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Alice Peck Day News Archive for September 2008

Balloon Kyphoplasty Can Give Pain Relief, Greater Mobility to Those Affected By Spinal Fracture

Dr. Leonard Rudolf has introduced a surgical procedure to Alice Peck Memorial Hospital that can show dramatic results for patients suffering spinal fractures from osteoporosis and cancer. Balloon kyphoplasty is a procedure designed to reduce back pain, correct spinal deformities, and improve a patient’s quality of life. It is minimally invasive and has a 90% success rate.

More than 10 million Americans have osteoporosis, according to the National Institute on Aging. The condition is more common in women than men. Osteoporosis causes the bones of the spine to weaken and often collapse, resulting in spinal fractures, which affect more than 700,000 patients a year. Traditional treatment for spinal fracture includes bed rest, medication and back bracing. These therapies may help to decrease the patient’s pain over time, but bed rest and back bracing may also interfere with the patient’s daily life, making it harder for them to keep their remaining bones strong with exercise or engage in hobbies and activities that are important to them. More importantly, these traditional therapies do not stabilize the fracture or correct any deformities that may occur from the fractures (such as the familiar ‘hunched back’ many older women experience). Untreated spinal deformities can result in chronic pain and debilitation, reduced lung function and an increased risk of other bone fractures.

Balloon kyphoplasty can significantly reduce back pain and repair the broken bone of a spinal fracture, using orthopedic balloons that are inflated to lift the fractured bone and return it to the correct position. The balloon is then removed and the surgeon fills the cavity with flexible cement. In many cases, the patient begins to feel immediate relief from pain after surgery. In general, balloon kyphoplasty takes about one hour per fracture treated. The procedure is performed with anesthesia and most patients can go home the same day.

Dr. Rudolf reports that he has treated many compression fractures with an excellent success rate. Worldwide, over 360,000 spinal fractures have been treated with balloon kyphoplasty.

Dr. Leonard Rudolf joined APD’s medical staff in 1987 and has introduced many procedures to APD, including knee and hip replacements and total ankle replacement. He is Board Certified in Orthopedics. His office in Lebanon can be reached at (603) 448-6344.

New England’s Next Great Retirement Community Breaks Ground in Lebanon

August 20 — On August 20, 2008, Alice Peck Day Health Systems broke ground for the Woodlands at Harvest Hill, beginning a significant new chapter in its mission to serve the needs of the community. More than 150 people, including future Woodlands residents, their families and friends, attended the ceremony. “This is an incredibly exciting day for us,” said Alice Peck Day Memorial Hospital President Harry Dorman. “The Woodlands represents a vital next step in our commitment to serve the evolving needs of seniors in our community. When we opened Harvest Hill in 1996, we strove to set a new standard for quality of care, services, and lifestyle. As our reputation grew, so did our waiting list, and for the past five years it has been clear that there was a much greater demand than our current facility could fulfill.”

Alice Peck Day’s administration and board members decided the time had come to address the need. “We started by convening a focus group of people on the waiting list for Harvest Hill and asking them what they wanted in their next residence,” said Rolande “Ron” Andrews, the administrator for Harvest Hill and the Woodlands. “We found they knew what the various retirement communities in the area had to offer, and none of them quite fit their needs. Many were ready to downsize, but still wanted a larger amount of residential space and more amenities than most senior living developments offered. They wanted gracious accommodations in a comfortable and convenient setting, with support in place to give them peace of mind as well as the ability to make choices about their own care. The Woodlands is a realization of their vision.”

To meet this challenge, Alice Peck Day turned to UK Architects of Hanover. “In designing the Woodlands, we kept in mind what the future residents told us they wanted, as well as ways that we could improve how the residents would live and interact,” said Chris Kennedy of UK Architects. “We were extremely fortunate in that the Woodlands started with a wonderful location in a forest that once surrounded a farm and pasture. In creating a building that would fit seamlessly into the setting, we looked for ways to protect that unique environment for future generations and to contribute to the Woodlands community’s sense of character.”

The new community is already taking shape. “This summer, I’ve been overwhelmed by the enthusiasm that I’ve been hearing from people regarding the project, and almost all of the largest apartments have been reserved,” said Andrews. “It’s a wonderful and amazing group of people who have already decided to make the Woodlands their home. As I look toward the next stages, the construction and development of the community itself, I am extremely excited to see how these great people shape what the Woodlands will become.”

APD Transitions Extended Care Facility to Skilled Nursing Unit

September 4, 2008 — Alice Peck Day Health Systems Corp. announced on Thursday, September 4, that it will no longer be accepting long term care patients at its Extended Care Facility, and that the facility will be phasing out long term care over the next 18 months to focus on providing skilled nursing and rehabilitative services.

“APD has a deep and successful history of providing long term care to the community,” APD President and CEO Harry G. Dorman, III, FACHE, said. “This was a difficult decision for our Health Systems Board to make, but after careful evaluation of cost and revenue, along with the growing demand for skilled nursing and rehabilitative care, we feel that the transition will help to sustain the hospital and better serve the Upper Valley’s changing needs.”

The landscape for long term care has changed. More care is being offered at home, with facility-based care increasingly used for short term stays and rehabilitation. The federal government and the state of New Hampshire have developed an increasing number of initiatives to keep people in their homes as they age, and short term skilled nursing and rehabilitative care are vital parts of this picture. “More and more resources are being expended in community-based care, focused on keeping people at home as long as possible, which is often the most favorable option for people,” explained Elizabeth Pomeroy, Administrator of the ECF. “Unfortunately, this means residents require much more support when they come to long term care, and they require more resources at greater expense.” APD has also seen a consistently increasing trend in the numbers of skilled nursing and rehabilitative referrals with more complex needs. The transition to a dedicated skilled nursing and rehabilitative unit will give the facility more resources to address this growing demand.

Over the last five years, APD has seen dramatic changes in its case mix and reductions in payments toward long term care. These changes have placed a significant financial strain on the health systems in recent years, with an annual loss of more than $800,000 in fiscal year 2007 alone. “As a small facility, it’s difficult to maintain a stable balance between short term and long term residential care, which means low reimbursements affect us more dramatically,” said Pomeroy. “Transitioning to a skilled nursing facility will give us greater financial stability, enabling us to continue providing high quality care.”

Pomeroy noted that the ECF is working to ensure that its 38 current long term care residents will find homes in other facilities over the next 18 months. “We have a great team of highly skilled staff who will work closely with residents and their families  (along with other highly regarded long term care, assisted living, and group home facilities) to find the most appropriate housing and care options. We will work diligently to maintain as normal a routine as possible for our residents during this transition.  It is our sincerest hope that we can honor the facility preferences and requests of our residents and their loved ones. We will fully support their transition and help them get settled into another facility. We do not plan to move residents receiving palliative care with a prognosis of 6 months unless they request a transfer.”

The ECF will continue to accept skilled nursing and rehabilitative patients during the transition. The Woodlands and Harvest Hill, APD’s retirement communities, operate independently of the ECF and will not be affected. After the transition is complete, the ECF will be a smaller facility with expanded rehabilitation services on-site.

There will be an overall staff reduction as part of the transition plan that will be addressed through the elimination of vacancies as a first step. “At this time, the earliest we anticipate that any staffed position might be eliminated is April 2009,” said Pomeroy. “We will encourage our staff to apply for other positions at APD, and there will be opportunities for staff to stay with the ECF and strengthen their clinical skills as we enhance the type of care we provide and strengthen our ability to provide increasingly complex care to the growing number of patients who are referred to us.” All employees will be supported throughout the transition. 

“We realize that this transition will be very difficult for our residents and staff,” Dorman said. “But we feel it is the best way to continue our mission of providing high quality health care to our community as a financially viable institution that responds to the Upper Valley’s changing needs.”

John Stark Welcomed As Director of Facilities

June 16, 2008 - Alice Peck Day Health Systems in Lebanon, N.H., is pleased to welcome Jonathan H. Stark of Grantham as Director of Facilities for Alice Peck Day Memorial Hospital. Before joining APD, Stark was Facilities Manager at Timken Aerospace of Lebanon, where his duties included project management, leadership, and team management. He received a BS in Safety Engineering from Keene State College in Keene, N.H., and is a Registered Environmental Manager.

“John is capable, experienced, and has a great attitude,” said Brenda Blair, Director of Human Resources at APD. “His strengths as a leader and project manager make him an excellent addition to the APD family.”