong>Gifford</strong> <strong>Medical</strong> <strong>Center</strong>’s clinic one Saturday,<br />

coupled with an echocardiogram, led to the diagnosis.<br />

“This place saved my life,” says Brooke, who had never<br />

even had high blood pressure before.<br />

Brooke, 57, took steps to improve his quality of life. He<br />

enrolled in <strong>Gifford</strong>’s new Cardiac Rehabilitation Program<br />

and spent three days a week for about three months<br />

working out at <strong>Gifford</strong>; learning about safe exercise, proper<br />

nutrition and stress reduction techniques; and gaining<br />

confidence to safely continue his workouts at home.<br />

Cardiac rehabilitation is an important step for people<br />

with coronary heart disease, with angina, recovering from a<br />

heart attack or heart surgery, with stent placement or other<br />

heart conditions. Like any rehabilitation program, cardiac<br />

rehabilitation includes a combination of education and<br />

exercise to help heart patients return to a healthy, active life.<br />

It’s led by three specially trained nurses, including Pam<br />

Overstrom. Pam calls cardiac rehabilitation an opportunity<br />

to embrace a new lifestyle. “Exercise transforms you,”<br />

she says. “It decreases stress. It increases strength and<br />

endurance.”<br />

And it’s only one of several new programs at <strong>Gifford</strong>.<br />

Pulmonary rehabilitation is medical therapy for<br />

chronic respiratory diseases, typically chronic obstructive<br />

pulmonary disease (COPD). For a person with COPD, a<br />

walk to the mailbox can be exhausting, and hospitalizations<br />

can be frequent. Pulmonary rehabilitation aims to increase<br />

endurance and reduce hospitalizations.<br />

“The cornerstone of the program is exercise. We’re<br />

hoping to improve patients’ ability to walk, go up<br />

stairs and do just regular daily activities,” says <strong>Gifford</strong><br />

Pulmonologist Dr. Marda Donner.<br />

Even though he quit smoking two decades before,<br />

Gerald “Rory” O’Connor of South Royalton was<br />

<strong>Annual</strong> <strong>Report</strong> <strong>2010</strong><br />

- 7 -<br />

diagnosed with emphysema. The diagnosis came after<br />

routine walks around his hilly farmland became arduous.<br />

Rory spent 10 weeks walking at a brisk pace on a <strong>Gifford</strong><br />

treadmill and left feeling more fit. “It certainly helped with<br />

my well-being,” says Rory, who at 82 is now trying to get<br />

into the routine at home to maintain his fitness.<br />

For Nancy Wallen, also an emphysema patient, the best<br />

part of the program was how much fun it was. “It got me<br />

out of the house. The atmosphere was really friendly. The<br />

group was really great. There was a lot of laughter, and<br />

that’s good for your soul,” says Nancy, 64, of Stockbridge.<br />

A final new program offering support to patients when<br />

they need it most is <strong>Gifford</strong>’s Patient Care Navigator<br />

program. The program provides support to women<br />

needing a biopsy following an abnormal mammogram.<br />

While the vast majority of biopsy results turn out to<br />

be non-cancerous, it can be a stressful time. Patient Care<br />

Navigator Brittany Ward, a radiology technologist, works<br />

to relieve some of that stress by serving as a support person<br />

and resource during the course of a patient’s diagnostic<br />

imaging and biopsy.<br />

Malisa Gemmell of Brookfield hadn’t even turned 40 yet<br />

when she found a lump in one<br />

breast accompanied by pain.<br />

Her doctor scheduled her for a<br />

mammogram and ultrasound<br />

right away. A follow-up biopsy<br />

was needed, and Brittany was<br />

at Malisa’s side the whole time.<br />

“It was very comforting,”<br />

says Malisa. “I couldn’t<br />

imagine going through this<br />

without her.”<br />

Thankfully, the lump in<br />

Malisa’s breast was benign.<br />

“This<br />

place<br />

saved<br />

my life.”<br />

Brooke Paige,<br />

Washington<br />

She’ll need a follow-up mammogram in six months and<br />

she’s counting on having her patient care navigator nearby.<br />

<strong>Gifford</strong>’s Best Kept Secrets


hospital division<br />

Left, physical therapist Patrice Conard, seated,<br />

helps a patient get back on her feet in <strong>Gifford</strong>’s<br />

inpatient gym.<br />

Right, physical therapy assistant Eric Christensen<br />

assists total-knee replacement patient Walter<br />

Goodrich with strengthening exercises.<br />

A key spoke in the circle of care:<br />

Inpatient rehabilitation at <strong>Gifford</strong><br />

Alice Jones, 65, of Randolph had hip replacement<br />

surgery at Dartmouth-Hitchcock <strong>Medical</strong> <strong>Center</strong> in<br />

November. She stayed at Dartmouth for a couple of days<br />

and then chose to return to her medical home – <strong>Gifford</strong><br />

– for inpatient rehabilitation.<br />

Inpatient rehabilitation is often needed following a<br />

surgery, like a knee or hip replacement, an accident, an<br />

acute illness or pneumonia to help patients return to home<br />

and hopefully, independence.<br />

At <strong>Gifford</strong>, inpatient rehabilitation includes physical,<br />

occupational and speech therapies as well as skilled nursing,<br />

hospitalist care and social services.<br />

Alice spent a total of five days rehabilitating at <strong>Gifford</strong>,<br />

receiving physical therapy and occupational therapy in the<br />

mornings and then a second round of physical therapy in<br />

the afternoons.<br />

The physical therapists got her moving, she says. And,<br />

“Occupational therapy was great. They showed me how<br />

to do things … get dressed and use the grabber to get my<br />

clothes.”<br />

<strong>Gifford</strong> Rehabilitation<br />

“They’ve<br />

done good<br />

by me.”<br />

Elwin Pierce,<br />

Warren<br />

Manager Eric Medved explains<br />

that for people like Alice the<br />

program – with its dedicated<br />

caregivers and gym space –<br />

“closes the gap” between<br />

having surgery and returning<br />

home.<br />

“We can ensure you have the<br />

necessary skills to transition<br />

to home,” agrees Hospital Division Vice President Linda<br />

Minsinger.<br />

Elwin Pierce of Warren knows all about that. He spent<br />

six weeks at <strong>Gifford</strong> in the fall recovering and rehabilitating<br />

from a bad infection in his knee that required part of a past<br />

knee replacement to be removed.<br />

He was referred to <strong>Gifford</strong> from another hospital for his<br />

rehabilitation, and Elwin was glad for the experience.<br />

“They’ve done good by me,” the 69-year-old lifelong<br />

Vermonter says. “Before I wasn’t moving much, and I<br />

was pretty sick when I went in. They got me better. I<br />

had physical therapy twice a day. They taught me how to<br />

handle a walker again.”<br />

Prior to transferring to <strong>Gifford</strong>, Elwin didn’t know<br />

<strong>Gifford</strong> even had a rehabilitation unit. He’s not alone.<br />

Many locals don’t know the service exists. But it does, and<br />

as Elwin and Alice found out, it’s a quality program.<br />

“We manage your care along the spectrum,” providing<br />

“continuity of care,” Eric says. From your initial visit with<br />

your primary care provider, to your visit with the surgeon,<br />

to your surgery, to your inpatient stay, to your inpatient<br />

rehabilitation, to your outpatient rehabilitation and doctors<br />

visits – your care is coordinated by <strong>Gifford</strong>’s health care<br />

professionals working collaboratively to get you better, and<br />

get you home.<br />

For Alice: “<strong>Gifford</strong> was my first choice.” She receives<br />

her primary care at <strong>Gifford</strong> and was completing the circle<br />

of care by following up with outpatient physical therapy at<br />

<strong>Gifford</strong>’s Kingwood Health <strong>Center</strong>.<br />

<strong>Gifford</strong>’s Best Kept Secrets - 8 -<br />

<strong>Annual</strong> <strong>Report</strong> <strong>2010</strong>


<strong>Gifford</strong> Adult Day Program participants and<br />

staff created a fall display for Vermont Adult Day<br />

Services Week in September. The program keeps<br />

seniors and the disabled active and safe.<br />

hospital division<br />

The best kept secret in long-term care:<br />

the <strong>Gifford</strong> Adult Day Program<br />

Across Vermont and in our own communities, many<br />

of our seniors are living alone, in unsafe conditions, and<br />

unable to perform life’s daily tasks like making meals and<br />

bathing. Still others rely on the care of a family member,<br />

often a spouse who is also older, or a child who works and<br />

cannot provide the 24-hour care required to safely and<br />

adequately support our seniors in need.<br />

For these individuals as well as disabled adults, there is<br />

a care option often termed “the best kept secret in longterm<br />

care.” That option is adult day services. Adult day<br />

programs bridge the gap between independent living and<br />

nursing home care, provide respite to family caregivers and<br />

are a safe alternative to isolated seniors.<br />

There are 14 such centers in Vermont, including one<br />

right in our own backyard in Bethel.<br />

The <strong>Gifford</strong> Adult Day Program began in 1999.<br />

Located below the Bethel Health <strong>Center</strong> on Route 107,<br />

the program provides participants with medication<br />

management, medical supervision, showers, nail care<br />

and other personal hygiene help, healthy meals, plenty<br />

of activities, transportation to and from the program and<br />

perhaps most importantly, a safe environment. The care is<br />

provided on a sliding fee scale and often with the help of<br />

state and federal sources, such as Medicaid and Medicare.<br />

In <strong>2010</strong>, the <strong>Gifford</strong> Adult Day Program cared for 34<br />

area seniors and the disabled.<br />

When she looks back over the year and sees how many<br />

of the participants have improved physically and mentally,<br />

Adult Day Director Judy Santamore is amazed. “It’s<br />

dramatic the change in them.”<br />

One participant has lost 50 pounds with improved diet<br />

and exercise despite mobility issues. Another – a young<br />

woman with a traumatic brain injury – has regained<br />

mobility and balance, learned more appropriate social<br />

interactions, improved her communication with others and<br />

gained needed weight. She is safer and happier in these<br />

surroundings.<br />

“Adult Day care has really been good,” says her mother,<br />

Penny Miller of Bethel. “I can’t say enough. She enjoys<br />

going. She’d like to go every day.”<br />

Eighty-nine-year-old Evelyn James, known to all as<br />

“Chichi,” has been attending Adult Day for eight years,<br />

following a diagnosis of Alzheimer’s and a referral from the<br />

Council on Aging.<br />

Stagecoach picks Chichi up weekdays at 7:30 a.m. in<br />

Brookfield, where she lives with her son, Bob Beaulieu,<br />

and his wife. She participates in activities with staff and<br />

other seniors, then returns home at 4:30 p.m. Bob calls the<br />

program good for his mother.<br />

“It keeps her active.” says Bob, noting she also receives a<br />

healthy meal, is bathed two or<br />

three times a week and “is well<br />

provided for.”<br />

The program is also needed<br />

respite for Bob and his wife<br />

from the stress and physical<br />

exertion of caring for an elderly<br />

parent with dementia.<br />

“It’s been a wonderful<br />

experience,” says Bob. “If it<br />

hadn’t been for Adult Day, I<br />

don’t think we’d be able to<br />

keep her at home as long as we<br />

have.”<br />

For Bob, Chichi and the<br />

dozens of others helped, the secret is clearly out.<br />

“I can’t say<br />

enough. She<br />

enjoys going.<br />

She’d like to<br />

go every day.”<br />

Penny Miller,<br />

Bethel<br />

<strong>Annual</strong> <strong>Report</strong> <strong>2010</strong><br />

- 9 -<br />

<strong>Gifford</strong>’s Best Kept Secrets


hospital division<br />

Left, Ginny Sedgwick registers patients right at their<br />

bedside in the <strong>Gifford</strong> Emergency Department.<br />

Right, Emergency Department Director and Physician<br />

Dr. Steve Fischer cares for patient Greg Winnie of East<br />

Randolph.<br />

High-quality,<br />

timely emergency medicine<br />

Visit a hospital emergency department almost anywhere<br />

else in the country and it’s likely that your wait for care<br />

is long. The movie “Sicko” depicts the worst of the often<br />

heart-crushing reality – patients dying on an Emergency<br />

Department waiting room floor as they await care that<br />

never comes.<br />

That’s the extreme. But, according to <strong>Gifford</strong> Emergency<br />

Department Director Dr. Steve Fisher, “It is not unusual<br />

in many emergency rooms to wait as long as six to eight<br />

hours to get in, and 24-<br />

hour wait times are not<br />

“The<br />

experience<br />

opened my<br />

eyes to the<br />

valuable<br />

team of<br />

professionals<br />

we have<br />

here.”<br />

Dave Eddy,<br />

Bethel<br />

uncommon.”<br />

At <strong>Gifford</strong>, “our wait times<br />

are among the lowest in the<br />

nation,” says Dr. Fisher. In<br />

fact, patients are not only<br />

receiving timely emergency<br />

care, but also some of the best<br />

care medicine anywhere has to<br />

offer.<br />

Staff members are highly<br />

trained – many meeting<br />

rigorous standards for national<br />

certifications for emergency<br />

medicine. Some also work<br />

at area tertiary care centers<br />

to hone their trauma skills,<br />

and many of the hospital’s<br />

emergency department nurses<br />

have worked in the field for 20 or 30 years.<br />

“<strong>Gifford</strong>’s equipment and services compare to any other<br />

emergency department,” says nurse manager Maureen<br />

Heyder, who has been on the job since 1969. The available<br />

diagnostic technology from CT scans to MRIs matches<br />

that of larger hospitals.<br />

“We can diagnose, treat and stabilize any emergency<br />

medical condition. We have a number of state-of-the-art,<br />

complex medical protocols,” adds Dr. Fisher, who has<br />

been an emergency room doctor and director for 17 years.<br />

Procedures for strokes and heart attacks, for example, can<br />

result in quickly diagnosing and transferring heart attack<br />

patients to area tertiary care centers for life-saving care.<br />

Dave Eddy, 56, of Bethel suffered a heart attack in early<br />

September. He was diagnosed in the <strong>Gifford</strong> Emergency<br />

Department and then flown by DHART to Dartmouth-<br />

Hitchcock <strong>Medical</strong> <strong>Center</strong>’s cardiac catheterization lab to<br />

have a stent placed in a completely blocked artery.<br />

Following his life saving care, Dave called his <strong>Gifford</strong><br />

emergency physician, Dr. Joshua White, and nurse Kelly<br />

Burrell “the ultimate professional team.” The experience,<br />

says Dave, “opened my eyes to the valuable team of<br />

professionals we have available here. I applaud <strong>Gifford</strong>’s<br />

quality of care.”<br />

Thanks to a new piece of equipment purchased by the<br />

<strong>Gifford</strong> <strong>Medical</strong> <strong>Center</strong> Auxiliary, emergency response<br />

for many heart attack patients will be even quicker in<br />

the future. With the new technology, emergency medical<br />

technicians responding to a 911 call will be able to transfer<br />

<strong>Gifford</strong>’s Best Kept Secrets - 10 -<br />

<strong>Annual</strong> <strong>Report</strong> <strong>2010</strong>


FACTOID<br />

<strong>Gifford</strong>’s Emergency Department nurses have about 300<br />

years of combined experience. About half of the staff has<br />

worked in emergency medicine for 30 years or more.<br />

Martin Johns<br />

<strong>Medical</strong> Director, Hospital Division<br />

an EKG taken in the field to the <strong>Gifford</strong> emergency<br />

department doctor. Depending on the results of that<br />

EKG, a patient may be sent directly to a tertiary care<br />

center to open up a blocked artery, resulting in even faster<br />

care – essential in a heart attack – and unique in a rural<br />

community in the United States.<br />

“Very few communities in the country have this type of<br />

collaborative relationship with their ambulance service,”<br />

says Dr. Martin Johns, <strong>Medical</strong> Director of the Hospital<br />

Division.<br />

<strong>Gifford</strong> is also collaborating within. The medical center<br />

has restructured to bring the Emergency Department and<br />

the inpatient unit together under one division to provide<br />

seamless care to patients who are admitted to the hospital.<br />

Many <strong>Gifford</strong> Emergency Department staff have years – even decades –<br />

of experience and national certifi cations. Pictured above are ED staff<br />

members Dr. Brian Sargent, ED nurse manager Maureen Heyder, registrar<br />

Carole Rennie and nurse Jamie Cushman.<br />

For the past five years, I’ve had the opportunity and<br />

privilege to work with a team of caregivers committed<br />

to quality patient care. They include compassionate<br />

nurses, midwives and physicians bringing babies into<br />

this world. Highly skilled responders and doctors saving<br />

lives in the ambulance and our Emergency Department.<br />

Caring providers, nurses, aides and therapists helping<br />

our inpatients recover and return home. A dedicated staff<br />

respecting the dignity and wishes of each of our nursing<br />

home residents. And for those at the end of life, our<br />

specialized palliative care team supporting patients and<br />

their families in our Garden Room.<br />

In <strong>2010</strong>, we’ve seen exciting changes and growth in all of<br />

these areas in the Hospital Division. <strong>Gifford</strong> continues to<br />

expand upon its commitment to the midwifery philosophy<br />

of birth. The hospitalist team manages all levels of disease<br />

for community members in need of inpatient care. The<br />

Advanced Illness Care Team is at the bedside of our sickest<br />

patients. The Menig Extended Care Facility has once again<br />

won state awards for quality.<br />

At the same time, we’re looking ahead to 2011 to<br />

further enhance the care we deliver. We are continuing our<br />

collaboration with area ambulance services to implement<br />

life-saving technologies and protocols for emergency<br />

care. We will remain true to our mission to maintain the<br />

personalized care for which <strong>Gifford</strong> is known.<br />

I believe in the incomparable personality of <strong>Gifford</strong>, and<br />

the quality and commitment of our providers and staff. As<br />

the new <strong>Medical</strong> Director of the Hospital Division, I am<br />

proud to represent such a talented team.<br />

<strong>Annual</strong> <strong>Report</strong> <strong>2010</strong><br />

- 11 -<br />

<strong>Gifford</strong>’s Best Kept Secrets


ancilliary services<br />

Left, Radiology manager Steve Votey positions a<br />

patient in the 40-slice CT scanner.<br />

<strong>Center</strong>, radiology technologist Carolyn Palazzolo preps<br />

for an X-ray. <strong>Gifford</strong> offers X-ray services in three<br />

locations, Berlin, Randolph and Sharon.<br />

Right, radiology technologist Michael Robichaud<br />

prepares to recieve the next MRI patient.<br />

Diagnostic imaging,<br />

with all the ‘bells and whistles’ and plenty of hometown charm<br />

It wasn’t so long ago that <strong>Gifford</strong> was announcing the<br />

arrival of its 40-slice CT scanner, rivaling technologies at<br />

larger neighboring hospitals.<br />

That scanner replaced an earlier model that was the<br />

oldest and only single-slice machine operating in Vermont.<br />

When <strong>Gifford</strong> sold it, it went to a veterinary practice.<br />

Today, much has changed. The modern and spacious<br />

Radiology and Nuclear Medicine departments at <strong>Gifford</strong><br />

offer state-of-the-art technologies with a personal touch.<br />

Some of the new equipment includes a digital ultrasound<br />

machine, a nuclear medicine gamma camera and a bone<br />

density machine for detecting osteoporosis. Digital<br />

mammography is the latest addition, completing the<br />

medical center’s upgrade to total filmless imaging. No<br />

more dark rooms to develop images or light boxes and a<br />

magnifying glass to see them.<br />

Mobile MRI services are<br />

available at the hospital and at<br />

“We have all<br />

of the bells<br />

and whistles<br />

that tertiary<br />

care centers<br />

have.”<br />

Pam Caron,<br />

Director of<br />

Ancillary<br />

Services<br />

two of <strong>Gifford</strong>’s health centers<br />

– the <strong>Gifford</strong> Health <strong>Center</strong> at<br />

Berlin and the Sharon Health<br />

<strong>Center</strong>. The Berlin and Sharon<br />

clinics also provide X-rays on<br />

site for the convenience of<br />

patients and timely diagnoses.<br />

“We have all of the bells<br />

and whistles that tertiary care<br />

centers have,” says Pam Caron,<br />

<strong>Gifford</strong> Director of Ancillary<br />

Services.<br />

These high-tech services are<br />

offered usually without the<br />

wait time of a larger facility<br />

and by professionals patients<br />

know.<br />

Chances are, says Radiology Department Manager Steve<br />

Votey, “Patients walk in the door and are cared for by<br />

someone they’ve known for many years.”<br />

It’s that personal touch that makes the difference, says<br />

Leslie Howard-McIntyre, 47, of Randolph.<br />

A private practice mental health counselor, Leslie has<br />

serious health problems, including a rare liver disease that<br />

has her liver so enlarged it’s collapsed most of one lung,<br />

causing her to be on oxygen all the time.<br />

So when it came time for her annual mammogram, it<br />

was the last thing she was thinking about. It wasn’t until<br />

the <strong>Gifford</strong> Radiology Department called her in November<br />

to tell her she was due for her appointment that she<br />

remembered and scheduled the annual exam.<br />

She had her mammogram in early December. Within<br />

days, Radiology Supervisor Terri Hodgdon was on the<br />

phone with Leslie asking her to come back in for a followup<br />

exam. The schedule was full, but Leslie was fit in.<br />

She had another mammogram, ultrasound and then a<br />

biopsy with her husband, Patient Care Navigator Brittany<br />

Ward and Breast Care Coordinator Jane Harrness at her<br />

side.<br />

“I started crying. I got really scared. They worked really<br />

hard to relieve my fears,” says Leslie.<br />

There was good reason for Leslie’s fears. She was<br />

diagnosed with stage one breast cancer.<br />

“They jumped on it quick. Not only did they get the test<br />

done that I needed, they were compassionate along the<br />

way. The Radiology Department was key to getting my<br />

diagnosis,” says Leslie, calling the staff “phenomenal” and<br />

that fateful call reminding her of her annual mammogram<br />

a blessing.<br />

“I’d be walking around right now with cancer if I hadn’t<br />

gotten that call,” says Leslie, who had a mastectomy in<br />

early 2011.<br />

<strong>Gifford</strong>’s Best Kept Secrets - 12 -<br />

<strong>Annual</strong> <strong>Report</strong> <strong>2010</strong>


Oncology nurses Sheila Metcalf, left, and Jessica<br />

Spencer, right, share a laugh with breast cancer<br />

patient Donna Viens of Randolph. Donna calls her<br />

<strong>Gifford</strong> caregivers “fantastic,” “caring”<br />

and “compassionate.“<br />

surgery division<br />

Kindhearted cancer care<br />

close to home<br />

Long-time local educator Donna Viens, 61, of Randolph<br />

found a lump in one of her breasts in October. She<br />

scheduled an appointment with her primary care physician<br />

Dr. Milt Fowler at <strong>Gifford</strong>, and he delivered the news that<br />

she feared.<br />

“‘If you want my gut reaction, it’s breast cancer,’” Donna<br />

recalls her physician saying. Her and husband Bruce’s next<br />

question was, “Are we going to Dartmouth or Fletcher<br />

Allen”<br />

Neither. Dr. Fowler referred Donna just upstairs to a<br />

<strong>Gifford</strong> surgeon.<br />

Since, Donna has seen general surgeon Dr. Ovleto<br />

Ciccarelli. She had a biopsy in <strong>Gifford</strong>’s Radiology<br />

Department with patient care navigator Brittany Ward at<br />

her side. Her oncologist, Dr. John Valentine, started her<br />

on outpatient chemotherapy under the care of <strong>Gifford</strong><br />

oncology nurses Sheila Metcalf and Jessica Spencer.<br />

Donna says she couldn’t ask for anything more. She<br />

calls her doctors “fantastic” and her nurses “caring and<br />

compassionate.”<br />

<strong>Gifford</strong>’s oncology program is among the smallest<br />

accredited by the Commission on Cancer of the American<br />

College of Surgeons. The program includes care from<br />

Dr. Valentine and specially trained nurses; outpatient<br />

treatments including chemotherapy, blood transfusions<br />

and other fluids as needed. There is also hormone therapy<br />

for breast and prostate cancers; many end-of-life supports<br />

through <strong>Gifford</strong>’s palliative care program; and oversight<br />

by an interdisciplinary Cancer Committee that meets via<br />

telecom with a radiation oncologist from Dartmouth-<br />

Hitchcock <strong>Medical</strong> <strong>Center</strong>.<br />

“We certainly can treat many cancers at <strong>Gifford</strong>,” says<br />

Dr. Valentine, an oncologist who sees patients at <strong>Gifford</strong><br />

and has been practicing for 30 years. “I enjoy coming<br />

to <strong>Gifford</strong>. I like the people who work there. I like the<br />

patients.”<br />

The personal touch from <strong>Gifford</strong>’s staff is part of what<br />

makes the local care special.<br />

Sheila has been a certified oncology nurse at <strong>Gifford</strong> for<br />

about 15 years. Because patients come back week after<br />

week for treatments and often stay for hours, working as<br />

an oncology nurse is extremely rewarding. “You get to<br />

know patients and their family members,” Sheila says. And<br />

because of the small size of <strong>Gifford</strong>’s oncology department,<br />

patients in turn get to know Sheila and Jessica.<br />

Their goal is to help patients feel well during treatment.<br />

“People really can go on and live their lives,” Sheila says.<br />

Best of all, says Jessica, “We’ve had people who have<br />

been down and are now leading a normal life.”<br />

Donna is one of those patients who is living remarkably<br />

well.<br />

She comes once every two weeks for chemotherapy<br />

to shrink her tumor and kill cancer cells, and other than<br />

a couple of tired days following treatment, is feeling<br />

well. She enjoys a “spectacular” lunch while undergoing<br />

treatment and is thankful for<br />

familiar caregivers and a short<br />

commute.<br />

“I can’t tell you how pleased<br />

we are,” Donna says. “I feel<br />

that I’m in good hands. I<br />

couldn’t ask for anything<br />

better.”<br />

“I couldn’t ask<br />

for anything<br />

better.”<br />

Donna Viens,<br />

Randolph<br />

<strong>Annual</strong> <strong>Report</strong> <strong>2010</strong><br />

- 13 -<br />

<strong>Gifford</strong>’s Best Kept Secrets


surgery division<br />

Left, podiatric surgeon Dr. Paul Smith moves the<br />

“mini c-arm” into place to take a live image during<br />

surgery of a patient’s foot.<br />

<strong>Center</strong>, central sterile supply technician Scott<br />

Dezotelle operates the new autoclave.<br />

Right, licensed nursing assistant Michele Young<br />

collects supplies in the Surgery Division’s inventory<br />

supply room.<br />

The best of both:<br />

Cutting edge, compassionate surgical care<br />

There are people who travel from across the globe to<br />

have surgery by <strong>Gifford</strong>’s esteemed podiatrists. Others are<br />

seeking out high quality eye surgery. Still others will only<br />

trust <strong>Gifford</strong>’s orthopedic surgeons to replace their knees<br />

or hips.<br />

These are high quality surgeons – some of the nation’s<br />

best. They’re the caliber of surgeon you would think would<br />

be operating out of the expansive surgery wing of a major,<br />

big city institution. But they’re not in New York or Boston;<br />

they’re at <strong>Gifford</strong> – a rural community hospital that has<br />

seen its surgery program grow in recent years with new<br />

surgeons, a new operating room, a renovated recovery suite<br />

and new technology.<br />

“We have a lot of surgeons who are doing big, innovative<br />

procedures for a small rural<br />

area, and we’re very fortunate<br />

“May the<br />

world’s<br />

population...<br />

have the<br />

same amazing<br />

health care<br />

I am having<br />

right now.”<br />

Ethan Hubbard,<br />

Chelsea<br />

for that,” says Jamie Floyd,<br />

Surgery Nurse Manager.<br />

<strong>Gifford</strong> boasts four podiatric<br />

surgeons, uniquely doing<br />

operations in the lower leg<br />

(not just the foot and ankle),<br />

and who have a focus on<br />

sports medicine.<br />

“These are very talented<br />

people,” says Dr. Ovleto<br />

Ciccarelli, a full-time general<br />

surgeon at <strong>Gifford</strong> and new<br />

Surgery Division <strong>Medical</strong><br />

Director. “They’re the top of<br />

the heap.”<br />

Besides Dr. Ciccarelli, Dr.<br />

Maury Smith and physician<br />

assistant Nikki Gewirz round<br />

out the general surgery team. There are two orthopedic<br />

surgeons – both women and tops in the their field, Dr.<br />

Stephanie Landvater and Dr. Bess Brackett. Eye surgeon<br />

Dr. Christopher Soares treats both children and adults. The<br />

Birthing <strong>Center</strong>, bustling and renowned, brings birthing<br />

women from across the state and thus results in some<br />

caesarean sections. A gastroenterologist visits from Fletcher<br />

Allen Health Care, and <strong>Gifford</strong>’s own urology providers<br />

offer a variety of services in the clinic and the operating<br />

room.<br />

Increasingly there is a focus on breast care, wound care<br />

and coordinated acute care, says Surgery Division Vice<br />

President Rebecca O’Berry.<br />

With the inception of the hospitalist inpatient care<br />

program in 2006, <strong>Gifford</strong> can now operate on sicker<br />

patients, or those with serious underlying health<br />

conditions. Those patients are also now seen by a doctor<br />

in <strong>Gifford</strong>’s pre-operative clinic. A patient’s unique care<br />

plan is then coordinated among the pre-operative, surgery,<br />

anesthesiology and hospitalist teams. “It’s a smooth<br />

process,” Rebecca says.<br />

Delivering high quality care additionally depends on<br />

giving surgeons the tools they need to diagnose, treat and<br />

operate on patients.<br />

“We’ve made a big investment in technology,” says Jamie.<br />

A “mini c-arm” is a new imaging tool used by surgeons<br />

in the operating room to take a single picture and<br />

continuous live image of a small body part, such as a<br />

foot, ankle or wrist. There is also a whole new endoscopy<br />

system as well as new eye surgery equipment and urology<br />

scopes. High-resolution monitors and new software allow<br />

surgeons a detailed look at diagnostic images and greater<br />

versatility in using those images. A new, larger autoclave<br />

for sterilizing surgical instruments keeps pace with the now<br />

busier operating rooms.<br />

Ultrasound-guided nerve blocks or anesthesia provide<br />

better pain control. For the first time a “pain-free”<br />

colonoscopy through the use of anesthesia is offered.<br />

Epidural catheters left in for three days can provide relief<br />

during surgery and following it.<br />

And then there are the less tangible – safety and systems,<br />

how nicely you’re treated, how well the staff communicates<br />

with you and your waiting family members, and how<br />

attentive the follow-up care is when you get home.<br />

<strong>Gifford</strong>’s Best Kept Secrets - 14 -<br />

<strong>Annual</strong> <strong>Report</strong> <strong>2010</strong>


FACTOID<br />

There are 25 podiatrists living in Vermont, and four of<br />

those are at <strong>Gifford</strong> (Drs. Nic Benoit, Kevin McNamara,<br />

Rob Rinaldi and Paul Smith), practicing in three<br />

locations – Berlin, Randolph and Sharon.<br />

Ovleto Ciccarelli<br />

<strong>Medical</strong> Director, Surgery Division<br />

Tom Dubee, 63, of Brookfield recently had surgery for<br />

the first time ever, at <strong>Gifford</strong>. It was a 10-minute procedure<br />

that involved podiatrist Dr. Robert Rinaldi making two<br />

tiny incisions to remove tension on an enlarged nerve in<br />

his foot. His brother had the same surgery five or six years<br />

ago, only his involved a large incision and cutting out the<br />

nerve, leaving him with no feeling in that part of his foot.<br />

“It was an outstanding experience,” says Tom of his<br />

surgery. “The hospital was great from the moment we got<br />

there until the moment we left.”<br />

Others patients agree. “I had the most amazing<br />

experience at <strong>Gifford</strong>. I come from the Boston area and my<br />

family wanted me to return home ‘where the real doctors<br />

are.’ I elected to stay with <strong>Gifford</strong>. It was absolutely the<br />

right choice,” one surgery patient commented.<br />

Still another was so impressed with his surgical<br />

experience at <strong>Gifford</strong> that he penned a letter to the editor<br />

of the local paper.<br />

“As I lay on the operating table at <strong>Gifford</strong> ... I had but<br />

one thought: May the world’s population ... have the same<br />

amazing health care as I am having right now,” wrote<br />

Chelsea’s Ethan Hubbard. “If I were to grade <strong>Gifford</strong><br />

<strong>Medical</strong> <strong>Center</strong> on everything, I would give them a<br />

hundred. Simply put, <strong>Gifford</strong> is the best!”<br />

For many of you, mine may be a new name. While I’ve<br />

worked at <strong>Gifford</strong> since 2007 providing weekend on-call<br />

coverage, unless you needed emergency surgery, we have<br />

probably not met before. In <strong>2010</strong>, I had the great privilege<br />

to begin practicing at <strong>Gifford</strong> full-time and be named<br />

<strong>Medical</strong> Director of our new Surgery Division that includes<br />

our third floor specialty, surgery, oncology and recovery<br />

staff.<br />

The creation of this division is among the milestones<br />

accomplished in <strong>2010</strong>, along with increased collaboration<br />

with primary care offices, emergency room providers<br />

and inpatient care teams to ensure seamless care for our<br />

patients. With our highly skilled and experienced hospitalist<br />

team, we’re now able to operate on sicker patients, and<br />

those with serious underlying health conditions. This<br />

comprehensive team of clinicians allows more people to<br />

receive surgical care close to home, with the support of<br />

family and friends in the local community.<br />

In addition, we’ve further refined our pre-operative<br />

process, added new technology and made great strides in<br />

systems improvements that better our efficiency and most<br />

importantly, your safety. These aren’t glamorous changes<br />

but are things that make a huge difference when it comes<br />

to caring for patients – and caring for patients is something<br />

I’m proud to say that <strong>Gifford</strong> does well.<br />

I spent 21 years in private practice in Connecticut before<br />

finding my medical home – my niche – at <strong>Gifford</strong>. It is<br />

an incredible medical center with talented surgeons and a<br />

staff filled with energy, ideas and a commitment to safe,<br />

compassionate, personalized patient care. These are traits<br />

you don’t often enough find in today’s world, and they are<br />

among <strong>Gifford</strong>’s most precious assets and greatest secrets<br />

to success.<br />

Operating room registered nurse Karyn Romanoski helps prepare a<br />

patient’s foot for surgery.<br />

<strong>Annual</strong> <strong>Report</strong> <strong>2010</strong><br />

- 15 -<br />

<strong>Gifford</strong>’s Best Kept Secrets


in the gifford community<br />

The <strong>Gifford</strong> Auxiliary:<br />

The Auxiliary completed its remarkable $300,000<br />

Menig Way Campaign pledge in October.<br />

Quietly giving back to the community<br />

<strong>Gifford</strong> Auxiliary members spend their time selflessly giving<br />

back to their community. But a best kept secret Auxiliary<br />

President Mickie Richardson asks you to decide and reflects on<br />

the organization, its role in the community and its giving to the<br />

hospital by awarding departments’ various “wish list” requests<br />

through Thrift Shop proceeds.<br />

Is the Thrift Shop one of Randolph’s best kept secrets<br />

Well, not to the dozens who shop there on a daily basis.<br />

But to the many who come in for the very first time, it’s a<br />

shoppers’ heaven.<br />

Thanks to the generosity of people in the community,<br />

the Thrift Shop offers a wide variety of goods – clothing<br />

of all sizes and colors, children’s books and toys, and<br />

everything from knick-knacks to holiday decor for your<br />

home. Donations are at an all-time high, and the creativity<br />

and dedication of the very capable staff has mushroomed.<br />

It’s wonderful. It’s not just the fact that we’ve been able to<br />

serve our community at a time when many truly need us<br />

– not just want us – it’s a synergistic event; because of our<br />

increased revenue, we’ve been able to fulfill the “wish list”<br />

of so many departments at the hospital. This just adds to<br />

the best kept secret.<br />

It’s the stuff that life is all about. The giving. The<br />

sharing. The giving back.<br />

For example, “wish list” giving has resulted in an exciting<br />

new communication system between the Emergency<br />

Department and ambulance services that will soon help<br />

speed up care for heart attack patients; new interactive<br />

training manikins help <strong>Gifford</strong> caregivers to keep their<br />

skills current; and materials are available to help families<br />

who are grieving the loss of a loved one.<br />

The Auxiliary’s other best kept secret is how easy it<br />

is to put your best talents to work. There are so many<br />

opportunities for folks to share their knowledge and keep<br />

this organization strong. Whether you want to be a cashier<br />

at The Thrift Shop, sort donated goods once a month or<br />

assist in some other way, the <strong>Gifford</strong> Auxiliary has room for<br />

you.<br />

Learn more by calling the Auxiliary at (802) 728-2617.<br />

Visit the Thrift Shop (located beside the hospital) at<br />

52 N. Main St., Randolph.<br />

<strong>Gifford</strong> Auxiliary Board members sport hats and mittens knitted by<br />

Auxiliary members and donated to six area schools in <strong>2010</strong>. From left<br />

are, Mickie Richardson, Ruth Lutz, Susan O’Malley, Polly Frankenburg and<br />

Kathy Corrao.<br />

FACTOID<br />

Over the course of five funding requests, beginning in<br />

2008, the Auxiliary has given $105,240 toward hospital<br />

programs and equipment purchases.<br />

<strong>Gifford</strong>’s Best Kept Secrets - 16 -<br />

<strong>Annual</strong> <strong>Report</strong> <strong>2010</strong>


Bill and Betsy Arnold both worked for <strong>Gifford</strong> for<br />

decades. Now Betsy is an essential volunteer and<br />

founding member of the Chaplaincy Program.<br />

A relationship of many decades:<br />

Betsy and Bill Arnold, and <strong>Gifford</strong><br />

in the gifford community<br />

To understand Bill and Betsy Arnold’s commitment to<br />

<strong>Gifford</strong>, you have to understand their history with the<br />

medical center.<br />

It started when Bill moved to Randolph in 1948 as the<br />

new Radiology/Lab Manager. At the time, there were only<br />

two people in the combined department taking X-rays and<br />

drawing blood for all patients. In fact, for more than a year,<br />

Bill was the only person in the department, virtually “on<br />

call” 24/7.<br />

Over time, the departments separated and grew, but one<br />

constant was Bill. He spent 52 years at <strong>Gifford</strong>, retiring in<br />

2000, then continuing part-time and later as a volunteer.<br />

For many years there has been another constant in Bill’s<br />

life and at <strong>Gifford</strong>, and that’s his wife Betsy.<br />

Betsy moved to Randolph in 1952 and sought out work<br />

at <strong>Gifford</strong>. Bill remembers the very day she walked through<br />

the hospital’s back door. She was looking for medical<br />

records, and an immediately smitten Bill was happy to<br />

show her the way. She was hired and, upon seeing her in<br />

the cafeteria afterward, Bill announced to his table of coworkers<br />

with complete certainty, “I’m going to marry her.”<br />

It took a year of courting, but in 1953 Bill and Betsy<br />

were married.<br />

Betsy worked in medical records, in the operating and<br />

delivery rooms, in coronary care, on the inpatient floor<br />

and in the office of a general surgeon until 1975 when<br />

arthritis forced her to stop working. She came back as a<br />

volunteer in X-ray to help out her husband of 57 years, and<br />

in more recent years has been instrumental in establishing<br />

and maintaining <strong>Gifford</strong>’s now 10-year-old volunteer<br />

chaplaincy program.<br />

FACTOID<br />

Volunteers gave more than 14,000 hours of time to<br />

<strong>Gifford</strong> in <strong>2010</strong>, helping support the medical center and<br />

nursing home’s operations and adding many smiling<br />

faces to <strong>Gifford</strong>’s entryways, offices, hallways and more.<br />

It was the reverend at Betsy’s church, Tim Eberhardt,<br />

who suggested starting an ecumenical chaplaincy program<br />

at <strong>Gifford</strong>. Betsy and Rev. Eberhardt were among the first<br />

people to approach new president, Joe Woodin, with the<br />

idea. Ten years later, Betsy is still extremely active in the<br />

20-or-so-member group that provides patients and their<br />

families comfort in times of illness, and sometimes loss.<br />

Her faith brings her to the group. Her fellow chaplains<br />

and the joy of helping others make the now 80-year-old<br />

stay.<br />

“It’s a wonderful group of people to work with, number<br />

one,” she says, adding, “Visiting patients is very rewarding.<br />

“I go in and I ask ‘How is your day going’ ‘How is your<br />

recuperation’ ‘What can I do for you’ They tell me their<br />

stories. Some of the stories are funny and some of them are<br />

absolutely amazing.”<br />

<strong>Gifford</strong> Chaplain Susan<br />

Thomas calls Betsy “the<br />

matriarch of the volunteer<br />

chaplains.”<br />

“She was instrumental<br />

in starting the program<br />

at <strong>Gifford</strong> but also has<br />

continued to serve as the<br />

historian, the ‘go-to’ person and<br />

often the authoritative ‘last<br />

word’ on a topic,” Susan says.<br />

“I give thanks to God for Betsy,<br />

and know she is well-loved by<br />

all the other chaplains as well as<br />

appreciated by the patients she<br />

visits.”<br />

“<strong>Gifford</strong><br />

is home<br />

to Bill<br />

and me.”<br />

Betsy Arnold,<br />

Chaplaincy<br />

volunteer<br />

“You hope that you have given someone some hope and<br />

counseling,” Betsy says. “I also tell them (patients) if they<br />

have to be in a hospital, this is the one to be in, and they<br />

agree.”<br />

<strong>Annual</strong> <strong>Report</strong> <strong>2010</strong><br />

- 17 -<br />

<strong>Gifford</strong>’s Best Kept Secrets


in the gifford community<br />

O Romeo!<br />

This group of ROMEOs ranges in age from the late<br />

60s to early 90s. They’ve been meeting around the<br />

area for more than 15 years. They now meet solely<br />

at <strong>Gifford</strong> – for convenience and good food. Pictured<br />

clockwise from the left are, Midge Meaney, Don<br />

Zilch, Melvin “Major” McLaughlin, Bob Cantlin, Nap<br />

Pietryka, Bud Cedarstaff and Lew Whitaker.<br />

For these ROMEOs, laughter, not Juliet, beckons<br />

“O Romeo, Romeo! Wherefore art thou Romeo” Why<br />

at <strong>Gifford</strong>, of course.<br />

Every Tuesday morning the ROMEOs meet at the<br />

<strong>Gifford</strong> cafeteria for conversation and coffee. Taking<br />

Shakespeare’s famous quote more literally, we asked the<br />

question “why” our Romeos call themselves by this name.<br />

Well, it’s actually ROMEO standing for Retired Old Men<br />

Eating Out, which comes from a passage in Tom Brokaw’s<br />

book “The Greatest Generation.”<br />

The group got its start in 1995 when Lew Whitaker<br />

of Randolph and the late Charlie Ludwig of Randolph<br />

<strong>Center</strong>, who both retired to Vermont from out-of-state and<br />

who both served on the local<br />

planning board, decided to get<br />

together for coffee. And, says<br />

“We’re just<br />

a bunch of<br />

good old boys,<br />

who like to get<br />

together ... .<br />

We talk about<br />

the good old<br />

days.”<br />

Nap Pietryka,<br />

Randolph<br />

Lew, now 89, to “…get away<br />

from the women for awhile<br />

and talk man talk.”<br />

Over time the group grew<br />

as others were invited to join<br />

them. They met at various<br />

establishments around the<br />

area – the Red Kettle in<br />

Northfield, Wilson’s in<br />

Bethel, the Barnard General<br />

Store, Eaton’s Sugarhouse in<br />

Royalton and even Vermont<br />

Technical College – but more<br />

recently settled on <strong>Gifford</strong><br />

as close to home in winter<br />

weather, affordable and<br />

serving up a good meal.<br />

“When the hospital got into the serving business, we<br />

found it was the best price and very good food,” says Nap<br />

Pietryka, a member of the now eight-person, invitationonly<br />

group.<br />

Nap’s been attending for about a decade and as an early<br />

octogenarian is among the younger members. “Major”<br />

Melvin McLaughlin, now in his 90s, is the group’s oldest<br />

and newest member.<br />

“We’re just a bunch of good old boys, who like to get<br />

together, who enjoy each other’s company,” explains Nap.<br />

Breakfast and silence come first; it’s all business when it<br />

comes to eating. But then the conversation, camaraderie<br />

and comedy begin.<br />

“We talk about the good old days. ‘You remember<br />

when… ’” Nap reports. Old comics, old cars and current<br />

sports are hot topics, but politics is off the table “We do<br />

have some basic rules, but nobody follows them,” Nap says<br />

with laughter in his voice.<br />

They joke with new members about “dues,” but there<br />

really are none. There did used to be a gavel, but it’s long<br />

lost. It was used to bring the group to order and to enforce<br />

one real rule: Only one conversation at time. But even<br />

that’s not really enforced anymore. “We bring it up once in<br />

awhile just for a laugh,” Nap says.<br />

One consistency is the meeting itself. They come in<br />

snow, sleet and freezing rain. Only a major holiday results<br />

in a cancellation.<br />

And then there are the Internet jokes. Some of the group<br />

members don’t even have a computer, but those who do<br />

bring in jokes they’ve printed off. Nap, the official joke<br />

reader, shares them with the group.<br />

“If laughing is good,” says Nap, “this group is going to<br />

live a long time.”<br />

Indeed.<br />

<strong>Gifford</strong>’s Best Kept Secrets - 18 -<br />

<strong>Annual</strong> <strong>Report</strong> <strong>2010</strong>


<strong>2010</strong>-2011 <strong>Medical</strong> Staff<br />

Anesthesiology<br />

Stephen Bender, MD<br />

Jens Bjerregaard, MD<br />

Dennis Henzig, MD<br />

Jon-Richard Knoff, MD<br />

Kathleen MacDonald, MD<br />

Nina Sharp, MD<br />

Cardiology<br />

Bruce Andrus, MD<br />

Chiropractic Sports Medicine<br />

Hank Glass, DC<br />

Emergency Medicine<br />

Roberto Abeyta, MD<br />

Steven Fisher, MD<br />

Sarah Johansen, MD<br />

Marc Keller, MD<br />

Todd Morrell, MD<br />

Saul Nurok, MD<br />

Scott Rodi, MD<br />

Wendell Smith, MD<br />

Joshua White, MD<br />

Lucy Wollaeger, MD<br />

Endocrinology<br />

Susanne Trost, MD<br />

Family Medicine<br />

Kenneth Borie, DO<br />

Terry Cantlin, DO<br />

Marcus Coxon, MD<br />

Tammy Gerdes, PA<br />

Jonna Goulding, MD<br />

Robert Kiess, MD<br />

Sheri Brown, FNP-BC<br />

Kim Ladue, FNP-BC<br />

Megan O’Brien, FNP-BC<br />

Brian Sargent, DO<br />

Mark Seymour, DO<br />

Starr Strong, PA-C<br />

General Surgery<br />

Ovleto Ciccarelli, MD<br />

Maury Smith, MD<br />

Laurie Spaulding, MD<br />

Marjorie Gewirz, PA-C<br />

Hospitalist Medicine<br />

Mandeep Hundal, MD<br />

Martin Johns, MD<br />

Joshua Plavin, MD, MPH<br />

Wendell Smith, MD<br />

Sue Burgos, PA-C<br />

Joshua Gleiner, PA-C<br />

Patrick Kearney, PA-C<br />

Fred Staples, PA-C<br />

Internal Medicine<br />

James Currie, MD<br />

Milton Fowler, MD<br />

Mark Jewett, MD<br />

Patrick Kearney, PA-C<br />

Mary LaBrecque, APRN<br />

Internal Medicine and<br />

Pediatrics<br />

David Pattison, MD, MPH<br />

Joshua Plavin, MD, MPH<br />

Mental Health<br />

John Porter, MD +<br />

Robert Vaillancourt, MA<br />

Midwifery<br />

Alexandra Bovey, CNM<br />

Donna Butler, CNM<br />

Laureli Morrow, CNM<br />

Kathryn Saunders, CNM<br />

Tanya Waters, CNM<br />

Naturopathic Medicine<br />

Christopher Hollis, ND<br />

Neurology<br />

Robin Schwartz, MD<br />

Obstetrics/Gynecology<br />

Brent Burgee, MD<br />

Ellamarie Russo-DeMara, DO<br />

Oncology<br />

John Valentine, MD<br />

Ophthalmology<br />

Jack Singer, MD +<br />

Christopher Soares, MD<br />

Orthopedics<br />

Bess Brackett, MD<br />

Stephanie Landvater, MD<br />

Pain Management<br />

Lan Nguyen-Knoff, MD<br />

Pathology<br />

Cathy Palmer, MD<br />

Brian Travis, MD<br />

Pediatric Cardiology<br />

Niels Giddins, MD<br />

Pediatrics<br />

Louis DiNicola, MD<br />

William Gaidys, MD<br />

Elizabeth Jewett, MD<br />

Joseph Pelletier, MD<br />

Pamela Udomprasert, MD<br />

Plastic Surgery<br />

Guy Rochman, MD<br />

Podiatry and Sports<br />

Medicine<br />

Nicolas Benoit, DPM<br />

Kevin McNamara, DPM<br />

Robert Rinaldi, DPM<br />

Paul Smith, DPM<br />

Pulmonary Medicine<br />

Marda Donner, MD<br />

Radiology<br />

John McIntyre, MD<br />

Scott Smith, MD<br />

Orthopedic Sports Medicine<br />

Peter Loescher, MD<br />

Urology<br />

Michael Curtis, MD<br />

John Daly, MD<br />

Nancy Blessing, PA-C<br />

<strong>2010</strong> <strong>Medical</strong><br />

Executive Committee<br />

Joshua Plavin, MD, MPH<br />

President, Medicine Division<br />

<strong>Medical</strong> Director<br />

Marcus Coxon, MD<br />

Vice President, Chair of<br />

Quality Council<br />

Ellamarie Russo-DeMara, DO<br />

Secretary<br />

Kevin McNamara, DPM<br />

Past President<br />

Ovleto Ciccarelli, MD<br />

Surgery Division <strong>Medical</strong><br />

Director<br />

Martin Johns, MD<br />

Hospital Division <strong>Medical</strong><br />

Director<br />

Terry Cantlin, DO<br />

Chair of Peer Review<br />

Committee<br />

Mark Seymour, DO<br />

Chair of Credentials<br />

Committee<br />

Joseph Woodin<br />

President and CEO<br />

medical services and executive committee<br />

+ Indicates providers who recently passed away.<br />

<strong>Annual</strong> <strong>Report</strong> <strong>2010</strong><br />

- 19 -<br />

<strong>Gifford</strong>’s Best Kept Secrets


statistics<br />

Admissions and visits by top 20 towns<br />

2009 <strong>2010</strong><br />

Inpatient admissions 1,623 1,726<br />

Short stay or same day<br />

admissions (outpatient) 1,233 1,469<br />

Other outpatients 66,897 69,547<br />

Grand total 69,753 72,742<br />

Total patient days of care 18,017 18,093<br />

Average daily census 49.4 49.6<br />

(hospital and nursing home)<br />

Average length of stay 3.0 3.1<br />

in days (acute patients)<br />

Deliveries 175 246<br />

Surgical procedures 2,208 2,852<br />

Emergency treatments 7,491 7,272<br />

Endoscopies 579 594<br />

Cardiology exams 2,783 2,953<br />

Respiratory care 11,124 11,789<br />

Laboratory procedures 144,605 152,944<br />

Radiology procedures 22,507 23,363<br />

(not including CT and MRI)<br />

CT scans 1,644 1,641<br />

MRI 1,326 1,550<br />

Radioisotope procedures 806 631<br />

Physical therapy procedures 26,686 27,320<br />

Number patient meals served 56,702 57,342<br />

Inpatient Outpatient Total<br />

Randolph/Braintree 496 22,653 23,149<br />

Bethel 143 6,379 6,522<br />

Royalton 93 5,794 5,887<br />

Northfi eld 119 3,158 3,277<br />

Chelsea 95 2,891 2,986<br />

Rochester 86 2,754 2,840<br />

Barre 100 2,640 2,740<br />

Tunbridge 47 2,507 2,554<br />

Brookfi eld 47 2,176 2,223<br />

Berlin 100 1,605 1,705<br />

Sharon 24 1,646 1,670<br />

Williamstown 52 1,551 1,603<br />

Stockbridge 22 979 1,001<br />

Granville 17 874 891<br />

Hancock 23 725 748<br />

Pittsfi eld 14 532 546<br />

Barnard 3 511 514<br />

Washington 11 492 503<br />

Montpelier 10 243 253<br />

Woodstock 1 243 244<br />

Other Vermont towns 202 9,079 9,281<br />

Other states 26 1,574 1,600<br />

Other countries - 5 5<br />

Grand total 1,731 71,011 72,742<br />

<strong>Gifford</strong> physician offices 88,243 97,074<br />

Percentage of giving<br />

by type<br />

Each year <strong>Gifford</strong> is fortunate to receive a variety of gifts.<br />

Many are to the medical center’s general fund and thus can<br />

be used as needed for hospital operations and programs.<br />

Others are for specifi c purposes, such as a gift to support<br />

the Garden Room, Adult Day Program or Birthing <strong>Center</strong>.<br />

We continue to receive payments on pledges for the Menig<br />

nursing home expansion project (the Menig Way Campaign).<br />

The pie chart shows the types of investments <strong>Gifford</strong><br />

receives - all of which are greatly appreciated.<br />

Specifi c Purpose<br />

(Restricted)<br />

Menig Way Campaign<br />

(Pledge Payments)<br />

16%<br />

47% Last Mile Ride<br />

(Restricted)<br />

10%<br />

General Fund<br />

(Unrestricted)<br />

14%<br />

Planned Gifts<br />

(Unrestricted/Restricted)<br />

13%<br />

<strong>Gifford</strong>’s Best Kept Secrets - 20 -<br />

<strong>Annual</strong> <strong>Report</strong> <strong>2010</strong>


Balance Sheet<br />

Years ended September 30, <strong>2010</strong> & 2009 <strong>2010</strong> 2009<br />

Statement of Operations<br />

Years ended September 30, <strong>2010</strong> & 2009 <strong>2010</strong> 2009<br />

fi nancials<br />

CURRENT ASSETS<br />

Cash and cash equivalents $4,953,499 $4,654,808<br />

Short-term investments 1,015,041 860,536<br />

Patients accounts receivable, net 6,963,230 7,136,962<br />

Other receivables 182,299 147,774<br />

Current portion of pledges receivable 59,406 88,256<br />

Inventories 1,035,282 918,018<br />

Estimated third-party settlements – –<br />

Prepaid expenses 989,988 738,576<br />

Total current assets 15,198,745 14,544,930<br />

ASSETS LIMITED AS TO USE<br />

Internally designated for capital acquisition 16,868,561 15,856,534<br />

Long-term investments 2,532,073 2,363,289<br />

Held by trustee under indenture agreement – 10,036<br />

Total assets limited to use 19,400,634 18,229,859<br />

PROPERTY AND EQUIPMENT, net 26,640,357 26,281,732<br />

OTHER ASSETS<br />

Bond issuance costs, net 118,268 158,241<br />

Pledges receivable, net of current portion – 34,976<br />

Other assets 31,588 –<br />

Total other assets 149,856 193,217<br />

Total assets $61,389,592 $59,249,738<br />

CURRENT LIABILITIES<br />

Accounts payable and accrued expenses 4,439,830 4,788,297<br />

Accrued salaries and related amounts 2,588,985 2,381,258<br />

Estimated third-party payor settlements 42,205 672,288<br />

Deferred revenue 41,077 37,744<br />

Interest rate swaps 3,039,948 2,234,805<br />

Current portion of deferred annuities 25,998 21,421<br />

Current portion of capital lease obligations 186,821 165,808<br />

Current portion of long-term debt 356,137 –<br />

Total current liabilities 10,721,001 10,301,621<br />

Long-term debt, excluding current portion 251,555 237,400<br />

Capital lease obligations, excluding current portion 96,675 268,308<br />

Deferred annuity, excluding current portion 141,514 127,273<br />

Long-term deferred compensation 20,042,302 20,315,000<br />

Total liabilities 31,253,047 20,947,981<br />

NET ASSETS<br />

Unrestricted 28,715,934 26,616,043<br />

Temporary restricted 950,872 1,014,354<br />

Permanently restricted 469,739 369,739<br />

Total net assets 30,136,545 28,000,136<br />

Total liabilities and net assets $61,389,592 $59,249,738<br />

WHERE THE MONEY COMES FROM<br />

We billed for services to inpatients $22,246,287 $18,500,384<br />

We billed for services to outpatients 72,943,414 64,338,471<br />

We had other operating revenue of 1,279,891 1,806,115<br />

Total operating revenue 96,469,592 84,644,970<br />

BECAUSE WE DID NOT RECEIVE FULL PAYMENT<br />

FOR AMOUNT BILLED<br />

From those unable to pay<br />

(charity care based on charges) 701,280 716,603<br />

From Medicare and Medicaid 27,233,694 22,097,338<br />

From other contracted payors 9,442,835 8,475,825<br />

Therefore we wrote off 37,377,809 31,289,766<br />

OUR NET REVENUE WAS 59,091,783 53,355,204<br />

WHERE THE MONEY GOES<br />

To pay our employees salaries and benefi ts 34,424,757 31,187,029<br />

To purchase supplies and services 16,348,164 14,184,622<br />

To allow for wear and tear on buildings<br />

and equipment 2,778,271 2,458,670<br />

To pay for utilities 903,629 1,019,473<br />

To pay for interest on our outstanding debt 554,908 722,197<br />

To allow for those patients who are unwilling<br />

to pay (bad debt) – 2,318,282 2,322,945<br />

OUR TOTAL EXPENSE WAS 57,328,011 51,894,936<br />

THIS PROVIDES US AN OPERATING<br />

REVENUE OF 1,763,772 1,460,268<br />

We had income (losses) from investments<br />

and nonoperating revenue of 1,011,582 (262,417)<br />

FUNDS REMAINING TO PAY ON OUTSTANDING DEBT AND<br />

TO INVEST IN THE HOSPITALS FUTURE<br />

(new and replacement equipment,<br />

new technology, new services, etc.) $2,775,354 $1,197,851<br />

Percentage of revenue<br />

by payor mix<br />

Medicare<br />

33%<br />

Medicaid<br />

21%<br />

Commercial<br />

and other<br />

third party<br />

43%<br />

Operating<br />

expenses<br />

Supplies<br />

& services<br />

31%<br />

Self pay<br />

3%<br />

Benefi ts<br />

14%<br />

Salaries<br />

46%<br />

Amortization<br />

& depreciation<br />

5%<br />

Bad debts<br />

4%<br />

<strong>Annual</strong> <strong>Report</strong> <strong>2010</strong><br />

- 21 -<br />

<strong>Gifford</strong>’s Best Kept Secrets


corporators<br />

<strong>Gifford</strong> Corporators<br />

Corporators have been part of <strong>Gifford</strong>’s history and oversight<br />

for more than 100 years. Corporators meet annually to elect or<br />

re-elect members of the Board of Trustees, serve on committees<br />

and special advisory groups, and are liaisons and ambassadors<br />

between <strong>Gifford</strong> and the communities it serves.<br />

Sally Abel<br />

Martin & Grace Adams<br />

David & Peggy Ainsworth<br />

George & Beatrice Allen<br />

David & Karen Anderson<br />

David & Joan Angell<br />

Phil & Rosalie Angell<br />

Barbara Angell<br />

Bill & Betsy Arnold<br />

Edith Artz<br />

Ellen Baker<br />

Jerry & Nancy Barcelow<br />

David & Sandra Barnard<br />

Brooks & Susan Barron<br />

William & Shirley Baumann<br />

Mary Ellen Black<br />

Harvey Blackmer<br />

Robert Borden<br />

Marianne Brigham<br />

William & Diane Brigham<br />

Dick Burstein<br />

Paul & Margaret Calter<br />

Robert & Marguerite Caron<br />

Norm Case<br />

Lorraine Chase<br />

Linda Chugkowski<br />

Lincoln & Louise Clark<br />

Robert & Glenda Clarke<br />

Leo Connolly<br />

Jack Cowdrey<br />

Beverley Davis<br />

Betsy Davis<br />

Jean Day<br />

Bob & Roberta Dean<br />

Barbara DeHart<br />

Steve & Nancy Dimick<br />

Russ & Sharon Dimmick<br />

Paul & Marlene Dolan<br />

Louis & Becky Donnet<br />

Pierre & Carolyn Donnet<br />

Dick & Marjorie Drysdale<br />

Nancy DuBois<br />

Lang & Lorraine Durfee<br />

Anna Dustin<br />

Molly Eddy<br />

Rev. Kathy & Bob Eddy<br />

Betty Edson<br />

Dick Ellis<br />

Bill & Carol Ellis<br />

Ted & Ruth Elzey<br />

Richard & Phyllis Forbes<br />

Dr. Becky Foulk & Tavian<br />

Mayer<br />

Polly Frankenburg<br />

Benjamin Fratkin<br />

Ron & Judy Gadway<br />

Randy & Pauline Garner<br />

David & Gay Gaston<br />

Rick & Robin Goodall<br />

Joan Granter<br />

George & Kelly Gray<br />

Ray & Nancy Gray<br />

Helen Greenlee<br />

Freeman & Jean Grout<br />

Josephine Haikara<br />

Ty & Kim Handy<br />

Marvin & Barbara Harvey<br />

Skip & Sybil Hazen<br />

Cathy Hazlett<br />

Steve & Joyce Hill<br />

Don & Allison Hooper<br />

Richard & Bunny Huntley<br />

Judith Irving & Steven Reid<br />

Sheila Jacobs<br />

Paul Kendall & Sharon Rives<br />

Jim & Jean Kennedy<br />

Carroll & Marguerite<br />

Ketchum<br />

Joe & Beth Kittel<br />

Reed & Karen Korrow<br />

Bennnett Law<br />

Sandy Levesque<br />

Tim Caulfield & Linda Morse<br />

Fred & Holly Locke<br />

Betty Ludwig<br />

David Silloway & Lynne<br />

Gately<br />

Bruce & Karen MacDonald<br />

Dick & Jean Mallary<br />

Nancy Mandigo<br />

Lyndon Mann<br />

Mary Markle<br />

Steven & Ellen Martin<br />

John & Joyce Mazzucco<br />

Bob & Phyllis McAdoo<br />

Major Melvin McLaughlin<br />

Charlie & Becky McMeekin<br />

Ken & Carol Merrill<br />

Gus & Pat Meyer<br />

Judy Moore<br />

Dr. Robert & Dorsey Naylor<br />

Gib & Barbara Noble<br />

Peter & Kathy Nowlan<br />

Stuart & Margaret Osha<br />

John & Gail Osha<br />

Donna Osha-Mowatt<br />

Charles Page<br />

Michael & Sally Penrod<br />

Peggy & John Poffenberger<br />

Dr. Andy & Jil Pomerantz<br />

Scott & Nelda Putney<br />

Charles Register<br />

Ellen Reid<br />

Edith Reynolds<br />

Joyce Richardson<br />

Caleb & Trish Rick<br />

David & Barbara Rochat<br />

John & Kathrine Roe<br />

Marvin & Carol Rogers<br />

Wendy Ross<br />

Sam & Jinny Sammis<br />

Franklin & Jane Sanders<br />

Jim & Diane Sardonis<br />

Dan & Joan Sax<br />

Irene Schaefer<br />

David & Emma Schumann<br />

Anne Silloway<br />

Gary & Denise Simpson<br />

Charlie & Louise Sjobeck<br />

Michael & Huibertha Sorgi<br />

Arnold & Priscilla Spahn<br />

Margaret Steele<br />

Jeff Steinkamp<br />

Ellie Streeter<br />

Larry & Ellie Strode<br />

Donna Morris & Bill Sweat<br />

Carl & Florence Symonds<br />

Peter Symonds<br />

Sue Sytsma & Ken Stevens<br />

Al Wilker & Vance Smith<br />

Duane & Patricia Webster<br />

Steve Webster & Susan Cliff<br />

Charles & Kathy Welch<br />

John & Susan Westbrook<br />

Lewis Whitaker<br />

Gordon & Grace Wiggett<br />

Wink & Bonny Willett<br />

Chris Wilson<br />

Peter & Joyce Winslow<br />

Newall & Barbara Wood<br />

Joe & Pat Woodin<br />

Audrey Woodruff<br />

Bob & Rose Wright<br />

<strong>Gifford</strong>’s Best Kept Secrets - 28 -<br />

<strong>Annual</strong> <strong>Report</strong> <strong>2010</strong>


gifford clinic sites<br />

In Closing<br />

Thank you for taking this behind the scenes look at <strong>Gifford</strong><br />

<strong>Medical</strong> <strong>Center</strong> with us. We hope you enjoyed reading<br />

about your community medical center and just some of its<br />

many services. Thank you especially to the many patients<br />

who granted us the distinct privilege of telling their stories<br />

in this <strong>2010</strong> <strong>Gifford</strong> <strong>Annual</strong> <strong>Report</strong>. We wish you all well.<br />

Clinic locations<br />

Advance Physical Therapy, Wilder<br />

Physical Therapy<br />

Bethel Health <strong>Center</strong><br />

Family Medicine, Mental Health (private practice)<br />

& Adult Day Program<br />

Chelsea Health <strong>Center</strong><br />

Family Medicine & Clara Martin <strong>Center</strong><br />

<strong>Gifford</strong> Health <strong>Center</strong> at Berlin<br />

Endocrinology, Midwifery,<br />

Orthopedics, Pediatrics & Podiatry<br />

Kingwood Health <strong>Center</strong>, Randolph<br />

Cardiology (Fletcher Allen), Diabetes Clinic,<br />

Endocrinology, & Rehabilitation Services<br />

Rochester Health <strong>Center</strong><br />

Internal Medicine<br />

For more information<br />

To fi nd a provider, contact:<br />

<strong>Gifford</strong> <strong>Medical</strong> <strong>Center</strong><br />

44 South Main Street<br />

Randolph, VT 05060<br />

(802) 728-7000<br />

info@giffordmed.org<br />

or log on to the “<strong>Medical</strong> Staff ” and “Area Health <strong>Center</strong>s”<br />

pages on our Web site<br />

To volunteer, contact:<br />

Julie Fischer<br />

Volunteer Services Coordinator<br />

(802) 728-2324<br />

jfischer@giffordmed.org<br />

To learn about the many ways you can<br />

support <strong>Gifford</strong>, contact:<br />

Ashley Lincoln<br />

Director of Development, Marketing and Public Relations<br />

(802) 728-2380<br />

alincoln@giffordmed.org<br />

or log on to the “Giving” pages of our Web site<br />

Sharon Health <strong>Center</strong><br />

Adult Medicine, Chiropractics, Physical<br />

& Occupational Therapy, Podiatry, Sports Medicine<br />

& a Certified Athletic Trainer<br />

Twin River Health <strong>Center</strong>, White River Jct.<br />

Urology<br />

www.giffordmed.org


<strong>Gifford</strong> <strong>Medical</strong> <strong>Center</strong><br />

44 South Main Street<br />

PO Box 2000<br />

Randolph, VT 05060<br />

Non Profi t<br />

U.S. Postage<br />

PAID<br />

Permit # 165<br />

Burlington, VT<br />

<strong>Gifford</strong> <strong>Medical</strong> <strong>Center</strong><br />

44 South Main Street<br />

Randolph, VT 05060<br />

(802) 728-7000<br />

www.giffordmed.org<br />

Bethel Health <strong>Center</strong><br />

1923 Route 107<br />

Bethel, VT 05032<br />

(802) 234-9913<br />

Rochester Health <strong>Center</strong><br />

235 South Main Street<br />

Rochester, VT 05767<br />

(802) 767-3704<br />

<strong>Gifford</strong> Health <strong>Center</strong> at Berlin<br />

82 East View Lane<br />

Barre, VT 05641<br />

(Just off Airport Road in Berlin)<br />

(802) 229-2325<br />

Twin River Health <strong>Center</strong><br />

108 North Main Street<br />

Whiter River Junction, VT 05001<br />

(802) 296-7370<br />

Chelsea Health <strong>Center</strong><br />

356 Route 110<br />

Chelsea, VT 05038<br />

(802) 685-4400<br />

Sharon Health <strong>Center</strong><br />

12 Shippee Lane<br />

Sharon, VT 05065<br />

(802) 763-8000<br />

Kingwood Health <strong>Center</strong><br />

1422 Route 66<br />

Randolph, VT 05060<br />

(802) 728-7100<br />

Advance Physical Therapy<br />

331 Olcott Drive, U2<br />

White River Junction, VT 05001<br />

(Just off Route 5 in Wilder)<br />

(802) 295-7333

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