ANNUAL REPORT 2012

2012 – A Year of Transition and Growth

“Celebrating Over 40 Years of Caring

Message from the Executive Director

2012 proved to be a year of many challenges but also of many rewards for North Country Home

Health & Hospice. We initiated many organizational transitions combined with seeing rapid

growth in our client referrals and client census. The clinical and management team demonstrated

tremendous strength in the team’s ability to not only persevere through these many changes, but

also to thrive as an organization. Our agency saw a growth in 2012 of 15% in client admissions,

exceeding our yearly goals, and positioning us to gain much strength and recognition as the

preferred provider of Home Health Care Services in our area. As I reflect on my first full year as

Executive Director, I am extremely proud of the team at North Country Home Health & Hospice

for their strength, expertise, and motivation. As we go forward with the continued challenges and

uncertainties facing our industry, one fact that I am certain is that the team at the North Country

Home Health & Hospice will sustain success.

This past year we identified many goals in our strategic planning sessions that have lead to

positive outcomes: We have streamlined many of our processes and work flow for improved

efficiency; We have enhanced our IT infrastructure to meet the demands of our technical needs;

We have increased our collaborations and partnerships with our local health care partners such as

Littleton Hospital, Cottage Hospital, and Ammonoosuc Community Health Center; We have

increased our community clinics such as foot care, health screenings, and immunizations; We

have provided specialized clinical training and support to enhance the skills of our clinicians; We

have expanded our supportive care program such as homemaker and home health aide services;

We have reached out to our local, state, and federal legislative representatives to support the

issues that face our industry; Most importantly we have enhanced our commitment for quality

services and positive client outcomes. We achieved recognition in the “High Honors” category

for patient satisfaction for being consistently above average in our patient satisfaction survey

outcomes. Thus, we continue our path with enduring passion towards a positive and successful

future.

I would like to thank the NCHHA staff, the Board of Directors, and our communities for

continued support and commitment to our Mission; to provide quality home health and hospice

care in an efficient, effective, and fiscally responsible manner. I look forward to continued

growth towards our strategic goals in FY 2013.

Elaine Bussey, MS, RN

Executive Director

2012 Year Highlights

Increase in referrals, admissions, and revenue

Expansion of Homemaker and Home Health Aide services

“High Honors” award from Deyta for consistently high patient satisfaction surveys

Expanded the transition of care programs and collaborations with Ammonoosuc

Community Health Services, Cottage Hospital, Littleton Regional Hospital

Enhancement of IT support and infrastructure

Improvement in efficiencies and work flow process for meet improved organizational

goals

Improvement in QI/QA program with specialized training for clinical managers

Improvement in clinical outcomes

Increase in community clinics and health screenings.

Home Health Care Program Report

In 2012 our Home Health services had 791 referrals and admitted 745 clients through our

Medicare, Medicaid, private insurance and other payers. Most of our referrals come from local

hospitals, physicians, and Dartmouth Hitchcock Medical Center with Littleton Hospital being

our largest referral source. Our clients reside in the 22 communities that we serve with the largest

number of clients in Littleton. Our staff traveled over 230,000 miles to provide home health and

hospice care to residents in our 22 Town service area. Our average census was 126 clients per

day.

Medicare is our largest revenue source thus governmental changes to that program can have

either a negative or positive impact on services depending on the outcome of the current

regulatory changes. The Home Care industry continues to monitor the constantly changing

concerns and the potential reduction in reimbursement along with an increase in costly

regulations and audits. We also continue to provide services under private insurance plans in

which we continue to improve those contracts. The state Medicaid program as well the Choices

for Independence program (NH Medicaid waiver program) allow us to provide services to those

individuals with chronic health programs and disabilities. Our clinical services include:

Nursing services

Rehabilitation services

Home Health Aides

Medical Social Worker

Wound care

IV Therapy

Disease Management

During 2012 North Country Home Health & Hospice (NCHHA) home health program provided

$131,591 of community benefit through programs such as health promotions, community health

clinics, foot care clinics, hospice and palliative care, volunteer services. And supportive care

services. We continue to work with our collaborative health care partners on transitions of care.

The objective is to reduce hospitalizations, improve client self-management of their disease

process, and improve outcomes through standardized care transitions across multiple health care

settings. The development of our Intake/Liaison nurse with Littleton Hospital has expanded to

Cottage Hospital. Our nurse liaison assists with care coordination and transition to home with the

hospital discharge planners. The nurse is present at the hospital on a weekly basis and has been

very successful in not only assisting with discharge planning but also with the coordination of

the necessary care and services for the patient and the family while transitioning back into the

community.

Referral Sources

COMMUNITIES SERVED NUMBER OF CLIENTS

Bath

28

Benton

1

Bethlehem

42

Bretton Woods

2

Carroll

1

Dalton

21

Easton

4

Franconia

48

Haverhill

111

Landaff

13

Lisbon

58

Littleton

253

Lincoln

69

Lyman

16

Monroe

13

Pike

10

Sugar Hill

13

Twin Mountain

2

Whitefield

35

Woodstock

33

Woodsville

23

Hospice Program Report

Our Hospice program admitted 74 patients to the program in 2012. Most of the patient’s services

are through the Medicare program with a smaller amount through Medicaid, Veteran’s

Administration, and private insurance. As with Home Health Services our largest referral source

is Littleton Hospital. Our average length of service for a Hospice patient under our care is 60

days (National average 69 days). Hospice provides comprehensive, holistic, and interdisciplinary

care that includes nursing services, social worker, home health aides and homemakers, physical

and occupational therapy, spiritual support, and volunteers.

The total days of service for Hospice this past year were 4311 routine days at home, 52 In-patient

care days, and 32 In-patient respite days. Our Hospice team provided 1332 nursing visits, 199

medical social work visits, 900 Home health aide visits, 247 Homemaker visits, 8 Hospice

chaplain visits, and 6 Rehab visits.

Or volunteer program provided 326 hours of service to our Hospice patients this past year. Our

Hospice volunteer coordinator trained 11 new volunteers in 2012 and our current total number of

active volunteers in 45. The service these volunteers provide to our patients is extremely

valuable to the overall Hospice experience for the patient and for their family and care givers.

Hospice volunteers bring kind words to our patients; prepare specials meals, share bits of

uplifting news as well as a myriad of other small acts of caring to our Hospice patients and their

families. Shared hugs, tears, and laughter are reflections of the special bonds with the special

relationships that are formed with the hospice volunteers

Our Bereavement services offers bereavement support both individually and in a group setting to

support those who have experienced the loss a love one. In 2012 we provided bereavement

services to 21 individuals. Our bereavement coordinator offers a support group twice each

month which averages 20 attendees.

Our Compassionate care program provides additional support services for those individuals not

covered by insurance or with limited resources. Within this program our Hospice team provided

Hospice visits and support to 26 clients.

Home Tele-monitoring Program

In 2012 NCHHA staff installed 22 Tele-health monitors. Tele-health monitor called the HomeMed

Monitoring System that is utilized by the Agency includes the monitor, a scale, a blood pressure cuff and

a finger sensor (for obtaining heart rate and oxygen level). The equipment is set up in the client's home

and is programmed to assist the patient with vital signs such as blood pressure, pulse, and temperature.

Voice prompts along with visual cues on the monitor guide the patient as to how to use the devise.

Specific information related to the patients specific health conditions are programmed into the devise to

assist the patient in understanding how to manage their health care issues. The entire process takes only a

few minutes. After the monitor collects the client information, it sends it electronically to our agency and

a nurse at the office will review the vital signs and other pertinent information and call the patient if a

problem or concern is found. This allows for daily monitoring of the patients status.

NCHHA does not charge clients any extra fee for the use of the monitor while they are under our care

for nursing services through insurance. Thus the improved outcomes and ability to meet care plan

goals benefits both our clients and improved outcomes for meeting care planning goals.

Our Client satisfaction with our Home Tele-monitoring program also remains high. Survey results

document 100% of clients strongly agree that the system is easy to use, assists them in self-

management of their condition, and provides a sense of security and peace of mind.

Supportive Services Programs

In 2012 NCHHA provided supportive care services to 101 clients and 10,108 hours of service

through the state grant programs such as Title XX, SCOA, and Title IIIB. These services are

primarily for homemaking, home health aide, companion, and respite services that are provided

to those who are unable to perform essential activities of daily living independently, due to

physical or mental limitations. Performance of these services is crucial in assisting elders and

disabled citizens to remain in their homes and avoid institutionalization. This program was

expanded this past year when North Country Home Health & Hospice absorbed 40 additional

clients from services previously provided by Grafton County Senior Citizens Council when that

agency closed its home care program.

North Country Home Health & Hospice Agency is committed to providing a continuum of care

to clients in our service areas. These supportive services programs additionally provide respite

services for family members and caregivers. The family support is a crucial element of caring for

individuals in their homes. These program provides support and relief in an effort to reduce

stress to the caregivers, thereby allowing the patient to remain in the home setting as long as

possible. NCHHA maintain a contract with the State of NH Department of Health and Human

Bureau of Elderly and Adult services for many of these programs. NCHHA is committed to offer

this program to support clients and their families since the benefit to remain in the comfort of

one’s home in a safe and supportive environment is crucial to our client’s overall health

outcomes. Studies have shown that Home Care maintains the patient’s dignity and independence

– qualities that commonly are lost in institutional settings.

Supportive Services Team

Community Clinics

NCHHA provides free health screenings in our various community clinics. In addition we

provide Flu vaccine immunizations and fee based foot care clinics. In 2012 we held 86 blood

pressure and blood sugar screening clinics. Weekly clinics are held at the Lincoln Senior Center,

Littleton Senior Center, the Opera Block in Woodsville, and the Highland House in Whitefield.

NCHHA held 3 flu vaccination clinics at our Cottage St. office, Littleton Senior Center, and

Lincoln Senior Center and we immunized 149 individuals. Our foot care clinics are held 8 times

per month at Horse Meadows Senior Center, Littleton Senior Center, Lincoln Green, as well as at

our Cottage St. office which is a total of 105 clinics per year.

Quality Improvement

2012 the clinical management team began participation in the Institute for Health Quality

Initiative Scholars Program. Through our membership in the Home Care Association of New

Hampshire two of our clinical managers were able to attend this very innovative program. This

allowed these managers to develop higher levels skills and provide analysis to measure and

monitor our quality improvement outcomes. This has resulted in our agencies ability to sustain

these positive results with our quality measures throughout the year. All of our quality measures

are equal to or higher than the state and national average. These measures are based on client’s

assessments and improvements in their ability to function and manage their medical conditions

or disease after they have had our home health care services. NCHHA has consistently had a

positive rate of patients not needed to be admitted to the hospital while under our care as well as

in improvement in pain management, medication management, and wound care.

NCHHA was also awarded the “High Honors” status form our national satisfaction survey

company, Deyta, that is now required for Medicare agency. 94% of patients compared to a state

average of 86% rate our services in the 9 to 10 category (10 being the highest) and 92%

compared to a state average of 84% would recommend our agency to a friend.

NCHHA continually provides record reviews, patient and employee satisfaction surveys,

supervisory visits, and quality outcome assessment to ensure that our team provides the highest

quality of care and services possible.

2012 HHCAHPS HONORS

Press release

North Country Home Health & Hospice Agency has been

named a 2012 Home Health Consumer Assessment of Healthcare Providers and

Systems (HHCAHPS) Honors recipient, a prestigious award recognizing home health

agencies that provide the best patient experience.

Established by Deyta, this annual honor acknowledges the top 20 percent of agencies

that continuously provide the highest level of satisfaction through their care as

measured from the patient’s point of view. The HHCAHPS Honors identifies the highest

performing agencies ranked by analyzing satisfaction measures covering both

performance and improvement of care over a twelve-month period.

“The HHCAPS Honors defines a new standard of excellence in the patient experience for

home health agencies”, said Bill Bassett, Deyta’s Vice President of Home Health.

”Identifying the top-performers in the home health industry is our way of recognizing

HHAs that are dedicated to providing high quality of care in a patient-centric approach.

The resulting patient experience is a key driver of ongoing patient and agency success.”

The HHCAHPS Honors rankings were compiled from the HHCAHPS survey results of

over 1,800 home health agencies from April 2011 to March 2012. Two domains of

performance were used in the calculations covering the nineteen questions that

comprise the five publically reported measures on Home Health Compare.

Elaine Bussey, Executive Director of North Country Home Health & Hospice Agency,

credits a skilled, compassionate staff that is committed to a program of high quality

care, and dedication to a standard which consistently assures the highest level of

satisfaction among patients and their families.

About Deyta, LLC

Deyta partners with thousands of hospice, home health, human services and other

organizations, to measurably improve the quality of patient care and services, the

experience of customers and employees, and the effectiveness of their operations. With

20 years of experience, Deyta offers proven solutions with powerful reporting,

educational programming, and extraordinary customer service. Deyta clients and

collaborators are providers, industry associations, regulatory agencies, vendors, and

consultants who are committed to improving healthcare.

Finance Director’s Report

North Country Home Health & Hospice Agency 2012 audited financial statements showed a

positive bottom line. The organization experienced a 22% increase in revenue over the previous

fiscal year. The auditors issued and “unqualified opinion” (clean audit) on the 2012 financial

statements as presented by management. The auditors conclusion states “We concluded that the

financial statements of North Country Home Health & Hospice Agency, Inc. are fairly presented

in accordance with accounting principles generally accepted in the United States., Brad

Borbridge, CPA.”

North Country Home Health & Hospice Agency’s income to expense is moving in an upward

trend. 2012 was a banner year for increased client services. With a 30% increase in Hospice

days, 30% increase is 3rd

party payer visits and 18% increase in PPS Medicare episodes.

The following charts; revenue over expense, revenue by payer and revenue by program show

how NCHHA achieved its goals.

NCHHA’s ideal payer mix should be two thirds Medicare, and one-third other payers and private

pay. In 2012 NCHHA’s payer mix was ideal.

2012 Revenue by Program

Health care systems recognize home health as an integral provider in achieving cost efficient

patient outcomes. Home based care daily cost to provide care is $60 per day as compared against

Nursing Home and Hospital stay at $214 and $2117 per day respectively.

Other important trend NCHHA tracks are our utilization of service record as depicted below.

Finance Department Strategic Goals for 2013

Conduct a strategic analysis of internal systems to improve financial performance to reduce the

number of AR Days Outstanding.

Develop departmental goals and documents to facilitate organizational ‘opt in” which will

support financial improvements.

Implement transition process to an accounting system which supports departmental revenue and

budgets to improve Directors oversights and fiscal management within their scope of

supervision.

2012 NCHHA Future Goals and Strategic Planning Highlights

In January of 2012 the NCHHA leadership team met to develop an organizational Strategic Plan.

The basis of the plan was review the goals and objectives from 2011 and to look back on our

successes and areas for improvement and then look ahead to plan for a successful future. The

following are the primary areas that NCCHA will focus on for organizational improvement for

2012.

Continue to analyze internal functions and capacity to utilize appropriate efficiencies.

Enhance outreach in the community

Staff training, education, and recognition

Monitor Medicare reimbursement changes and develop necessary internal responses as

needed.

Continue Improve and enhance technology utilization

Enhance supportive care programs and community clinics

Participate with Health Care Partners on Transitions of care programs and opportunities

2012 Community Outreach and Partnership Activities:

Hospice Walk-a-thon during Lupine Festival

Memories of Mother Tea

Little Regional Healthcare Women’s Health Conference

Care Transition teams: Littleton Regional Healthcare, Cottage Hospital, Speare Hospital

Littleton Area Chamber of Commerce Annual Meeting.

Littleton Area Chamber of Commerce Business after Hours

North Country Health Consortium

Littleton Community Center Wellness Fair

Littleton Area Chamber of Commerce Home Show

Horse Meadows Senior Center Wellness Fair

Employees

In FY 2012, we employed 45 employees. Of those, 62% have been with us 5 or more years and

28% 10 or more years. Two employees have been with us for 22 years. We have also been

honored by the fact that we had a 68% return rate on our Employee Satisfaction Survey and that

86% rated us as one of the best places to work.

Employees Position Years of Service

Sherry Alix RN/Case Manager 5 Months

Lorinda Blood Finance Director 2 Years

Elaine Bussey Executive Director 1 Year

Anita Boardman LNA 19 Years

Susan Boudreau Clinical Support 1 Year

Regina Bowler Director of Clinical Services 6 Years

Dena Breault RN/Case Manager 2 Year

Patricia Brown RN 4 years

Alberta Colby Accounting/Billing 3 months

Pamela Comeau LPN 4 Months

Maureen Conway-Tague Physical Therapy Assistant 10 Months

Sally Crossley QI/LNA Supervisor 5 Years

Beth Edwards Volunteer Support 6 Years

Linda Elliott HR Manager 13 Years

Frances Foster Homemaker 15 Years

Ashley Gordon LNA 10 Months

Debra Hall RN/Intake/Liaison Coordinator 1 Year

Kathleen Head RN 1Year

Amy Houghton Billing/Accounting 1 Year

Nancy Howard RN 8 Years

Inga Johnson Hospice Director 17 Years

Nina Karlson LPN 8 Months

Holly Knowles RN/Case Manager 2 Years

Beverly Lamanna Social Worker 5 Months

Roberta Lehouillier LNA 9 Years

Brigette Lepine RN/Case Manager 2 Years

Sue Manah Buteau Hospice Volunteer

/Bereavement Coordinator 1 Year

Rossana Martel LNA 2 Years

Bernadette Martino RN 10 Months

Joanne Merrill RN/Case Manager 1 Year

JoAnn Miller Supportive Care Scheduler 22 Years

Kristina Naylor Homemaker 6 months

Nancy Norman Accounting/Billing 22 Years

April Paye Clinical Support Supervisor 11 Years

Marion Pineo Clinical Support/Medical records 6 Years

Virginia Poole Homemaker 20 Years

Martha Reed Medical Social Worker 9 Years

Maryann Richards RN 4 Months

Amy Remick Physical Therapist 1 Year

Patricia Rivera LNA 7 Years

Sue Robinson Finance Director 4 Months

Corey Safford Occupational Therapist 9 Years

Jacqueline Scott Homemaker 20 Years

Wanda Skrobak Homemaker 8 Years

Sara Smith Homemaker 7 Months

Megan Thayer LNA 7 Months

Jan Tyrrell Homemaker 6 Years

Roxanne Wessels LNA 17 Years

Valerie Williams RN 7 Months

Photo Courtesy of The Bridge Weekly/Andrea M. Fitzgerald

Dena Breault and Home Care patient Roger Bedor

Our nurses and clinical team work with the patient, their family caregivers, and their physician to

collaborate in helping keep the patient healthy at home. Patients want to be in their own home

and environment. North Country Home Health & Hospice nurses such as Dena Breault focus on

patient care and clinical strategies to improve patient outcomes so they can remain healthy and

safe at home and in their community.

Roger Bedor, age 69, of Littleton was one of Dena’s many patients. A former over-the-road

trucker and construction worker, Bedor has been plagued by health concerns for the last two

years. Since last August, he has required the services of NCHHA’s skilled nursing care, physical

therapy, medication management, and blood draws while taking care of himself at home.

Dena Breault, RN/Case Manager visited Bedor two to three times a week. “Dena seldom spends

less than an hour with me per visit. I’ve had a bunch of unusual things, and the nurses at North

country Home Health & Hospice have had their hands full. Dena has done a great job and is

very helpful. I’ve got nothing but good to say about these folks,” says Bedor. “I’m especially

appreciative of Dena’s painless blood draws. She really has a knack. She’s a thorough teacher,

too.” Breault sometimes brings a Plymouth State College nursing student with her on visits, and

Bedor has enjoyed watching her instruct the student in some of the simpler techniques. Breault

loves community nursing and covers Littleton and towns to the east. “It’s a whole different view

of nursing. One on one you see all the dynamics of that person, and it gives you a much broader

and accurate picture because you are being invited into their homes.” Breault’s day starts at 8am

and involves traveling twenty to one hundred and thirty miles a day, usually on back roads, to

visit three to eight patients a day. Her day ends when her visits and computer entries and non-

direct activities are completed. In addition to her visits, Breault checked the transmission from

Bedor’s Tele-monitor, and she called him to check on him after a doctor’s visit. “We are the

eyes and ears for the physicians and assess and report in many cases,” she says. “If it wasn’t for

them (NCHHA), I would be in a facility. I don’t want to go in. I want to stay in my own home

with my own things. I know they will get me through this, and I’ll be better,” said Bedor.

(article written by Andrea M. Fitzgerald)

Roxy Wessell, nominee for Licensed Nursing Assistant of the Year

Presented award by Sally Crossley, QI/Supportive Services Supervisor

In these days of transition and change within our home care industry, North Country

Home Health & Hospice is truly blessed to have the longevity, commitment, and dedication of

the 22 years of service from Roxie Wessel. Roxie is a true gem for the clients she serves

throughout the North Country. Her years of experience combined with her strong sensitivity and

insight provides such a richness of compassion and care that is second to none. Roxie is certainly

the most requested LNA from our clients since she always provides reassurance and competence

in her skills and manner. Roxie has the ability to remain calm in all situations with her easy

nature along with her knowledgeable and capable manner. From caring for a patient transitioning

from the hospital to home, or a patient living in the community with a chronic disease, or when

providing end of life care to Hospice patient, Roxie always displays the outmost in her

caregiving skills and professionalism. As one of her patient’s stated “Roxy gives us the best

possible aide we could have…She is more than excellent.”

Roxie has been a strong mentor to her peers and is always willing to train new LNA’s as

they begin their new role as caregivers. Our agency is very fortunate to have such as exceptional

LNA as Roxie for this mentorship role to assure that our new LNA’s are receiving superb

orientation and training. Roxie is extremely well respected by her peers and by the clinical team

at our agency. Roxie can also always be called upon to help out in our community clinics, assist

in installing our home Tele-health monitors, and fills in for our LNA scheduler as needed. Thus,

Roxie’s 22 years of experience has brought an exceptional value to our organization and to our

home care services. Our agency is very proud to have such a committed, experienced, well

respected LNA and we all highly recommend her for LNA of the year. She demonstrates strong

communication skills with her supervisor and the clinical team regarding her patients to ensure

that nothing is over looked. Roxie brings such as strong wealth of experience, compassion, and

support to our patients, to our agency, and to our community. North Country Home Health &

Hospice is very lucky to have her!

Board of Directors

NCHHA has been equally as fortunate to have a dedicated group of community members who

have volunteered their time and efforts to serve on our Board of Directors. The 2012 members

of the Board of Director’s are as follows;

BOARD OF DIRECTORS Years of Service

Carol Boucher, 7 Years

Gary Cassady, President 7 Years

Dan Cullen 3 Years

Evelyn Elms, Vice President 4 Years

Erin T. Hennessey, Treasurer 4 Years

Diana Jones 2 Years

Beverly Shaw 10 Years

Jeffrey Stinson 1 Year

Carolyn Walko 5 Years

Kim Woodson , Secretary 3 Years

Michael Conklin Emeritus

Aaron Cox Emeritus

HOSPICE VOLUNTEERS

We have approximately 45 active Hospice Volunteers who are men and women of all ages who have

a genuine concern for others and a willingness to share their time and skills. Each of our Volunteers

brings something special to the lives of those they touch. In 2012, they provided 326 hours of to the

residents in our service area who are living with a life-limiting illness. In the fall of 2012 NCHHA

conducted a six week Hospice volunteer training program for 8 new Hospice volunteers. Thank you

to all our volunteers!

HOSPICE VOLUNTEERS Years of Service

Tom Alt 7 Years

Karma Bailey 2 Year

Barbie Beck-Wilczek 9 Years

Fred Bedard 3 Years

Grace Bigelow 13 Years

Regina Bowler 2 Year

Pat Buchanan 17 Years

Scott Burgess 1 Year

Marguerite Christopher 3 Years

Dick Comstock 6 Years

HOSPICE VOLUNTEERS CONTINUE Years of Service Heidi Comstock 6 Years

Pam Dexter 6 Years

Ann Marie Donlon 8 Years

Ann Edson 3 Years

Tony Ehrman 13 Years

Mary Fillius 7 Years

Lorraine Fougere 3 Years

Dori Hamilton 2 Years

Nancy Howard 3 Years

Eleanor Ingbretson 6 Years

Loriann Jesseman 6 Years

Gail Kilner 17 Years

Ann Laflamme 3 Years

Holly Lakey 13 Years

Jeanie Munro 3 Years

Karen Neuringer 1 Year

Bob Nunes 3 Years

Ellie Opalinski 15 Years

April Paye 12 Years

Ginny Poole 3 Years

Tina Reynolds 6 Years

Helen Rode 1 Year

Joan Santy 3 Years

Jane Smalley 15 Years

Sr. Carmel Souliere 6 Years

David Stringham 1 Year

Pat Whipple 6 Years

Newly trained volunteers in 2012:

Alberta Colby

Mary Ann Duranty

Kate Kelly

Beverly Lamanna

Theresa Lavoie

Louie Lavoie

Lavina Maykut

Joanne Schuyler

NCHHA has several contract staff who provide very valuable services to our team.

Contract Staff Position Years Affiliated

Ray Bennion Occupational Therapist 7 Years

Maciej Kubkowsi Physical Therapist 12 Years

Paul Lister Speech Therapist 35 Years

Jennifer Scianna Speech Therapist 18 Years

Clare Wilmot, MD Medical Director 4 Years

Phil Lawson, MD Hospice Medical Director 2 Years

Lyn Winter Hospice Clergy 3 Years

John Sauter, MD Hospice Medical Director(alternative) 13 years