Changing market presents challenges for LRGHealthcare

MEREDITH — The leadership and trustees of LRGHealthcare spoke of addressing the challenges of the changed marketplace for health care through partnerships with regional institutions and local agencies within the community of providers. "Collaboration," reads the annual report, "is now a basic requirement in healthcare to make needed resources and services available to patients."

The challenges of the changing environment were reflected in the financial report by Henry Lipman, senior vice president of financial strategy and external relations. Although operating expenses rose little more than $2 million, operating revenue fell by about the same amount, shrinking income from operations to $353,000, compared to $4.5 million a year ago. Meanwhile, non-operating gains jumped from $133,000 to $2.3 million, enabling the corporation to post a positive net margin of 1.2 percent.

Lipman said that the decline of operating revenue reflected changes in the insurance market, which find more individuals and families paying a greater share of the coverage provided by employers. When they cannot defray the cost, it is absorbed by the provider. At the same time, as the population ages, more are covered by Medicare, which fails to reimburse providers for their full costs. And with pressures on nursing homes, the hospital has been pressed to place older patients, particularly those with infirmities or dementias, requiring care after treatment, which has increased lengths of stay.

Lipman stressed that LRGH is in sound condition, paying its bills on time, servicing its debt, funding its pension obligations and holding sufficient cash reserves. But, he acknowledged that the operating results are "representative of a challenging trend," which LRGH is meeting by increasing productivity by offering value added services and pursuing partnerships."

The most significant of these partnerships, the Granite Health Network (GHN) was formed in April 2011 when five of the largest hospitals in the state — LRGHealthcare, Catholic Medical Center, Concord Hospital, Southern New Hampshire Health System and Wentworth-Douglass Hospital — joined to leverage their administrative and clinical resources to enhance the quality and improve the efficiency of medical care. Together the quintet employs 15,000 people, including 900 physicians, serves 500,000 individuals and counts operating revenue of $1.5 billion.

Chuck Van Sluyter, interim president and chief operating officer, said that the GHN has achieved clinical and operating efficiencies of $4.5 million, including trimming the costs of laboratory tests and blood products while the introduction of Cigna's accountable care model has spared LRGH $250,000 in the past two-an-a-half years.

In January, GHN announced the Tufts Freedom Plan, a provider-payer insurance company administered by the Tufts Health Plan. The employees of the member hospitals will be enrolled in the plan, which will compete in the New Hampshire marketplace.

Dr. Peter Doane, chief medical officer, said that the partners of GHN are sharing their expertise and experience to develop standardized care protocols ground in sound evidence and best practices. Among the protocols followed throughout the system are those for management and treatment of chronic asthma and acute low back pain. In addition, there is a protocol for identifying and treating patients suffering from depression, whose healthcare costs are 50 percent higher than those of other patients.

Maggie Pritchard, executive director of Genesis Behavioral Health, traced the agency's partnership with LRGH to 2005 and noted that it has grown closer ever since. In particular, she stressed that patients suffering from mental illness are more likely to seek help at the emergency department, an ineffective and expensive setting, in the Lakes Region than elsewhere in New Hampshire. Greater investment in the outpatient services Genesis provides, she said, will enable those with mental illness to live healthier, more productive lives while sparing the hospital the cost of housing patients while awaiting treatment in an appropriate setting.

LRGH recently partnered with Massachusetts General Hospital to diagnose and treat patients with strokes using video conferencing and image sharing technology. Dr. Fred Jones, chief of emergency medicine, and Kendra Peaslee, director of emergency services, explained that specialists in Boston can examine patients and sitting in the emergency room of both Lakes Region General Hospital and Franklin Regional Hospital in less than 25 minutes.

Bill Grimm of Franklin, who joined the board of trustees of Franklin Regional Hospital in 2000 and has been a trustee of LRGH since the merger in 2002, was honored with the Sally Proctor Award. In presenting the award Scott Clarenbach, chairman of the board of trustees, emphasized his contribution to the safety of patients. A member of the Quality Improvement Committee, Grimm worked closely with Gloria Thorington, director of medical safety and health management, to fashion a scorecard to measure the strengths and weaknesses of the organization. He considers everyone — patients, employees and members of the community — stakeholders and when the board tackles an issue is the first to ask "what about the stakeholder?"

Pritchard received the Rhoda C. Ladd Award. Clarenbach described her as "passionate and instrumental" and called her "an incredible advocate" who has been "a great support to LRGHeathcare." Despite the challenges of constant change and decreasing financial resources, Pritchard, he said, has recruited a strong team to meet the mental health needs of the community. She championed the opening of the psychiatric unit at Franklin Regional Hospital and helped to bring telepsychology to the emergency department of LRGH.

Job fair draws diversity of employers, seekers

LACONIA — A job fair, featuring a diverse array of nearly three dozen local employers and four employment agencies, drew more than 300 people, a significant number of high school students among them, to the ballroom of the Margate Resort yesterday.

The fair was presented by the Lakes Region Chamber of Commerce, whose executive director Karmen Gifford said she was very pleased to have such a healthy mix of employers and so many students from Belmont, Franklin, Gilford and Laconia come searching summer jobs and eying future careers.

Many of the businesses, including landscapers, restaurants, retailers and resorts, were primarily seeking seasonal employees, but not exclusively from the ranks of students.

Josh Lemire of T-Bones & Cactus Jacks said he expects to add between 35 and 40 employees to the normal complement of about 50 to handle the heavier customer volume during the summer. He anticipated many of his hires would not be looking past the summer, but said that the company was always looking for good employees and willing to offer the most promising permanent positions. Lemire, who has been with the company for 16 years, said those wishing to work in the hospitality industry would find the compensation and benefits attractive and competitive.

Abby Young of Centerplate Inc., the food and beverage concessionaire seeking 100 people to staff its operation at the Bank of New Hampshire Pavilion at Meadowbrook, said jobs waiting tables, tending bar, preparing food and washing dishes are seasonal which pay an inexperienced employee $8 or $9 an hour. But, she added that Centerplate operates across the country, and for good workers "there is room to grow within the company." She said she had taken many applications, including some from former employees.

Amanda Ouellet, assistant manager of the Taco Bell restaurant set to open on in place of Kentucky Fried Chicken on Union Avenue next month, said that she needs 40 or 50 employees, about half of them full-time, adding: "We're right where we want to be." Noting that there is "lots of turnover" in fast food franchises, she welcomed the applications submitted at the fair.

Several retailers from Tanger Outlets seeking to gird up for the summer season were offering part-time jobs starting at minimum wage. One representative of a major brand said that most of the stores at the mall have only two full-time employees, the manager and an assistant, and staff the sales floor with part-timers.

Kathy Nelson, assistant vice president of Bank of New Hampshire, said the bank is seeking to fill 15 positions throughout its organization, most requiring experience, but also some entry-level jobs.

"We're seeing qualified applicants," she said, explaining many are seeking full-time work in place of part-time jobs. She said that the bank is expanding and anticipates there will be new positions to fill.

Hannaford was also seeking additional employees for the summer, 30 for its store in Gilford, and 50 or 60 for its store in Meredith. Kim Sansoucie said, "There is a lot of competition for employees, but so far we've been very lucky."

"We're always hiring," said Nicole Lemelin of the Lakes Region Community Services, who was seeking "direct support professionals" to work closely with the disabled. She said that the agency provides the necessary training and pays between $10.68 and $14,72 an hour plus travel expenses. "It's been a good day," she said, pointing to a stack of applications. 

Aavid Thermalloy, New Hampshire Ball Bearing, EFI, three of the premier manufacturers in the region, had a presence at the fair. Representatives of all three said they were competing for employees in a shrinking pool of talent. Chris Currier of EFI said that the firm is seeking to expand and requires software, mechanical and electrical engineers, which are in short supply. He said that the company employs 350 people, eight out ten of whom are skilled employees.

Arthur Karageorges of Aavid Thermalloy explained that the Laconia facility designs and develops products, which are subsequently manufactured in plants with lower operating costs. Consequently, the local workforce is highly skilled. "It's difficult to get qualified people," he confessed. "we never have enough CNC (computer numerical control) operators." Karageorges said the company offers two internships each year and has partnered with the manufacturing programs at the Huot Technical Center and Lakes Region Community College. "And we've had a couple people stop by today," he said. "I try to bring them her between June and September," he laughed, "so they miss the winter."

Nicole Murray, human resources administrator at New Hampshire Ball Bearing, echoed her counterparts at EFI and Aavid. "There's a huge knowledge gap," she remarked, explaining that experienced employees are retiring in growing numbers, taking 40 or 50 years of exceptional skill and institutional memory with them. "We're trying to bring in experienced help," she said. "When we find experienced machinists, we're throwing cookies at 'em. And we found one today."

Like Jeremy Hiltz of Hiltz Excavating Inc. of Ashland, said finding capable employees is "the biggest challenge in our industry." He said that someone who starts at $12 an hour "gets paid to learn," but the work offers opportunities to earn a six-figure income. He suggested that too few have "the patience to start at the bottom and work their way through the ranks." He said he found one potential employee at the fair.

With unemployment dropping below 5 percent in the Lakes Region as the summer tourist season approaches, several innkeepers, restaurateurs, landscapers and retailers said that the fair provided a good opportunity to reach young people seeking seasonal and part-time work. Those businesses appeared to draw the most applications, leaving the manufacturers fishing the same small pool and the excavator eager to pay someone to learn.

Laconia metal roofing contractor faces criminal charges

TILTON — A former Laconia metal roofing contractor is facing criminal charges in Massachusetts for allegedly taking a check for $16,066 in September 2013 from a Pepperell, Mass., man and not performing the roofing work for which he was contracted.

Jonathan Taylor, 47, of 3 Daniel Drive in Tilton, is facing one felony charge of larceny greater than $250 by false pretenses in the Ayre, Mass. District Court, said Pepperell Police Lt. Todd Blain earlier this week. A spokeswoman from the Middlesex County Attorney's Office said yesterday that Taylor's case is still ongoing and he is next scheduled in court on April 22.

Taylor has also been arrested by Tilton police on charges that he issued bad checks. He is due to be arraigned for these charges later this month in Franklin.

Taylor, who filed for bankruptcy protection 16 months ago, operated his business, Northeast Metal Roofing Inc., from an address on Court Street in Laconia.

"He took my check and I never had contact with him again," said Dominick DiMassino. "He left me with a house that was stripped and tarped in October."

DiMassino said he met Taylor at a metal roof raising party. "He gave me a card, he came down and I got a quote," DiMassino said.

While DiMassino was infuriated by Taylor's alleged actions, he said he became concerned about others who may be victims after he did some Internet research. He also wants his money back.

Efforts to speak to Taylor's attorney for comment were unsuccessful.

As DiMassino was doing his online research he reached out to Hollie Ottman of Tilton who had a similar encounter with Taylor in August 2014 and was also searching for other victims on the Internet.

In a police report created by the Tilton Police Ottman says that she agreed to hire Taylor to put a metal roof on her house. She told police she gave him $500 in cash for a down payment in July 2013.

She gave him an additional $1,000 after he gave her an estimate of $3,000 to complete the job and told her it would take him two days and the work would be done in August.

Police records indicate Taylor told her he needed money for the materials and she gave him another $1,000, bringing the total she had given him to $2,500. Three days later, on Aug. 28, 2014, he told her he was running behind.

She told police he gave her a number of reasons why he said no metal had been delivered to her house and was told that the distributor "messed up the order."

In September he said he was working in Massachusetts and would find out about the metal. She said he began ignoring her text messages.

When she called the metal distributor she learned that Taylor had not ordered the metal and she said she became afraid she had been ripped off.

She contacted the police who began calling Taylor who told the investigating officer that he wanted to reimburse Ottman.

On Sept. 20, the officer learned from Ottman that she had not gotten her money, so he called Taylor again. The two agreed Taylor would pay Ottman by Sept. 22. When she hadn't been paid by Sept. 24, the officer called Taylor again but never got a call back.

The officer recommended that more follow-up was needed and the case was brought to the Belknap County Attorney's Office for a review to see if any criminal charges could be brought.

County Attorney Melissa Guldbrandsen said this week that she reviewed the case and determined that at this point she would not be able to get a criminal conviction because she would be unable to prove that Taylor intended to steal from Ottman when he took her money.

She also said that larceny and theft laws in New Hampshire and Massachusetts differ, and that she was unable to comment on what happened in Pepperell, Mass.

Tilton Police Chief Robert Cormier said yesterday that Taylor was arrested by his department for issuing bad checks in a case unrelated to Ottman's. He said he was released on $1,500 personal recognizance bail and is scheduled to appear in the 6th Circuit Court, Franklin Division on April 27 for an arraignment.

The Sun learned that Taylor has filed for Chapter 13 bankruptcy protection in January 2014. His filings with the U.S. Bankruptcy Court, New Hampshire District show he has assets of about $13,000 and debts greater than $204,000.

Neither DiMassino nor Ottman knew about the bankruptcy filings and both said they would be contacting their own lawyers to see if it would make sense to join the list of Taylor's creditors that already include the Internal Revenue Service, the N.H. Department of Labor, and the N.H. Division of Human Services, Office of Child Support.

Ottman and DiMassino say they have spoken to a number of other people in both New Hampshire and Massachusetts whom they believe were also victims of Taylor or his now dissolved company.

As for DiMassino, he said he tracked down Taylor's metal supplier in Maine who referred him to a roofer who finished the job.

DiMassino said he paid the roofer who finished the job and he is very happy the roof was complete by snowfall, but said he is still furious that he was taken for $16,000.

Ottman is not giving up. She said she has contacted other victims and is encouraging them to go to their local police departments and file complaints. Her hope is that if enough people file legitimate complaints the Belknap County Attorney's Office will be able to do something.

Taylor's attorney, Raymond J. DiLucci, did not return The Laconia Daily Sun's phone call. His bankruptcy case has been continued to April 28.

Phase II of WOW Trail gets Planning Board OK

LACONIA — The Planning Board has agreed to recommend the plan for the second phase of the Winnipesaukee-Opechee-Winnisquam (WOW) Trail to the City Council for approval.

Two of the board's members -- Bill Contardo and Jay Tivnan -- dissented from the board's position. Cantardo lives in South Down Shores, and Tivnan is a resident of Long Bay. The third phase of the WOW trail is planned to pass through both condominium communities, along the western shore of Paugus Bay. Residents there have voiced opposition to the route, proposed alternative routes and contributed to a legal fund to challenge construction of the third phase of the trail.

Warren Hutchins, chairman of the Planning Board, explained that since the WOW Trail is a municipal project, it does not require the approval of the board, but was presented as a courtesy.

Jay Poulan of HEB Engineering Inc. of North Conway, explained to the board this week that the second phase begins at the Laconia Public Library and runs to the Belmont town line, where it joins a paved path. For most of its 5,000 feet the trail will be built within the railroad right-of-way. He said that there would be two sections of boardwalk outside the railroad right-of-way to cross wetlands near Bartlett Beach and a bridge would be built to cross Durkee Brook.

Two property owners raised objections to the route. Jeff Joyce of 361 Court St., spoke for himself and his father, who owns the property next door at 373 Court St. The two properties are the westernmost private lots within the city on the north side of Court Street.

Joyce said that the commercial building at 373 Court St. actually encroaches into the railroad right-of-way. He said that the trail, together with the chain link fence required by the Bureau of Rails of the New Hampshire Department of Transportation (DOT), would obscure the view of the lake from both properties and impair their value. Moreover, he was concerned about how construction of the trail would add to stormwater run-off on to both lots. Finally, he feared that the trail would attract undesirable elements, who already walk back and forth between Laconia and Belmont along this route, which is often strewn with litter of all sorts.

Poulan said while the trail would run close to the two properties neither would be affected by the drainage, which would be designed to carry stormwater toward the lake. Alan Beetle, president of the WOW Trail, said that fears of loitering and vandalism are misplaced, recalling that residents of Moulton Street expressed the same concerns when the first phase of the trail was designed. He said that as more and more people used and maintained the trail the problems residents anticipated diminished.

Robert Dupont, who owns half-a-dozen properties further east on Court Street, including a lot with more than 300 feet bordering the railroad right-of-way and a scrap of shorefront just west of the outlet of Durkee Brook, also objected to proximity of the trail to his property. Like Joyce, he took special exception to the chain link fence. He suggested routing the trail through Keasor Court and along Court Street, offering donate land to facilitate an alternative route.

City Councilor David Bownes (Ward 2), the council's representative on the Planning Board, said that while he was reluctant to change the route of the trail, he recognized that the requirement of chain link fencing along its route was a legitimate concern of abutting property owners. At his initiative the board agreed to urge the City Council to press the DOT to substitute the chain link fence with more aesthetic fencing like a split rails, particularly where the trail is adjacent to residential properties.