Monadnock Community Hospital deals with challenges after Dartmouth Health merger falls through

  • Monadnock Community Hospital STAFF FILE PHOTO BY BEN CONANT

Monadnock Ledger-Transcript
Published: 6/22/2022 3:20:24 PM
Modified: 6/22/2022 3:20:05 PM

For more than two years, GraniteOne Health, the parent company of Monadnock Community Hospital in Peterborough, and Dartmouth Health worked on a merger.

Monadnock Community Hospital President and CEO Cyndee McGuire said the merger received approval from the Federal Trade Commission in April 2021, and got a favorable response at a series of public hearings last October. She said there were concerns about competitiveness, but “I felt like we had come to some good agreements.”

However, it was concerns over competitiveness that doomed the plan, as state Attorney General John Formella said he would not approve the transaction because it violated a clause in the state constitution that requires “free and fair competition in the trades and industries,” and the hospitals stated they could not accept restrictions placed on them by the attorney general’s office. 

The merger falling through has left MCH working on what happens next.

“We’re very strong,” McGuire said. “We’re strong financially. We’re strong clinically.”

However, Monadnock Community Hospital is facing challenges, including being short-staffed. If the hospital were fully staffed, McGuire said it would have about 525 employees. In the past, it would have  had about 20 open positions, but is now 80 to 85 short. Traveling workers and contractors have made up some of the difference, but they cost more.

“We’d rather pay it to our own staff,” McGuire said. “It causes a lot of strain on the organization. It’s not like we can just pass on price increases to the patient.”

Due to lack of staff, there have been days where the hospital capped the number of patients in its inpatient unit. MCH has six beds in its Birthing Suite, which are not capped, and 19 beds for medical surgical patients, which it has had to cap three or four days in each of the past two weeks. It is a situation that Laura Gingras, vice president for philanthropy and community relations at MCH, stated is not unique to the hospital.

“It’s a day-to-day situation,” McGuire said. “Every day, we evaluate, based on our staffing, how many patients we can admit.”

Recruiting has been on the upswing, as in recent months, the hospital has added advanced practice registered nurse (APRN) Michelle Brumaghim in Monadnock Behavioral Health Services, APRN Tiffany Gaudet in Behavioral Health Services, Dr. Miry Makebish in Monadnock Regional Pediatrics, APRN Sarah Neal in pain management with Monadnock Orthopaedic Associates and physician assistant Thomas Quinn with Monadnock Orthopaedic Associates.

In the next few months, MCH will be adding an ARPN and surgeon in Monadnock Orthopaedic Associates, a physician at Monadnock Regional Pediatrics, two physicians at Monadnock Internal Medicine and a physician at Antrim Medical Group.

McGuire said Dr. Daniel Perli, named chief medical officer in April 2021, has done a great job recruiting.

“It’s been quite a good year,” she said.

According to McGuire, the majority of the recruits are new graduates, and will be mentored by existing primary-care providers. She said the sense that MCH would be part of a larger system was a draw, but now that the merger is off, MCH will work with Dartmouth Health to connect them academically.

“New grads, it’s nice to have that connection,” she said.

Even without a merger, MCH and Dartmouth Health have a longstanding relationship that includes Dartmouth Health staffing MCH’s cancer center. The hospital also gets telehealth services from Dartmouth Hitchcock.

“We can have these kinds of relationships,” McGuire said. “It’s just a lot less inefficiency if we were all in one (system).”

One area in which the merger failing has hurt MCH is information technology, as McGuire said smaller hospitals struggle with infrastructure and MCH is very short-staffed in that area. The hospital has separate systems for inpatient and outpatient care, and under the merger, MCH would have been part of Dartmouth Hitchcock’s system for all operations.

“We’re going to have to seek out something there,” McGuire said.

Going forward, McGuire said a priority for Monadnock Community Hospital will be how to retain and take care of staff, including determining what work will look like, in person or remote.

“Our main focus really right now is on our workforce,” McGuire said, adding that MCH is also trying to find housing for employees, and would like to work with a community group to do so.

As the hospital approaches its 100th anniversary next June, McGuire said it has great support from its board of trustees and the community.

“It’s a great pleasure to know we have the support of the community,” she said. “For a hospital and community of our size, we have a tremendous level of support.”

McGuire said the merger falling through was disappointing, “But we’re not going to stop. We’re going to look into the future and see what our best options are.”


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