Amid takeover and pandemic, Concord hospital looks to the future
After a year of unprecedented turmoil, caused not only by the pandemic but also by the region’s biggest healthcare consolidation in decades, Concord Hospital’s finances appear to be back on track.
“From the end of February up to where we are sitting today, the (patient) volume has returned… to normal and we are experiencing what I would consider a more normal year. Our operating margin is around 3%, ”said Scott Sloan, the hospital’s chief financial officer, in a recent discussion with the Monitor.
Sloan said the hospital, a nonprofit, has long aimed for an annual income 2.5% to 4% above expenses. During the pandemic, which saw elective proceedings halt for months and increased costs related to COVID-19, that margin fell to around 1.5%, despite $ 29.5 million in funding from the CARES Act and a payment of $ 5 million from FEMA to cover costs related to personal expenses. protective gear.
But in recent months things have improved, possibly due to a build-up of demand after a year of suspension.
“We are seeing strong demand and increasing volume. One of the assumptions… is that people were waiting for the vaccine and as they received it they became more comfortable receiving care, ”Sloan said.
During the first wave of the pandemic, all hospitals shut down most non-emergency and non-COVID care, but when the second wave struck in early winter, a more nuanced approach was taken.
“We were more successful with the lessons we learned from the first wave in the spring. We rolled out what we called the dimmer model, declining some elective work to speed up COVID work if needed – not shutting down but managing, continuing to provide non-COVID care, ”said Robert Steigmeyer, president and chief executive officer. the management of Concord Hospital.
It has helped that the pandemic has never grown as widespread in New Hampshire as in other parts of the country. State intensive care units, for example, were almost full on a few occasions but never nearly ran out of beds.
All industries and businesses have battled the pandemic, but Concord Hospital had an added complication as it sought to buy out Franklin and Laconia hospitals to come out of bankruptcy.
After no other bidders came forward, Concord Hospital acquired LRGH for $ 30 million. Concord Hospital had talked about merging or buying LRGH in the past and in recent years it has resumed maternity services.
Fortunately, said Steigmeyer, there wasn’t much to be done in terms of modernizing or closing buildings.
“We have some work to do… it’s really pretty minor. There are no major physical changes at the plant at this point, ”he said.
The biggest change to date has been the opening of an orthopedic clinic in what is now called Concord-Laconie Hospital, with surgeons and providers from Concord Orthopedics PA. A separate clinic, Advanced Orthopedic Specialists in Gilford, closed recently because Concord Hospital did not renew its contract.
Franklin and Laconia Hospitals and some health care agencies made up the general health care of the Lake District. It declared Chapter 11 bankruptcy last year, mostly over $ 128 million in debt fueled by the expansion of Laconia hospital and the creation of a computerized system to process electronic medical records. .
Kevin Donovan, who left LRGH to become CEO of Concord Hospital-Laconia and Concord Hospital-Franklin, said an “extremely high percentage” of staff remained in the new entity. There are no unionized staff.
Steigmeyer said labor agreements had been signed with more than 100 clinical providers and more than 1,000 staff, and benefits and insurance coverage had been transferred.
“So far it’s been pretty smooth,” he said.
Some patients who previously traveled to Franklin or Laconia have been transferred to Concord Hospital during the uncertainty surrounding bankruptcy and may return.
“We expect more volume, and part of that will be a repatriation of the volume that has arrived at Concord Hospital. Program by program, day by day, we are adjusting staffing levels to meet local care, ”Steigmeyer said. “Some people who have sought treatment from Concord and who can potentially be treated in Laconia; less to Franklin. I expect that as we really build the system in Laconia and Franklin more people will stay. “
The question of which services, if any, will be transferred between hospitals is still under consideration. The country’s shortage of nurses complicates any decision.
“New Hampshire has 14,500 jobs open. Half are in health care and 1,350 are registered nurses (registered nurses), ”Donovan said.
He said that one of the advantages of combining the three hospitals is that it gives more options to medical and technical staff, which makes it easier “not only to hire but to retain these nurses”. Before the takeover, LRGH had too few procedures to keep some clinicians and registered nurses.
By the standard measure of beds staffed or licensed, Concord Hospital is one of the largest hospitals in the state, behind Dartmouth-Hitchcock and the two Manchester hospitals. It is more than twice the size of Laconia and perhaps four times the size of Franklin.
(David Brooks can be reached at 369-3313 or [email protected] or on Twitter @GraniteGeek.)