Tuesday's GOP primary for Flanders' seat

Results of Tuesday's Republican primary race for the seat of the late state Rep. Don Flanders, R-Laconia. Winner will face Democrat Philip Spagnuolo Jr., in a Belknap County District 3 special election on Feb. 27.


Les Cartier, 96 - winner


William Henry Davies, 37

Losses at LRGH

Hospital considers cutbacks in response

By RICK GREEN, LACONIA DAILY SUN

LACONIA — LRGHealthcare, which runs Lakes Region General Hospital and Franklin Regional Hospital, is considering potential cutbacks in services, including maternity care, after three months of poor financial performance.

The not-for-profit organization had an operating loss of more than $1 million in October and November and is expecting further losses when December numbers are compiled.

President and CEO Kevin Donovan said action is needed to stem the losses, but no firm decisions have been made.

Maternity services are under the microscope because they lose money.

“We lose $2 million to $3 million per year on the program today and 2018 is projected to be worse,” Donovan said.

“Second, the birth rate in our program and service area is dropping rapidly. Births have dropped from 348 in 2015 to 283 in 2017 and we are projected to deliver around 270 babies in 2018.

“Finally, it is proving close to impossible to attract providers to cover the services with a sustainable call frequency.”

Aging population

Medicaid pays for 60 percent of the program's births, which are declining locally amid an aging population and a preference by some women to have their babies elsewhere.

“Belknap County is one of the oldest in the state and is projected to continue to age so that by 2020, 32 percent of the population will be over the age of 65,” Donovan said.

For a normal newborn, direct costs associated with the delivery of a baby amount to $10,700. Medicaid pays $2,250 of that total.

Also, LRGH sees more than double the state average of babies born with drug dependency, or neonatal abstinence syndrome, a condition that greatly increases costs for medical care.

Financial challenges

The company has had financial challenges for several years.

In 2016, it recorded an operating loss of $1.8 million, an improvement over the prior-year loss of $11.3 million. In the 2017 fiscal year, which ended with Sept. 30, the organization was $1.5 million in the black on operations.

The finances seemed positive until light patient volume combined with low payments in October through December hurt the bottom line.

Federal role

In a memo written to employees, Donovan said the U.S. Department of Housing and Urban Development, which insures $117 million in the company's debt, “is worried.”

The federal department has a role in making sure the company's financial performance allows it to live up to its obligations.

“Because the U.S. government is insuring that debt, they have controls over us to mandate performance,” he said. “They get very nervous when our performance starts to go in wrong direction.

“They could bring in consultants to turn things around. My belief is we would much rather be thoughtful about our own situation with local control.”

Likewise, decisions made on the national level about the Affordable Care Act also affect financial performance locally.

Congressional action to eliminate the individual mandate, which penalized people for not buying medical insurance, will lead to fewer people having insurance and a greater number of patients who will not be able to pay for services, Donovan said.

National trend

Meanwhile, smaller hospitals across the country have been feeling financial stress, and maternity programs, which are expensive to maintain, have been closing.

A University of Minnesota study shows that more than half of rural counties in the U.S. have no hospital where women can give birth.

At the same time, many communities feel strongly that those services should be available.

“That's an emotional discussion for people, and rightfully so, as it relates to family birthplace,” Donovan said.

He said a range of options are being examined.

One possibility is a partnership arrangement that would allow maternity services to be provided in a more economical way.

Lakes Region General Hospital has 132 beds. Franklin Regional Hospital is a 25-bed hospital. The system also has 22 affiliated medical practices and service programs.

 

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Hooked on ice

02 11 Ice Harvest 5
It takes many hands to harvest the 200 tons of ice from Squam Lake needed to serve the Rockywold-Deephaven Camps through the summer season. (Tom Caldwell/Laconia Daily Sun)

Century-old practice continues on Squam Lake

By THOMAS P. CALDWELL, LACONIA DAILY SUN
HOLDERNESS — By the time ice-in was declared on Lake Winnipesaukee last week, the ice at Squam Lake’s Deep End was close to harvest.
For the crew at Rockywold-Deephaven Camps, it was a sign that the weeks of preparation were ready to culminate in three short days of sawing and transporting ice from the lake to the camps’ ice houses, where they will serve campers who come to spend time there next summer.
In a tradition dating back to the late 1800s, the crew continues to monitor ice conditions, looking for the thickness to reach 12 inches, the ideal amount for ice blocks. Each 15.5-inch by 19.5-inch by 12-inch-thick block weighs 115 pounds, and the camps need about 3,600 blocks — more than 200 tons of ice — to last through the summer.
The crew also includes volunteers working in exchange for their own ice. Among them are C.C. and David White, who are living “off the grid” in Sandwich.
C.C. said they were originally from New Hampshire but had moved to Maine. They decided to return to New Hampshire to “live gently off the earth” and they arranged to help the Rockywold-Deephaven crew so they could obtain the 125 blocks of ice they would need during the coming year. She said that, with 125 blocks, they never run out of ice and, this year, they still have some of the ice they harvested last year.
She described the Rockywold-Deephaven crew as being like family, even if they only get together once a year.
That family was missing one of its own this year, as Norm Lyford of Ashland, who had helped with the ice harvest for 72 years, could not participate this year, due to a heart condition.
Lyford’s father had worked for the camp, and Norm would accompany him on many occasions, so he grew up as part of the Rockywold-Deephaven family. At age 18, he started working there, as well.
Before refrigeration, iceboxes were common, and ice harvests kept them stocked with ice. Jon Spence said the Gifford-Wood Company made most of the ice-harvesting equipment that the camp still uses today, but the Holderness camp is one of the only remaining ice-harvesting operations. Most businesses, such as the Laconia Ice Company, make their own ice today.
Lyford said Rockywold-Deephaven Camps once considered switching to refrigerators. The camp purchased seven of them one year, planning to gradually replace the iceboxes in the cabins.
“The campers objected,” Lyford said in a 2015 interview. “They didn’t want them. They liked being able to take an ice pick and chop the ice off, and they said they wouldn’t come back again unless they got the iceboxes back.”
Safety first
Last week, the ice at Deep End measured between 9 and 10 inches, so John Jurczynski set up a safety orientation for Friday in preparation for beginning the harvest on Monday when the ice was expected to reach the desired 12 inches in thickness.
Due to the extreme cold, the ice had reached between 11 and 14 inches by Sunday, an unusual variance. Because of the thinner ice along the shore, Jurczynski decided to limit the number of trucks on the ice to one at a time.
Safety is a big concern, and the camp has a manual setting out the procedures to make sure the ice harvest is efficient and safe. It covers clothing, including ice cleats to prevent slippage on the ice, as well as signs to indicate thin ice and building a ramp to get trucks on and off the ice safely.
Spence said it takes weeks of preparation to make sure the equipment is ready for service, and the harvest area has to be cleared of snow before any equipment is brought onto the ice. They also bring a tool shed, ice ramp, and loading chute onto the ice.
The power equipment needed for an ice harvest includes a circular ice saw and chainsaws, and Spence said they make sure they have two of each, including a spare engine for the circular saw, because if they miss their window of opportunity, the ice conditions will change and make the harvest impossible.
He said the current ice saw is the second the camp has had, and it is on its third engine. The saw rests on the camp’s original sled — also made by Gifford-Wood, according to Spence.
By the time they began operations on Monday, the ice had reached 15 inches, which increased the weight to 144 pounds per block. Jurczynski said that makes the harvest quicker, but it also makes it more difficult to move the ice, and results in more irregular blocks.
Those irregular blocks still serve a purpose. The crew places them around the perimeter of the harvest field where they serve as a warning to snowmobilers and others that the ice will be thinner and unsafe there.
The operation
Carl Hansen operated the ice saw on Monday, first creating a 50-foot channel leading to the chute. The circular saw cuts within a couple of inches of the bottom of the ice but avoids getting into the water to prevent ice buildup on the blade. Chainsaws and handsaws complete the cuts.
The ice saw then carves a grid, again not cutting all the way through the ice, to set the size of the blocks at 19.5 by 15.5 inches.
Once those blocks are sawn into rows, ice pikes are used to move them up the channel toward the ice chute. An ice hook attached to a winch on the platform is placed behind each section of five blocks and the winch pulls the blocks up the chute where they are then loaded onto the waiting truck.
Hand shovels and scrapers are employed to clear away any accumulated snow before the ice saw makes its cuts, and ice picks break out the ice cakes from the field in four-foot lengths. Ice tongs lift the blocks along the edge of the edge of the ice field, and are used to unload the ice in the icehouse.
Jurczynski said the ice house is insulated with sawdust. As each level of ice is unloaded, the tops of the blocks are shaved to create a smooth, even surface for the next layer of ice. Once the ice house is filled, sawdust is put over the top to provide the additional insulation that will keep the ice from melting before it is needed during the summer months.
Spence said it isn’t over when the ice harvest ends. The crew then oils and stores away the equipment for the next year, repairing or replacing any damaged equipment. All on-ice structures are removed and stored away.
There is even a use for leftover ice. Spence said he was asked to come up with something, and he drilled a hole in the blocks and placed candles inside to make luminarias for the camp.
When summer arrives, guests will have their ice delivered in wheelbarrows to stock the iceboxes that will keep their beverages and snack items cold during their stay.
Proof that the tradition will last is the number of campers who came as children and still return each year in adulthood — some of them into their 90s.
02 11 Ice Harvest 1
Blocks of ice harvested from Squam Lake in January will serve the iceboxes of the Rockywold-Deephaven Camps and a few other locations next summer. (Tom Caldwell/Laconia Daily Sun)
02 11 Ice Harvest 2
John Jurczynski secures a winch to blocks of ice being harvested from Squam Lake on Monday. (Tom Caldwell/Laconia Daily Sun)
02 11 Ice Harvest 3
When the ice becomes too thick — more than 15 inches — it can have irregularities that cause it to be sidelined. The rejected blocks still serve a purpose: They are placed around the perimeter of the ice harvest area to warn snowmobilers or others out on the lake that the ice that reforms over the hole is not safe. (Tom Caldwell/Laconia Daily Sun)
02 11 Ice Harvest 4
Carl Hansen operates the circular saw that cuts the lake ice into blocks, after C.C. White, in the background, has used a shovel to remove the snow from that area. (Tom Caldwell/Laconia Daily Sun)

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