After spending a week in Concord Hospital, Allan Clark transitioned to Merrimack County Nursing Home’s reopened short-term rehabilitation unit, where he was greeted by the home’s resident cat, Skeeter.

Skeeter’s daily visits reminded Clark of his own feline companion awaiting his return home following what would hopefully be a brief stay at the rehab facility, where he ended up spending the next two weeks working to regain his strength.

“We have a cat at home, so it was a nice connection to home for him,” his wife, Judy Clark, said.

The short-term rehab, or skilled care unit reopened on July 25 after it was closed during the COVID-19 pandemic.  

For those looking to return home after a hospital stay, it provides a critical midpoint that has been sorely missed. This space, typically used for transitional care, became an isolation unit for COVID-positive patients. 

Now back up and running, the rehab unit serves as a place for patients to regain the skills they need in order to return home. For Clark, this meant practicing using stairs, getting in and out of bed, sitting down and standing up from chairs, and cruising down the hallway with his walker.

“It's geared towards these patients coming in, getting the therapy and the skilled nursing services they need, and then returning home in a short period of time,” nursing unit coordinator Erin Berry said.

Clark, a resident of Chichester, underwent both physical and occupational therapy while at rehab, enjoying visits from his children, grandchildren, friends, and neighbors in the afternoons. 

Discharged last week, he recalled the kindness of the staff and how they, in turn, lifted his own spirits.

“They all had a good sense of humor,” Clark said. “They worked as a team and they answered all my questions.” 

Staffing shortages have prevented the nursing home, which boasts a total of 290 beds, from being able to reopen all the units at once. Instead, it’s taken place gradually, with the long-term care unit reopening last year. The transitional care unit remains closed for the time being.

Rehab director Bruce Bourbeau described the recovery process as a collaboration between staff, patients, and families, beginning with conversations to assess what the patient’s home situation looks like and to set goals.

“When we’re working on mobility balance, for instance, if they have stairs to enter the home, we address those skills,” Bourbeau said. “If you have to do your own laundry, we're able to address that. We have a laundry room here, and there's a full home-like kitchen with a fridge and stove and a standard, traditional bathroom with a tub-shower combination, so we're able to simulate a lot of what they're going back to.”

Clark improved enough to be discharged after two weeks. While the transition back to his home environment has taken energy, he expressed gratitude for the attention he received while a patient. Even in the middle of the night when Clark needed something, he felt not only taken care of but treated with kindness.

Judy Clark described how the staff went out of their way to make her husband smile when he wasn’t feeling cheery.

“They communicated extremely well,” she said. “All their support staff, from laundry to the cook in the cafeteria, they all were just friendly people who made you made you feel comfortable.” 

Repeated conversations with the nurses and unit administration helped ensure Clark’s comfort and his progress. 

“We have the ability to utilize the entire campus,” Bourbeau said. “We're able to do outdoor ambulation. We're able to do curb management, working on endurance. It doesn't mean we just have to walk up and down the hallway. We can go sit out on the front patio and work there. It's amazing just to get outdoors, to see how that person will just brighten up.”

The reopening of the unit elicited reflection from the staff on the acute challenges the nursing home faced during the pandemic, during which the facility stopped accepting new patients and numbers hit an all-time low.

“Looking back, I think in some ways we became stronger,” director of nursing services Stacey Daitch said. “The people that stayed here, the staff, they stayed because they just love this population and weathered through a lot of difficult times together.” 

Getting back to normalcy these past few weeks with the unit back up and running has been refreshing, she added. 

The unit’s reopening also helps the stream of patients from hospital stays flow better, Daitch noted. Especially during the first couple years of the pandemic without the short-term rehab unit and units like it at other facilities, some patients ended up staying in hospitals longer, and others went home without first making the transition to a short-term rehab facility.

“Hospitals were bottlenecked not being able to discharge folks to other nursing homes,” Daitch said. 

Concord Hospital began referring patients to the short-term rehab unit as soon as it reopened.

“Discharging patients from acute care to skilled or other alternative care has been challenging because of staffing at those other locations,” Concord Hospital public affairs manager Dawn Beers said. “It’s a challenge we’ve faced trying to get people who need it a continuation of care before going home.”

As the nursing home’s staff looks ahead to the coming months, they expect the unit to become busier. They also look forward to growing their staff enough to eventually reopen the transitional care unit.

“To be able to gradually open up beds, it’s what the community needs,” Daitch added. “And it’s what we needed too.”

Rachel Wachman can be reached at rwachman@cmonitor.com.