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Amid takeover and pandemic, Concord Hospital looks ahead

  • Robert Steigmeyer Courtesy David A. White

  • Concord Hospital medical personnel wave to passing emergency vehicles in front of the hospital on Friday afternoon, April 10, 2020.

Monitor staff
Published: 6/5/2021 1:00:13 PM

After a year of unprecedented turmoil, caused not just by the pandemic but also the region’s biggest health-care consolidation in decades, finances at Concord Hospital appear to be back on track.

“Starting in very late February through where we sit today, (patient) volume has returned … to normal and we’re having what I would consider a more normal year. Our operating margin is about 3%,” said Scott Sloan, chief financial officer for the hospital, during a recent discussion with the Monitor.

Sloan said the hospital, a not-for-profit, has long aimed for annual income that is 2.5% to 4% above expenses. During the pandemic, which saw elective procedures halted for months and a surge in COVID-19-related costs, that margin fell to about 1.5%, despite $29.5 million in CARES Act funding and a $5 million payment from FEMA to cover costs related to personal protection equipment.

But in the past few months things have improved, perhaps due to built-up demand after a year on hold.

“We see a strong demand and growing volume. One of the hypotheses … is people were waiting for the vaccine and as they got it, they’re more comfortable receiving care,” Sloan said.

During the pandemic’s first wave, all hospitals shut most non-emergency and non-COVID care, but when the second wave hit in early winter, a more nuanced approach was taken.

“We were more successful because of the learnings we gathered in the first wave, back in the spring. We deployed what we called the dimmer-switch model, turning down some elective work to ramp up COVID work as necessary – not shutting down but managing, continuing to deliver non-COVID care,” said Concord Hospital President and CEO Robert Steigmeyer.

It helped that the pandemic never became as extensive in New Hampshire as in other parts of the country. ICU’s in the state, for example, were almost full a few times but never came close to running out of beds.

All industries and business have wrestled with the pandemic, but Concord Hospital had an extra complication because it sought to buy the hospitals in Franklin and Laconia out of bankruptcy.

After no other bidders arose, Concord Hospital acquired LRGH for $30 million. Concord Hospital had talked about merging with or buying LRGH in the past and in recent years took over its maternity services.

Fortunately, said Steigmeyer, not much needed to be done in terms of upgrading or closing buildings.

“We do have some work to do … it’s really fairly minor. There are no major physical plant changes at this point,” he said.

The biggest change so far has been opening an orthopaedics clinic in what is now called Concord Hospital-Laconia, with Concord Orthopaedics PA surgeons and providers. A separate clinic, Advanced Orthopaedic Specialists in Gilford, closed recently because Concord Hospital did not renew its contract.

The Franklin and Laconia hospitals and some health care agencies made up Lakes Region General Healthcare. It declared Chapter 11 bankruptcy last year, mostly due to $128 million in debt fueled by an expansion of the Laconia hospital and creating a computerized system to deal with electronic medical records.

Kevin Donovan, who has transitioned from LRGH to be CEO for Concord Hospital-Laconia and Concord Hospital-Franklin, said an “extremely high percentage” of staff have stayed with the new entity. There are no unionized staff.

Steigmeyer said employment agreements have been signed with over 100 clinical providers and more than 1,000 staff members, and that benefits and insurance coverage have been transferred.

“Thus far it has been fairly seamless,” he said.

Some patients who previously went to Franklin or Laconia have shifted to Concord Hospital during the uncertainty over the bankruptcy and may go back.

“We expect more volume, and part of that will be some repatriation of volume that has come to Concord Hospital. Program by program, day by day, we’re adjusting staffing levels to meet local care,” Steigmeyer said. “Some folks that have sought care in Concord that potentially can be cared for in Laconia; less so in Franklin. I expect as we really build the system in Laconia and Franklin, more folks will stay.”

The question of what, if any, services will be shifted between hospitals is still being considered. Complicating any decisions is the nation’s nursing shortage.

“New Hampshire has 14,500 open jobs. Half are in healthcare and 1,350 are RNs (registered nurses),” Donovan said.

He said that one benefit of combining the three hospitals is that it provides more options for medical and technical staff, making it easy to “not just hire but retain those nurses.” Before the takeover, LRGH had too few of some procedures to keep some clinicians and nurses licensed.

By the standard measure of either staffed or licensed beds, Concord Hospital is one of the biggest hospitals in the state, behind only Dartmouth-Hitchcock and the two hospitals in Manchester. 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 or on Twitter @GraniteGeek.)

David Brooks bio photo

David Brooks is a reporter and the writer of the sci/tech column Granite Geek and blog, as well as moderator of the monthly Science Cafe Concord events. After obtaining a bachelor’s degree in mathematics he became a newspaperman, working in Virginia and Tennessee before spending 28 years at the Nashua Telegraph . He joined the Monitor in 2015.

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