Mt. Ascutney to Upgrade Rehab Program

Windsor — The nursing home at Mt. Ascutney Hospital and Health Center has been empty since late August, and now the Windsor hospital is preparing to renovate the space for the hospital’s acute care rehabilitation program.

In the next few months, Mt. Ascutney will seek state approval for the estimated $2.5 million project. If approved, construction would start next spring and mark the beginning of a three-phase effort to bring Mt. Ascutney’s 40-year-old facility up to modern standards, said CEO Kevin Donovan.

The overhaul is aimed at helping Mt. Ascutney remain viable in a changing environment for small health care providers, Donovan said.

“This is really about doing the right thing for our patient population,” Donovan said in an interview Monday. “We provide really good care in a tired facility. Now, we will have really good care in a nice facility.”

Mt. Ascutney has offered inpatient rehabilitation care for decades, and it is one of only two rehab options for acute patients in Vermont, the other being Fletcher Allen Health Care in Burlington, said Belinda Needham-Schropshire, director of rehabilitation.

Mt. Ascutney is known throughout the Twin States for providing acute rehabilitative care, and it is a key part of the hospital’s long-term vision, Donovan said. But with just six rooms available to treat up to 10 patients, Mt. Ascutney has struggled to offer patients privacy and a quiet place to recover from severe conditions. The limited space has also made it difficult to manage patients, as officials have to consider a person’s condition and gender when assigning patients to a double-occupancy room.

The renovation would move inpatient rehabilitation into the former nursing home, creating 10 single-occupancy rooms and easing the burden on administrators to manage room assignments. It will also reduce the risk for infections spreading from one patient to another.

“It’s really challenging to provide the right care,” Needham-Shropshire said.

The renovation is expected to take seven months, Donovan said. The second and third phases would bring outpatient therapies into the main hospital building and also add rooms in the medical/surgical area. All told, the entire project could cost $3.5 to $4 million, said Paul Calandrella, Mt. Ascutney’s chief operating officer.

The renovations to the nursing home represent one way in which the 25-bed hospital, which has more than 300 full- and part-time employees, is positioning itself in the marketplace as financial pressures force small institutions to make tough decisions about the services they provide. Many hospital administrators, including those at Valley Regional in Claremont and Alice Peck Day Memorial Hospital in Lebanon, have said small hospitals need to find a niche rather than try and provide across-the-board care. Mt. Ascutney’s strategy is to focus on primary care, same-day surgical care and acute rehabilitation, Donovan said.

But retooling an organization can be painful. The decision to shut down the nursing home was a financial necessity but fraught with emotion, officials said. Not only did it force 23 residents to find someplace else to live, but it also affected the jobs for 35 full- and part-time staff.

Most of the nursing home residents relocated to other facilities in the Twin States, though a few went outside the region, Donovan said. As for the staff, half of the people found other jobs within the organization. Others took severance packages and found different jobs. The home’s administrator retired, said Needham-Shropshire.

Mary Desmarais is among the employees who found other jobs within the hospital. She worked at the nursing home for 39 years, most recently as a case manager helping to admit and discharge patients, enroll them in Medicaid and attend to other needs.

She is now a case manager in another part of the hospital, performing similar duties but for different patients. The closing of the nursing home was difficult, she said, but the staff were able to manage by focusing on relocating patients.

“It was great to be part of a cohesive team that really worked together,” she said. “We focused on patients’ needs. We just kept that focus.”

The nursing home had long been a financial drain on the hospital, but it was the federal spending cuts known as sequestration that forced the decision to close it. The hospital had a $500,000 decrease in its Medicare funding because of the cuts and closing the nursing home improved Mt. Ascutney’s bottom line by $1.2 million. That money is going toward the expansion of the inpatient rehabilitation program, among other services.

The entire three-phase project would span several years and rely largely on donor contributions, Donovan said. There may be some revenue boost from the improved rehabilitation program, but the changes at Mt. Ascutney are being driven by more than money, he said.

“We built our strategic plan based on what was the right thing to do,” he said.

Chris Fleisher can be reached at 603-727-3229 or cfleisher@vnews.com.