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Not-for-Profit, Award-Winning Community News and Views for Windham County, Vermont • Since 2006

Grace Cottage Hospital explores expansion plan

TOWNSHEND—From somewhere between the bottom line and the bottom of the heart, Grace Cottage Hospital has been dispensing health care in the West River Valley and beyond since 1949, when Carlos Otis, its first doctor, delivered its first baby, Aug. 8, the day after the then-12-bed hospital opened.

More than six decades later, Grace Cottage is still devoted to providing family care as well as serving as a critical-access hospital — and planning for its future with a new medical building program.

Despite an incalculable number of changes to health care and its delivery in that time, the hospital’s official mission statement remains: “Excellence in health care and well being, putting people first. To be the standard for patient care.”

Today, GCH has a 19-bed in-patient hospital, employs more than 160 people, including 14 practitioners of family care, internal medicine, pediatrics, mental health, and hospice services; rehabilitation departments that provide physical, occupational and speech therapists; laboratories and a radiology departments.

Services include a 24-hour emergency department and residential facilities for its full-time Rescue Inc. crew. The full-service Messenger pharmacy is across the street, and, newest of all, the Community Wellness Center, offers nearly a dozen classes, from yoga to strong bones to belly dancing.

More than 7,500 individual Vermont patients were seen at GCH in fiscal 2009, according to Andrea E. Seaton, vice president for planning and development and president of Grace Cottage Foundation. That number does not compute patient visits, but numbers of people. It also does not include users from out-of-state or some second-home-owner patients.

Eighty-eight of the state’s 251 towns sent residents to GCH. As its home town, Townshend (population 1,149), not unexpectedly, sent the highest number, 1,205 patients; next was Newfane (population 1,680) with 1,187. Twenty-eight mostly far-away towns sent just one person apiece. (The population figures are from the 2000 U.S. Census.)

What more could one want? How about a new two-story medical office building? 

Bottom line

The medical building project, according to Chief Executive Officer Mick Brant, would not only enforce the bottom-of-the-heart part of GCH — such as the wish to provide private rooms for all patients for privacy and infection control — but would also strengthen the bottom line component by keeping services viable for a future that presages longer, healthier lives.

In other words, for a future that calls out for wellness care — which Brant says “in its infancy” and has not yet proved to be a bottom-line enhancer.

  The proposed building would also provide space for deeper rehabilitative services that do help to strengthen the bottom line. The hospital also expects that chronic care and hospice services will comprise a big part of its future.

Brant defined four goals going forward: expand and consolidate rehabilitative services, consolidate the physician clinics (there are now three), provide private rooms for all patients (there are now three private and 16 semi-private rooms) and control patient traffic (for example, the front door of the hospital is also the emergency and ambulance entrance).

More specifically, Brant talked about a “one-practice, team-care collaborative so that a patient’s records are seamless and electronic.”

Seaton and Brant emphasized the ever-changing regulations from the federal Centers for Medicare and Medicaid and how those agencies, as well as state laws, pretty much establish what protocols the hospital follows. 

Conceding that not everyone has health insurance, they believe that, given Medicare’s huge presence in the delivery of and reimbursements for care, Seaton believes, “the country is really operating under a single-payer system now.”

“There is no particular dominant diagnosis now,” Brant said. “We see everything — diabetes, hypertension, conditions that require stabilization, such as stroke and heart diseases. We have seen an increase in major trauma, such as chain saw accidents and ski and car accidents.” He and Seaton attribute this to population growth.

“It’s purely anecdotal,” Brant says, “but in my three years, I’ve seen a higher level of complexity and a higher level of trauma.”

Seaton strongly believes “there are critical issues to be resolved” and a new building would go a long way toward that resolution. “We’ve done an awful lot of just getting by with inefficient use of space and energy. It’s not the best environment.”

Seaton explains that plans for the new building remain just that — plans. There’s no cost estimate. 

“It’s still too early to tell,” she said, but anticipates an area of about 20,000 square feet. The two-story structure will rise between Stratton House and the hospital and use a small portion, perhaps six spaces, of the 57-space gravel parking lot at the north end of the hospital campus.

The hospital itself was the last major construction at GCH.  Opened in 1998, the 18,750-square-foot structure cost $2.5 million.

“That was 12 years ago,” Seaton noted, “so we can expect the new building to cost more.”

Seaton mentioned the 2010 annual fair raised $50,000 for new medical imaging equipment to be use for a new 15-slice CT scanner to replace the four-slice machine now is use.

She also emphasized the need for major increases in emergency room space. “We estimate that use has about tripled in the past couple of years,” she said.

Brant reported that Eide Bailly, an accounting and business planning company with offices in nine midwestern states, has been hired to determine affordability and how to obtain financing. 

Options include government agencies such as Housing and Urban Development, rural health development agencies, as well debt financing and donations. Brant and Seaton agree that a four-year plan is a realistic goal.

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Originally published in The Commons issue #76 (Wednesday, November 17, 2010).

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