CANAAN — In spite of strong community support for the Mascoma Community Health Center, it continues to face challenges.

The executive director, Rebecca Ekholm, opted not to renew her contract after just one year, and the health center’s medical director, Dr. Pierre Angier, whom Ekholm hired, also has given his notice.

The change in leadership comes as the nonprofit Canaan health center, which first opened in 2017, has yet to break even and is struggling with cash flow issues.

“Hopefully those things iron themselves out over the next couple of months,” Peter Thurber, the board’s chairman, said of the financial issues.

“It comes in and goes right out at this point,” he said of cash. “Our payers are 30-60 days behind (but) our vendors still want to get paid on time.”

Ekholm, a 44-year-old Plymouth, N.H. resident, said it wasn’t the organization’s fiscal challenges that led her to leave the leadership post, which she described as her “dream job.”

The organization, which now has 5,800 patients, “is a diamond in the rough,” she said, and it serves a “medical desert.”

The “health center is necessary for that area for sure,” she said. “I hope the community will continue to support the practice.”

But, she said, “I felt that my mission for the practice might have been inconsistent with the board’s direction.”

She declined to provide details about the difference in “operational direction” that she and the board have, but said that she would like to return to lead the organization at some point in the future.

“I would love to go back,” she said. To do so, however, she would like to see a “more stable climate.”

A message left for Angier at the health center on Monday was not returned by deadline.

For now, Scott Berry, the center’s previous executive director, has returned from retirement to lead the center, Thurber said. Berry is expected to lead the center for as long as a year until the board can find a permanent replacement for Ekholm. The board plans to launch searches for permanent replacements for Ekholm and Angier soon, he said.

“In the meantime, operationally nothing’s really changing right now,” Thurber said. It’s “staffed just where we would be.”

The organization has nearly 20 employees, Ekholm said. It provides primary care and dental care in its Roberts Road location.

“The staff are really what drives that place,” she said.

Ekholm agreed with Thurber that the change in leadership should make little difference to patients.

“I think that they’re going to be fine,” she said. “The place will run the same way. The foundations are there.”

For now, Ekholm continues to assist the organization with the paperwork necessary to help it become a look alike federally qualified health center, which has been a goal since the center first opened in order to allow the organization to receive federal payments to support its work.

Thurber said he hoped that status will be achieved within a year. That will be a few years behind schedule due to the pandemic.

The organization was poised to ink a deal with Franklin, N.H.-based HealthFirst Family Care Center when the pandemic hit in 2020.

That deal would have brought the Mascoma Community Health Center such perks as a federal grant to help support operating expenses, an opportunity for providers to take advantage of an educational loan forgiveness program, a boost to reimbursement rates from government insurance payers Medicare and Medicaid, access to a lower-cost prescription drug program and federal malpractice insurance.

The pandemic caused the Mascoma Community Health Center’s revenues to dip by half, along with its donations, which it uses to offset revenue shortfalls, Thurber said. The organization has an annual operating budget of about $1.7 million.

“We were hemorrhaging money (and) they were hemorrhaging money,” Thurber said. The “timing didn’t work.”

Now, the Canaan health center is busy enough that it can make a go for the federal status on its own, Thurber said.

It’s “still in start up” and they “still have things to fix,” he said of the health center. But the “fact is we’ve never been so busy.”

Nora Doyle-Burr can be reached at ndoyleburr@vnews.com or 603-727-3213.

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