Changing of the guard: Warren takes over as CEO of LRGHealthcare

LACONIA — "I'm picking up the baton Chuck is handing off," remarked Seth Warren, who will take up the reins as chief executive officer of LRGHealthcare next month, succeeding Chuck Van Sluyter, the interim CEO appointed when Tom Clairmont retired a year ago.

Warren and Van Sluyter yesterday discussed the transition together with the strategic plan developed by the Board of Trustees, staff, partners and patients to address the changing health care marketplace.

Warren has spent the last 16 years with the Sisters of St. Francis Health Services, Inc. or Francisan Alliance, a Catholic health care system headquartered in Mishawaka, Indiana consisting of 13 hospitals and numerous clinics, with 18,000 employees, the last six as president of St. James Hospital in Chicago Heights and Olympia Fields, Illinois, a 400-bed teaching hospital. He is well acquainted with the challenges posed by the aging, uninsured and underinsured population served by LRGH as 45 percent of the patients at St. James Hospital were enrolled in Medicare and another 15 percent in Medicaid.

"I came in with my eyes wide open," said Warren, moving Van Sluyter to add "there's no place to hide."

Warren said that the overarching objective will be to provide a continuum of care with the goal of "trying to keep people out of hospital," where both the hospital and its patients incur costs that can be avoided by a regimen of preventive care, managing illness and wellness programs.

The strategic plan sets a number of priorities. First and foremost it calls for assessing the needs of the population LRGH serves and tailoring services to meet them, which will include expanding the walk-in clinic — Convenience Care — along with pediatric and gynecological services. At the same time, in partnership with Genesis Behavioral Health, Horizons Counseling Center and other agencies LRGH will seek to improve and integrate treatment for mental illness and substance abuse mental health in the community.

LRGH will enhance and pursue its collaborative relationships with other healthcare and social service providers in the region to ensure a seamless experience for patients. Tightening communication and procedures between health care providers in different departments within LRGH and with other agencies in the community will improve management of patients and outcomes of treatment. And telehealth services, like those used to treat stroke victims in partnership with Massachusetts General Hospital, will be expanded.

Van Sluyter said that several other initiatives are already underway. The emergency department will be expanded. The debt will restructured. And communications about the treatment and conditions of patients between practitioners within the hospitals will be computerized through a partnership with the Speare Memorial hospital in Plymouth.

Of all LRGH's collaborative relationships the Granite Health Network, a consortium of five of the largest hospitals in the state formed in 2011, is especially promising. The aim of the partnership is to leverage clinical and administrative resources of the members to improve the quality and efficiency of medical services. Van Sluyter said that efficiencies approaching $5 million have already been achieved.

Earlier this year the network announced the Tufts Freedom Plan, a provider-payer insurance company administered by the Tufts Health Plan, in which the 18,000 employees of the five member hospitals will be enrolled. The company will ultimately compete throughout the state with other other health insurance carriers.

Meanwhile, Warren will be faced with improving the financial performance and condition of LRGH in the teeth of what he called "payment pressures — lower, slower, no payment." This week Moody's investment services lifted its negative outlook for nonprofit hospitals, like LRGH, which has been in pace since 2008, noting that prospects have improved especially in states, including New Hampshire, where Medicaid enrollments have been expanded.

Warren said that although reimbursement rates could be higher, as the number of insured patients has grown, the volume of emergency room visits has declined and the opportunity to manage chronic illnesses, sparing patients costly acute care services, is greater. On the other hand, he said that payments to hospitals are more closely tied to the quality of the care they provide — as measured by readmission and infection rates, for example — placing a premium on operating excellence and efficiency.

"Chuck was the change agent," Warren said. "He marked the pathway for me to follow."

"But, you have to implement the plan," Van Sluyter replied, adding that "the higher you climb, the more the horizon embraces."

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At Laconia VFW, Bush says U.S. needs to fix 'a few big things.. to really take off'

 LACONIA — Much more of a presence on stage than on screen, Jeb Bush drew an enthusiastic response from a crowd numbering more than 200 at the VFW Post 1670 last evening with remarks ringing with aspirations rather than stinging with anger as, in his words, he campaigned "with joy in my heart and arms wide open."

Touting his record of shrinking the government while expanding the economy in his two terms as governor Florida, Bush began by saying "if we fix a few big things, complex thing, this country is going to really take off." As a governor, he said, he was "a disrupter" and as president would "turn the place — Washington, D.C. — upside down."

With a balanced budget amendment to the constitution and a line-item veto for the president, Bush said fiscal order would be restored. Rescinding the "mind-numbing" rules and regulations that stifle enterprise and innovation, he continued, would spur the expansion of industry and commerce. And lowering taxes while simplifying the tax code would stimulate investment. Setting a target of economic growth of four percent for the next decade, Bush asked "why don't we try?"

Success, Bush said, would require a more peaceful world, which only American leadership could ensure. "Our enemies don't fear use and our friends don't know where we are," he remarked. The Obama Administration, he noted, has improved relations only with Iran and Cuba while relationships with our closest allies have soured. The diminishing numbers of men and women under arms, he said, "sends a signal that we're not serious about leading the world" while the nuclear accord with Iran legitimized their effort to develop a nuclear weapon. "The military option should never be taken off the table," he declare. "It only empowers your enemies to behave in the way you don't want them to behave."

Bush sparingly referred to Donald Trump, his principal antagonist among the 17 candidates in the GOP field. He spoke of candidates "preying on fear and angst, one larger than life" in particular, then, twice mentioned Trump by name and charged "this guy is not a conservative, He doesn't believe in the greatness of this country."

Asked if he would engage Trump, he shot back "I will not participate in some reality TV show. This is not about Donald Trump," he continued. "It is about people who have lost their optimism." However, he added that if Trump were ugly or insulting about his person or family "damn right I'm going to fight back."

While affirming his conservatism, Bush spoke about the importance of restoring "a degree of civility," "shared values" and " common ground" to politics and government and, in support of his own candidacy added to his record of success as a governor his "willingness to campaign outside the comfort zone."

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Group continues work toward establishing new shelter for area homeless families

LACONIA — After nearly two years of examining the homeless situation in Laconia, a group of people representing various area social service agencies have determined there is a need for a cold-weather homeless shelter for families in the area.

Colleen Garrity is the president of Belknap House — a fledgling not-for-profit agency that is in the process of raising money for a building and property somewhere in or very close to Laconia. Once established, it will be open from October until May.

"Over the past five years we've seen the number of homeless families increase and it's made us feel quite helpless," Garrity said.

Currently there is one shelter, the Salvation Army-owned Carey House, that serves all of Belknap County and it has space for only three families at a time. As an outreach worker for St. Andre Bessette Catholic Church, Garrity works on the front lines of homelessness and is one of the first calls people in need of emergency shelter make.

"This is very real and it's not getting any better," she said.

Belknap House has a Website: and a Facebook page. She said there are various subcommittees created and one of them is tasked with fund-raising.

So far, she said there have been some restaurant-sponsored fund raisers and a golf tournament scheduled for Lochmere Country Club on September 14. Garrity said they are still accepting entrants for the golf tournament and there are a few holes that still a sponsor.

Garrity said the initial goal is to raise $50,000 to $60,000 through fund-raising and grants so they can find a piece of property for consideration. She said before it could be used it would have to be ADA compliant and sprinkled. She said she hopes there will be some case work and life-skills services that will be provided by the shelter staff as well as shelter from winter's cold.

"We know this is a process," she said, adding that from the beginning of a similar shelter in Portsmouth until it became a reality took more than three years.

"We'll keep plugging away and keeping people aware of the problem in Belknap County," said Garrity.

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