CCH Establishes Coronavirus Work Group

Although the risk to the public remains low for the Coronavirus, Calais Community Hospital has been following the lead of the Maine CDC in preparing for the possibility of cases.    A work group was established last month at CCH to review processes and procedures to be instituted now and in the event of a local exposure.   The work group consists of staff from nursing, lab, environmental services, infection control, quality management and more.   It is a full team effort to get ready for just in case, even though the hope is that most of the plan never has to be activated.

What you can expect now if you seek treatment at the CCH ED or any of the CRMS offices are brief screening questions about symptoms and recent travel.     The goal of the screenings would be to identify as quickly as possible the need to isolate a patient from other patients and the general public to reduce the risk of spreading virus.  

The CCH work group follows CDC guidance for screening, testing and treatment if needed.    As of this week there are currently only fourteen cases diagnosed in the United States, with the closest being in Massachusetts.  Symptoms of the Coronavirus are fever, cough and shortness of breath that can start two to fourteen days after exposure.    Anyone with symptoms should wear a face mask, avoid contact with others, not travel, wash hands often, and cover mouth and nose with tissue or sleeve (not hands) when coughing or sneezing.   Before going to a doctor’s office or emergency room, call ahead and tell them about your recent travel and symptoms to allow the best precautions to be taken for intake to the facility.  Further information and updates is available on the Maine CDC website.

Coronavirus

The Maine Center for Disease Control and Prevention (Maine CDC) is providing information about the recent coronavirus outbreak that originated in central China. It’s important to note Maine has NO confirmed or suspected cases associated with the 2019 novel coronavirus. Five cases total have been identified in the United States as of January 27, 2020.

Maine CDC created and regularly updates a webpage with information about the 2019 novel coronavirus. Visit the webpage at: www.maine.gov/dhhs/coronavirus.

The U.S. Centers for Disease Control and Prevention maintain that the immediate risk of contracting this novel virus remains low in the United States. There are currently advisories for travel to China, and airport screening for individuals returning from the affected area to provide education and medical support. The best preventive measures are to wash hands thoroughly with soap and water, cover your mouth and nose when coughing and sneezing, and stay home when you feel sick.

Calais Community Medical Services Welcomes James Eshleman, D.O.

Dr. James Eshleman joins
CRMS Family Medicine

Calais Community Medical Services is pleased to announce that Dr. James Eshleman has joined the Family Medicine office.   He will be seeing patients at the CRMS practice on a part time basis 2-3 days per week.   Dr. Eshleman spent over four decades at his family practice office in Norway, Maine.  Following retirement he was able to spend more time at his vacation camp in West Grand Lake.   However, after three weeks he decided full retirement was not for him and reached out to Calais Community Hospital to offer his services.  

Dr. Eshleman earned his D.O. from Philadelphia College of Osteopathic Medicine in Philadelphia, PA and served his post graduate training at the Osteopathic Hospital of Maine in Portland.  He is Board Certified in Family Medicine and Geriatric Medicine.   He served as Medical Director at many of the nursing homes around the Norway, Maine area for over 40 years and served as a preceptor for Tufts Medical Students for 9 years. 

Dr. Eshleman’s family includes his wife of 46 years, Louise, six children, fourteen grandchildren and two great grandchildren.   Much of the family remains in the State with a few scattered as far away as New Jersey and New York.   In their down time, he and his wife enjoy spending time at camp, hunting (which he describes as taking his gun for a walk) and fishing (he honestly confesses that Louise is better than he is).   With his semi-retirement he hopes to be able to travel and see Alaska, the Grand Canyon and Italy – for his wife, because “If she’s smiling, I’m smiling.”  

Dr. Eshleman states his experience in the area has been a positive one and he is very pleased to be here.  “I feel at home and I’m excited to bring my services to the area,” he shared.    Dr. Eshleman began seeing patients in December.  To schedule an appointment with him, call 454-8195, option 1.  Please give both Dr. & Mrs. Eshleman a warm welcome when the opportunity presents itself.

Calais Community Hospital Chapter 11 filing

On September 17, 2019, Calais Community Hospital filed for Chapter 11 bankruptcy protection in the United States Bankruptcy Court for the District of Maine.  The hospital will remain open and operating as usual during the bankruptcy process, which is expected to last approximately 12 months.

Filing for Chapter 11 protection during debt reorganization enables the hospital to continue providing high-quality health care in local communities and to keep jobs in the region. Chapter 11 is also a tool to restructure legacy and operational debt. The hospital currently employs over 275 people and is the largest employer in Calais.

Hospital administrators expect minimal impact on operations and staff during Chapter 11. They have requested permission from the presiding court to pay employees in the ordinary course of business. This is a typical request that is granted in Chapter 11. No layoffs are planned.  Restructuring debt will allow the hospital to emerge from Chapter 11 protection on better financial footing.

“The hospital is not closing.  We remain committed to providing exceptional patient care during the Chapter 11 process. All departments are operating as usual and our talented team is focused on delivering high-quality health care services to our community,” said Rod Boula, chief executive officer of Calais Community Hospital (CCH).

Over the last several years, in spite of the numerous steps CCH has taken to operate more efficiently, a combination of local and national factors have created conditions that have made debt restructuring in Chapter 11 a necessary step. These factors, including downward trending of utilization, high levels of charity care and bad debt, inadequate reimbursements, and increasing regulatory requirements have all contributed to significant losses. 

The hospital has reduced losses from -$2.64 million in 2014 to approximately -$574,600 in 2018. 

“We expect a prompt and efficient reorganization, and to emerge from Chapter 11 restructuring a stronger hospital,” continued Boula. “With continued community support and steady utilization of our services, we can stabilize this hospital and provide high-quality health care to the region now and in the years to come.” 

Patients coming to the hospital will continue to get care and should see no change in how they receive care at the hospital or any of CCH’s outpatient offices. 

“Our dedication to the health of our patients remains our priority.” said Dr. Peter Wilkinson, long-term internist at CCH. “Our team of providers and caregivers will continue to work diligently to ensure that we are providing the best care possible to the people of our region.”

KEY POINTS

  • Calais Community Hospital is not closing.  During bankruptcy, employees get paid, and hospital services will continue without interruption.  Patient health and safety remain our top priority. 
  • By entering the bankruptcy process and restructuring debt, Calais Community Hospital will emerge a stronger and more resilient hospital.  The goal is to ensure that the community will continue to have hospital services close to home.
  • During the bankruptcy process, day-to-day operations will stay the same, so if you come to the emergency room, for example, you will receive excellent care and you won’t notice any difference in our ability to help you get well.  If you have a scheduled appointment with your provider, your visit will be unchanged.
  • Bankruptcy is the best option to ensure that Calais Community Hospital can continue to provide high quality health care and keep jobs in the community. Restructuring strengthens the hospital’s long-term financial position and gives the hospital better options moving forward. 

WHAT CAN THE COMMUNITY DO TO HELP?
You can support the hospital and 281 local jobs by using our services.  Next time you need medical care, come see us. 

FREQUENTLY ASKED QUESTIONS

Is the hospital going to close? 
No. Our goal is to ensure that hospital services continue to be available in northeastern Washington County.  Bankruptcy is a restructuring process that occurs along-side normal day-to-day hospital operations. We aren’t closing our doors. Patients will continue to get care, employees will be paid, and the hospital will run normally.

Will there be layoffs?
No layoffs are planned within the bankruptcy process. We continue to monitor our overall effectiveness at providing excellent care for our patients and will adjust operations as needed.

Why does Calais Community Hospital (CCH) need to file for bankruptcy?
Over the last several years, in spite of the numerous steps CCH has taken to operate more efficiently, a combination of local and national factors have created conditions that have made bankruptcy a necessary step. These factors, including downward trending of utilization, high levels of charity care and bad debt, inadequate reimbursements, increasing regulatory requirements, and high-cost temporary providers have all contributed to significant losses.  Health care delivery is rapidly evolving and reimbursements are not evolving fast enough to keep up with the expenses associated with rural access to critical hospital services.

Will services be cut?
We do not plan to cut services at this time. In order to continue to provide high quality health care to our patients and keep jobs in the region, we will continue to evaluate all aspects of our operations and service lines will be aligned to regional demand. 

How long will this bankruptcy process last?
Approximately 12 months, however, the Chapter 11 process can be longer or shorter depending on several factors.

Are there other options besides bankruptcy?
Other options were thoroughly explored and none offered a path to long-term stability as effectively or quickly as the Chapter 11 bankruptcy process.  Chapter 11 is a commonly used tool in the life-cycle of a business that gives a fundamentally sound organization the option of restructuring its debt.  In our case, we have worked diligently over the last few years to reduce losses and improve operating efficiency to the point where Chapter 11 is an option. 

Even with bankruptcy, can the hospital afford to stay open?
Yes.  Several factors are helping us improve our balance sheet and “right-size” expenses and revenue. We have a solid business plan in place and with increased community utilization of our services, we fully expect CCH to exit bankruptcy on stronger financial footing. 

What can the community do to help?
We have served this region for over 100 years.  We value our relationship with our patients and we remain dedicated to providing exceptional care, close to home.  You can help us by choosing Calais Community Hospital for your health care needs.

What happens when CCH exits bankruptcy?
When we emerge from bankruptcy, we will be on much stronger financial footing.  Financial health and long term viability gives us many more options for partnering, collaborating, and finding the best solutions to serve the ever-changing health care needs of the community.  

Basil to Pesto

Since moving my basil plants outside (thanks Kris), they have really flourished! With such an abundance of basil I figured a batch of pesto was in order. See my step by step process below or click here for a printable version of the recipe.

Pesto

Ingredients

2 cups fresh basil laves

2 cloves garlic

1/3 cup pine nuts

½ cup Parmesan cheese

¼ tsp. Pepper

½ cup Olive Oil

1.  Add the fresh basil leaves, garlic, pine nuts, parmesan cheese and pepper to the bowl of your food processor.  Pulse until a coarse mixture forms.

2.  Turn the food processor on low and slowly add the olive oil in a steady stream.  Process until smooth.

Nutrition Information

Serving Size: ¼ cup

Homemade                                                 Commercial

Calories: 368                                                   Calories: 290

Carbohydrates: 3 grams                                 Carbohydrates: 4 grams

Protein: 6 grams                                             Protein: 4 grams

Fat: 38 grams                                                  Fat: 29 grams

Sodium: 204 mgs.                                           Sodium: 960 mgs.

Note: Although fat content, and thus caloric content is higher in the homemade, the fat sources are heart healthy (nuts and olive oil) and sodium content in the homemade is significantly lower than in the commercial product.

Let’s Salsa!

With an abundance of garden tomatoes I thought Salsa was in order. Here is a link to printable version of the recipe: Salsa Recipe.

Salsa
Ingredients
6 Roma or garden tomatoes cut into quarters
1 jalapeno, seeded and roughly chopped
½ large yellow or red onion peeled and roughly chopped
3 cloves garlic, chopped or crushed
Juice of lime
1 cup loosely packed fresh cilantro leaves
1/8 tsp. cumin
Instructions
Place all ingredients in a blender or food processor and pulse until just chunky. Taste and adjust seasonings if needed. Refrigerate at least an hour to let the flavors meld.

Nutrition Information Comparison
Serving Size: ¼ cup
Homemade Salsa Bottled Salsa
Calories: 13 Calories: 20
Total Fat: 0 Total Fat: 0
Sodium: 18 mgs Sodium: 300 mgs.
Carbohydrates: 3 g Carbohydrates: 5 g
Protein: 0 Protein: 0

Diced Tomatoes

Since I am having a lot of great tomatoes this year I decided to put up some diced tomatoes.

Did you know that canned tomato products contain a lot of sodium? Two cups of canned diced tomatoes have around 840 mg sodium. Two cups of my diced tomatoes that I froze  have around 8 mgs of sodium.

Homemade Tomato Ketchup

By CCH Dietitian Mona Van Wart – I loved making this tomato ketchup. I thought it was really fun to do and the end product was fantastic . As I was making the ketchup,it took me back to my childhood when I was a little girl helping my Mom process vegetables from our gardens.

I do not use ketchup as a condiment, but I do have a couple of favorite recipes of my mother’s that uses ketchup as the main ingredient for the sauce. I decided instead of freezing the ketchup as I originally had planned I would make those recipes and then portion and freeze the end products for my lunches.

A pdf version of the recipe can be found on the Health Eating page or by clicking here.

Ingredients

6 pounds tomatoes (about 12 large tomatoes)

½ cup brown sugar

¾ cup onion (finely chopped)

2 cloves garlic (finely chopped)

½ cup red wine vinegar

½ cup cider vinegar

½ cup balsamic vinegar (I chose the kind that had 0 mgs. Sodium)

Cayenne pepper (optional)

Directions

  1. Preheat the oven to 450°F.
  2. Wash tomatoes.
  3. Halve the tomatoes, drizzle some olive oil over them, and place on 1-2 baking pans.
  4. Roast for 20 minutes or until they are soft and wrinkled looking, but not burnt.
  5. Let the tomatoes cool, and then transfer them to a blender or food processor and puree until they are smooth.  Process in small batches.
  6. In a heavy-bottomed pot over medium heat, warm the sugar, keeping it moving with a spoon, for about a minute.
  7. Add the onion, garlic and the pureed roasted tomatoes.  Reduce the heat to medium-low and cook for 10 minutes.
  8. Add the three kinds of vinegar and continue to cook for another 30 minutes or until reduced by two-thirds.  The ketchup should be thick.
  9. Remove from heat and season to taste with the cayenne pepper, if desired.
  10. Strain the ketchup through a mesh strainer into a glass or stainless steel bowl. 
  11. To cool the ketchup, fill a large stockpot about halfway with a mixture of half ice, half water, and submerge the container in the ice bath to chill.  The ice-water level should come most of the way up the outside of the container, but don’t let any water into the ketchup. 
  12. Stir the ketchup occasionally until the temperature reaches 70°F on a thermometer.
  13. Then remove the container from the ice bath, cover and transfer to the refrigerator where it will keep for 3-5 days.
  14. Ketchup can be frozen in small freezer bags or containers, or I read that it can be put in ice cube trays and then put them in a freezer container.

Nutritional Guidelines (per serving)

1 serving = 1 Tbsp       Calories: 8      Fat: 0 g      Carbs: 2 g      Protein: <1 g      Sodium: <1 g

(Comparison – Store bought ketchup)

1 serving = 1 Tbsp       Calories: 19      Fat: 0 g     Carbs: 4.5 g     Protein: <1 g     Sodium: 154 mgs

Plant Relocation & Some Harvesting

I thought my plants might do better outside. So with the help of Kris Mesman, we transferred the plants outside in front of the Health Services Building.

These are my potatoes that I planted in a container. I like small potatoes so I planted 8-10 slices with eye of the potato in a container that was around 18” in diameter.If I had wanted less but larger potatoes I would have planted 4-6 slices of eye of the potato in the container.