ANNUAL REPORT

Are you interested in a piece of glassware? Mrs.Y. Fitzhugh'Hardcastle, 1st Vice-President of The Nashoba CommunityHospital 'Auxiliary, shows Mrs. Mildred Allen of the BusinessOffice some new items recently placed on sale in the GiftShop located in the lobby of the Ayer Unit. The Talent Auction,held as advertised on April 27, sweltd the Auxiliary's treasuryby some $2400.

REPORT OF THE PRESIDENT

OF TNCH AUXILIARY

The Auxiliary of The Nashoba Greens Sale, a Talent Auction,Community Hospital in May Food Sales on Town Meeting-proudly completed almost two Days, Harvard Tog Shop, Ayerand one-half years. as A con- Thrift Shop, and the GiftCarts.solidated group with a con- Donation' Day in the Falltinued record of achievement brought forth remarkably gen-and service. The Community erous gifts of food valued atHospital Iviemorial Aid (est- $911 and money gifts.ablished in 1928) andtheGro- The success of the eventston'Community Hospital Aux- enabled the Auxiliary. to re-iliary (established- in 195t) decorate the lobby of the Gro-combined upon the merger of ton Unit, donate to the 1966S. the Hospitals on oJanuary 1, Development Fund, assist in

S1945. s o the- refirbishment o, o the-H .. avfang-assume3dth e.Presi- -jrounds'at'both units>andto.

'ertiaavely short termiif memi ments of the Axliary. Aawed by the. many hours of has been the payment of theSservice andquiet dedication Hospital's share of maintain-

i of so many women from the ing the Easter Seal Rehabill-Town units of Ayer, Groton- tation Team. .Thisteam pro-

Pepperell; Harvard, Shirley vides to Hospital patients one4 and Littleton. To all of you day a week the services of aI say "WellDone" and "Thank Speech Therapist, an Occupa-You" for the cooperation you tional Therapist, and a Medi-have given me as well as for cal Social Worker, as well asyour accomplishments on be- furnishing one day or so eachhalf of-the Hospital. month to the Nursing Staff theAmong. the volunteer ser- educational services of a re-

vices rendered to the Hospi- gistered nurse speciallytal are these: the replace- trainedin rehabilitative nurs-ment each week of blood by ing procedures. The Auxiliaryexchange trips to Leomin- has voted to continue supportster Hospital, making of of this Team.Pinkie Puppets for the Ped- A more detailed account ofiatric Ward, servicing the the donations appears in theGift Carts in each unit, spon- report of Mrs. Roland Saw-siorship of the "Candy Strip- yer, our Treasurer.ers" (Teen Age Volunteers), During the year, various

:and other in-hsopital ser- members of the Auxiliaryhavevices, attended conferences at re-Fund raising projects were gional, state and New England

many, varied, and successful, levels.These included rummage This record could only besales, a Christmas Fair, the Cont. Page2

This is our new(?) Groton Lobbyl Work has just been com-pleted on a very extensive redecoration ofthe lobby and offices

'in the Groton Unit. Under the joint chairmanship of Auxilians,Mrs. Francis P. Nash of Groton and Mrs. Robert Winslow ofLittleton, the area has been completely re-painted, new fiber-glass draperies made to specifications, the lobby floor carpeted,and many other smaller improvements made. This major face-lifting project was made possible.by donations of both money andtalent, by The Nashoba Community Hospital Auxiliary. Mrs.,Leslie Rowe, Auxilian from Groton, shows Mrs. Jean Fiske of'the Mediciti Record Department some of the items exhibited inthe Gift Shop's display case built recently for the Groton Lobby.

'Mrs. ;Barbara Jankoski, Admitting Office, checks on a plant" .delivered:for a patient.

Supplement To THE PUBLIC SPIRIT , Thursday May 25, 1967

THE NASHOBA COMMUNITY HOSPITALPRESIDENT'S REPORT, 1966-1967

As of this May two full years have passed since The NashobaCommunity Hospital began its existence. The former twoHospitals which were consolidated to make this possiblehave 'now become one in every sense of the word except forthe creation of a new single physical plant.

When I look back at the problems that faced our people inJanuary of 1965, we have come a long, long way. Each andevery one of us, Doctors, Staff, and Trustees have learned tolook at this service that we offer as a single effort. To do thisin just a little over two years is something about which weshould be very proud.It requires a great amount of patience, understanding, and

cooperation to make such a consolidation possible, and to doit in such a short time with so little-friction and misunder-standing is a very rare thing to experience. It would not havebeen possible without the full cooperation of every last personwho works with, or for our Hospital.

I wish that I could thank everyone of you personally. To thosewho are members of the Staff, you have waited quietly througha long period of uncertainty about your jobs and work conditions;thank you for this patience and the understandingthat goes withit. To our Medical and Dental Staffs goes'great credit for oneof the most impressive bits of teamwork that I have seen. ToRobert V. Fay, who has filled the part of the vital link throughwhich we are related to each other and as the basic channel forcommunication, goes my heartfelt thanks. I know that there weremany times when he must have wondered just which way the shipof state was headed, yet he never gave up trying to find new andbetter ways to guide it and ease its twisting movements throughso many new channels. The policy guidance and-the generousassistance offered to the Administrator by our Officers andTrustees has made my job an easy one. A President of a newcorporation can consider himself lucky if he has the help ofsuch a group as we have helping us.I feel that the Ladies of our Auxiliary are due a special

"thanks". You are vital to us because in many ways you areour eyes and our, ears, as well as one of our main supports.Whatever it is that makes a group work well as a team is avery dear and valuable relationship to protect when big changesare taking place. I marvel at the job you have done! You areto be congratulated. The Junior Volunteer Aides deserve muchcredit for helping so many patients to have a more comfortablestay. We appreciate your help.

From here we look ahead. Our, ship is running smoothly andon a relatively easy sea. Where we go from here is largely amatter of our ability to plan. I feel that Richard C. Taisey,who will be your new President, is by far the best qualifiedman to take over. As Vice-President of the Corporation andas chairman of the Long-Range Planning Committee, he bringsthe experience and feeling for the future to the job of guidingus along the way.

Nathaniel BowditchMay 8, 1967 President, Board of Trustees

We have Junior Auxillans alsol Mrs. Marjorie Klein (RN),Relief Head Nurse and also Volunteer Coordinator for theJunior Volunteer Aides, demonstrates to a new class of juniorvolunteers some of the procedureswhichthe Aides, when quali-flied, will be permitted to perform for the patients.

OFFICERS AND TRUSTEESPresident: Nathaniel Bowditch - GrotonVice-President: Richard C. Taisey - GrotonTreasurer: Sidney F. Mason - PepperellSecretary: Mrs. Douglas M. White - GrotonAlbert E. Anderson - HarvardFrederick W. Backes - HarvardJ. Murdock Blake - Groton _William S. Boettcher - PepperellNathaniel Bowditch - GrotonMiss Grace C. Cummings - HarvardMrs. Richard E. Danielson - GrotonArthur W. Ferguson - GrotonAlfred E. Glavey - LittletonNorman Grant - GrotonMrs. Vernon H. Griffin - ShirleyHamilton Heard, Jr. - ShirleyMrs. C. Frederic Jellinghaus - LeominsterDonald A. Kennedy, Ph.D. - LittletonCarl A. P. Lawrence - GrotonGeorge E. Lawrence - GrotonJoseph Madigan - GrotonMrs. Kenneth W. Marriner - PepperellSidney F. Mason - PepperellRev. Henry Mattocks - AyerMrs. Francis P. Nash - GrotonE. Paul Nebel - AyerDana T. Norris - GrotonMalcolm J. Odell - ShirleyRichard J. O'Toole - AyerMiss Margery Peabody - GrotonThomas A. Pine - TownsendHerbert G. Pratt - LittletonDonald B. Prouty - LittletonLouis H. Ressijac - AyerAdelard A. Roy - GrotonHon. George W. Shattuck - PepperellJames E. Shaw - DunstableRichard C. Taisey - GrotonPaul R. Taylor - PepperellLawrence Terry - HarvardGordon E. Westby - LittletonMrs. Douglas M. White - GrotonMrs. John C. E. Williams - TownsendMrs. Louis C. Zahner - Groton

MAY 1966 - MAY 1967

IPPB Treatment - Doctor Edward B. Hopkins checks hispatient, Ysabel M. Caron, as she receives a treatment on theIntermittent Positive Pressure Breathing machine. The GrotonRotary Club, during the year, donated another one of thesemachines for use in the Groton Unit.

REPORT OFMEDICAL STAFF PRESIDENT

The immediate period ofpost-consolidation uncer-tainty has given way to a morestable atmosphere withthoughts now turned to our Ho-spital of the future. My pre-decessor, Doctor Charles T.Porter should be commendedfor his effective leadership ofthe medical Staff thru the pasttwo years. The Staff was onrecord as favoring consolidat-ion for a significant periodprevious to the initial ground-work. Now 2 1/2 years post-consolidation, the Staff appre-ciates even more this new

.unification of effort; - '

During the'past year theMedical Staff has experienc-ed several loses and severalgains. The death of DoctorHarold Ayres on May 28,1966,marked the end of a Medicalera in our community. Hisdevotion to the practice ofMedicine was witnessed evento the last days of his lifeas he admitted a patient tothe Hospital only 48 hoursprevious to his death.The recent death of Dr.

J. Walter Desmond, for manyyears President of the DentalStaff, ended the life of a manwho might well be consideredthe pioneer of his professionin our community. Among hismany distinctions was thehonor of "Dentist of theYear" in the state of Mas-sachusetts. Both the Dentaland Medical Staffs have lostan esteemed friend with hispassing.The resignation of Doctor

Fae Adams in January 1967,was received with regret bythe members of the Staff, aswell as many future mothers.Her withdrawal from theactive Staff coupled withDoctor Leon White's loss in

April of 1966, left a largehiatus in our Active OBS-GYN Department. We werefortunate in obtaining theservices of Doctor Leah T.Myers who opened her officein Groton on August 15, 1966,and has helped to close thegap.Doctor Robert S. Borden, a

member of the now rare spec-ialty of. General Practice,joined our Staff in December1966. Hisenthusiastic desireto work and to cover approx-imately one-third of theAcci-dent Calls has' been a greathelp to the rest of the Staff.It has also resulted in a morestable coverage of the com-munity.Doctor F. Woodward Lewis,

Past President of the Mas-sachusetts Chapter, AmericanAcademy of General Practice,has been appointed a delegateto the American Academy ofGeneral Practice. Dr. Will-iam N. Stecher is chairman ofthe program committee for theProgram Committee for theMassachusetts Chapter, Am-erican Academy of GeneralPractice.Doctor James C. Stevens as

Chief of Anatomical andClinical Pathology has con-tinued his modernization ofthat department to provide theHospital with a Laboratoryun-surpassed in the area. Theseadvances contribute directlyto the rising standard of Medi-cal care in our institution.

Our committees have re-mained active during the pastyear. The Record Committeecontinues to have the benefitof Doctor Arlie Bock's inter-est and advice which has beena valuable asset over the

Cont. Page 2

Yes,- this is the Newborn Nurseryl Now located in theGroton Unit, many improvements and economies in the careof the newborn patient have become possible. Mrs. Eliza-beth Fernald (LPN) prepares to check tiny baby in theIsolette. In the upper-left-hand corner of the picture canbe seen a- hand-carved "Madonna" plaque.This was pre-sented to the Hospital by Mrs. Louise White (RN) in mem-ory of her late husband , Doctor Leon E. White, a memberof the' Medical Staff for eleven years and also Chief ofObstetrics for several terms.

( I

So much has happened In the year 1966-1967 that extensiveuse is being made of pictures in the Annual Report with thehope that Ithe subject matter may be visual and more inter-esting and that this written report may be considerablyshortened for the reader.

By far the most important event for the hospital and healthfield;, as well as for residents of the entire country, was' theactual initiation of the Federal Medicare Program on July 1,1966. It seemed, when the legislation was originally enacted,that -the "lead time" might be adequate to allow for planningand development of policies and procedures at the federallevel, but it became apparent early in 1966 that this could notbe the case. In any event, persons over 65 generally becameeligible for hospital, medical, and some other health benefitson July 1, 1966, and hospitals did take care of the Medicarepatients. In our area, there was no great influx of patients andour facilities were not taxed. There were many problemsassociated with prompt identification of patients as eligiblefor Medicare, and the cash position of the Hospital wasextremely tight for several months. By and large, however,our difficulties in these areas have pretty much disappearedand we seem to have taken Medicare in stride. One serioussituation has developed, in this as in most other parts of thecountry, and that is the lack of certified ECF's (extendedcare facilities) to which patients may be transferred as soonas they no longer require the services of an acute hospital.This Hospital's Board of Trustees is aware of the need andhas given approval to a plan for assigning eight or more ofour acute beds in the Groton Unit as an extended care facility.It Is hoped that the details may be settled and the servicesoffered to the residents of this area by the early sunmmer.Andither area of broad import to the Hospital -Js in State

Legislation which is now pending. The many different cost-reimbursement formulas established by various rate-settingagencies would be eliminated, and each hospital in the Com-monwealth would be paid on the basis of a uniform scheduleestablished for each hospital on the basis of its own demon-strated and allowable costs. The status of Blue Cross reim-bursement to Massachusetts hospitals is under study at thistime, and it is expected that a more equitable and reasonableformula may be authorized by the General Court and by theappropriate State agencies and officials.

' Lanoratory iecnnrelanymrs:-S.unre.' osmeT- rarequipment-necessary for routine laboratory wbrk, and also for emergencyprocedures, including blood transfusions, is available at eachlaboratory location. ..

of current inflationary trends andalso, even more especially,becapse of the impact of new federal and state legislationwhich have increased the minimum wages hospitals*must pay,have-liberalized regulations governing payment of overtime,and have removed hospitals and their personnel from some ofthe bargaining restrictions which had typified the health field.As a result, salaries have moved up rather rapidly and thecharges to patients for services -rendered have been adjustedupward. In our local situation,. charges have advanced-some-what. out of proportion because our continuing low averagebed. occupancy has not furnished enough leeway to meet in-creasing salary and othe r costs and still have enough quali-fied personnel on duty to meet the peak and emergencydemands for hospital service.Real progress on consolidation has been made during the

past year. The pictures included in this report explain manyof the structural changes which have been made. The new 6-bed pediatric unit, located in part of what used to be.the Ayerobstetrical suite, is working out quite satisfactorily. Exceptfor an occasional emergency almost no pediatric patientshave been admitted to the Groton building. The space occu-pied previously in Ayer by the old pediatric unit, a privatepatient's room, and the nursing station has been remodeled ex-tensively. The former infant Formula Room hasbeenconvertedto an urgently needed patient treatment and examining room.Many other changes have also been made with the final resultthat the combined bed complement of both units has been,raised from 81 to 84 beds. This modernizing and remodelingwas made possible by donations which had been made to the1965 Development Fund and by specific cash gifts from TheNashoba Community Hospital Auxiliary. Still under discussionIs the feasibility of coordinating all surgery in one unit,as opposed to scheduling surgery on alternate days In thetwo units.Many suggestions have been made, and .discarded,as to the best way to unify the Dietary Department.. Thestudy continues, however, and one or two more promnisingsolutions are now under consideration.

Whiplash Injury? In-the Physical Therapy Department Mrs.Edith Baker (RPT) adjusts controls for patient, Lucille Hamil-ton, to receive treatment on the Cervical Traction equipment.Unit in the right foreground is an ultrasound machine.

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ADMINISTRATOR'S REPORT

Where willlfindthat reference? Dr. Jeffrey H. Harris, Chair-man of the Medical Staff Library Committee, is pictured as hemakes use of one of the reference books available in the MedicalStaff Library. Library can be used to enlarge space availablefor major conference room purposes.

President Richard C. Talsey, has made real progress duringthe year. The Board of Trustees authorized the purchase, inDecember 1966, of a magnificent 40-acre site on WashingtonStreet in Ayer, abutting the Groton line. At the time of thepurchase it was pointed out 'that, while the purchase didnot necessarily commit the Trustees to building a newhospital at any given time, the purchase price was veryfavorable and the site would lend itself admirably to thebuilding of an area health and medical service complex.Work has already begun on demolition of the house and haybarn located on the so-called "Eliades Property" and onconversion of the dairy barn to a storage building. Thecash, exclusive of current note and mortgage, needed tocomplete this transaction was taken from the 1966 Devel-opment Fund.

The second Important step taken in long-range .planningwas authorization by the Executive. Committee to retainAnthony J. J. Rourke (MD) of New Rochelle, New York, todo a feasibility study. It is expected that, once the feasibilitystudy has been accepted, plans may then be developed for anofficial architectural competition to be conducted in accord-ance with" rules established by the American Institute 'ofArchitects.Planning on the area and state levels has received much

attention in the past year, and official representatives ofthis Hospital have devoted much time and thought to there-organization' and policies of the Central MassachusettsRegional Hospital Planning Council. The.council has re-cently been incorporated, and new bylaws were adopted onApril 27, 1967. It is a little too .early to say whether thechanges will meet requirements of already-enacted FederalP.L. 89-749 and pending State legislation, but progress hasbeen made and it is expected that further bylaw changeswill be made as the need arises. The areas of special con-cern are the percentage of membership allocated to "con-sumers" of health service, the real meaning of the term"cdlmprehiensive health4evic80' 0&ai htliif r'annlng isto be truly voluntary..Another organizational change at the area level, during the

past year, involved the official changing of the name,but notof the purposes, from Hospital-Administrators' Club of theWorcester Area to the Worcester Area Council of the Mas-sachusetts Hospital Association. This new designation cor-responds with the names of the other 5 member area coun-cils of the Massachusetts Hospital Association and clearlydifferentiates this area association council from the areaplanning council described above.The cooperative arrangement between the Hospital and the

Easter Seal Society worked out quite satisfactorily in itssecond year, and the contract has recently been signed forthe third year; which began on April 1st. Under the newcontract the Hospital will reimburse the Society for 60%of the salary expenses involved in making available to Hos-pital patients (both inpatients and outpatients) the servicesof occupational therapy, speech therapy, medical-social ser-vice, and nursing rehabilitation. With these services, plusthe Hospital's own Physical Therapy unit, the complementof rehabilitation services available to patients is quite com-plete and made it possible for the Trustees to authorizethe establishment, hopefully in the early summer, of anextended care service. Plans are to assign rooms #51 and#52 in the Groton building to this use. Policies governingadmissions to the ECF, type of nursing care to be avail-able, appropriate utilization of services, and optimum lengthof stay are now being developed.

The Joint Commission on Accreditation of Hospitals sur-veyed both units and issued a 3-year accreditation certificatefor the period beginning September 20, 1966. The biennialState inspection for licensing by the Bureau of HospitalFacilities was made a week ago, and it is expected that ourlicense will be. renewed soon.

The Hospital has been most fortunate in the past year withthe extremely generous support voluntarily given by membersof the towns served. The 1966 Development Fund Appeal hasalready received donations of almost $41,000.00. The Sub-scription Office (or the Annual Appeal for Maintenance Funds)received, in the fiscal year 1965-1966, a total of $19,280.000from 4555 area residents, a truly remarkable demonstrationof local support and interest. The cash value of gifts madeby The Nashoba Community Hospital Auxiliary, including foodvalued at $911 and received on Donation Day - 1966, amountedto the inspiring total of nearly $7,900.00.

Bequests made to the Hospital in this same period were asfollows: Estate of Miss HelenE. Bigelow of Harvard - $1,000.00(received), Estate of Mrs. Bertrand H. (Bessie B.) Hopkins,late of Ayer - $2,000.00 (received), Estate of Herbert H. Proct-or (on death of his widow, Grace) of Ayer - $20,000.00 (re-ceived), Estate of Frank C. Fletcher of Ayer - $2,000.00 (notyet received), Estate of Alexander H. McDonald of Littleton -$500.00 (not yet received), Estate of Miss Emma A. Bagsterof Harvard - $1,000.00 (not yet received).Other major gifts include: Mrs. Donald (Alma B) Humphriss

Memorial Fund - 2 Adjustable Height Beds: Ayer Rotary Club- 2 Adjustable Height Beds; Groton Rotary Club - IntermittentPositive Pressure Breathing Machine; In memory of DoctorJohn Lambert by his son, Benjamin deF. Lambert (MD)-60milligrams of radium. Richard J. LaVigne, (MD) - cost ofthe conversion of the radium (acknowledged above) Intoneedles with modern platinum containers.

Cash donations by 2 Medical Staff Members tothe LaboratoryDevelopment Fund and to the Radiology Development Fund.Items of equipment by Mr. and Mrs. Wendell Nutting of Ayer,Mrs. Monica and Miss Josephine M. Buda of Groton in memoryof Mrs. Betty Caldwell, Mrs. Frank C. Fletcher of Ayer, Mrs.Joseph Croteau of Shirley, Stanley Conant of Littleton, Mr. and

Mrs. Albert E. Stalling of Groton, Frank Finn of Westboro,Fae M. Adams, (MD) of Littleton, David A. Wiklund (MD) ofGroton, and a gift of $100.00 by the Groton School MissionarySociety.

Many other gifts were received, especially flowers, books,and tray favors, but space does not permit individual acknow-ledgment.To all donors, on behalf of the Board of Trustees, sincere

and grateful thanks is offered.The many organizations who have helped to make the oper-

ation of the Hospital simpler and more complete Include:Ayer and Groton Police and Fire Departments and the Ambul-ance services of Ayer, Groton, and Pepperell; the WelfareRepresentatives of each of the area towns; the Nashoba As-sociated Boards of Health and the several town Health De-partments; the Selectmen of the Towns of Ayer and Groton;the Nashoba Chapter of American Red Cross; the local LionsClubs for their assistance in. conducting a Glaucoma Clinicat the Hospital; a group of volunteers from among the studentsof the Groton School, who, during the winter, assisted us inLaboratory, Radiology, and Medical Records with the filingand re-arranging of files; the Editors of the PUBLIC SPIRIT,FREE PRESS, TOWNSEND TIMES, LOWELL SUN, FITCHBURGSENTINEL, WORCESTER TELEGRAM for their generouscooperation in helping the Hospital keep its public up to dateon activities and planning. Many other organizations andindividuals have also assisted during the year, but again ourspace is limited. To all a sincere "Thank You."We are saddened to report two deaths. A member of the Hon-

orary Medical Staff, Harold W. Ayres (MD) of Groton, died inGroton on May 28, 1966, at the age of 84. Active up to a veryshort time before his death, Doctor Ayres typified the physicianwho is so often referred to as the "country doctor" and the"family doctor". He had been a member of the Medical Staffof each of the original Hospitals before consolidation and hadserved with distinction for several terms as President.J. Walter Desmond (DMD) of Shirley, a member of the Hon-

orary Dental Staff, died in Arizona on February 25, 1967, atthe age of 71. To him is due the credit of having formed aDental Staff at a tim e when comparatively few hospitals inthis country had seperate dental staff organizations. Alwaysinterested in the welfare .of his patients, he had been wellnamed "Dentist of the Year" onlyafewyears before his death.

PAP Smear Procedure - Mrs. Eva Weise, Laboratory Tech-nician, processes specimens for Doctor James C. Stevens whodetermines diagnosis and advises the patients' attending doctorsof his findings.

This Annual Report, although long, does not, by any means,cover all that has happened during this eventful year, but itis hoped that some idea can be gained of accomplishmentsand of the people and organizations who made these thingspossible.This report can be considered reasonably complete only

after officially and personally recognizing the following per-sons: Nathaniel Bowditch who, as President and friend,worked so long, tirelessly, and constructively In helping tobring about "consolidation" -and, more important, in makingit work.

Bertrand B. Hopkins, (MD), who, as President of the MedicalStaff, has helped to make straight the many ways whichseemed to become difficult as a result of the many changeswhich came with Medicare, Utilization Review Committees,and the like.

Benjamin F. Lawton, (DMD), who, as President of the DentalStaff, has given effective Staff leadership and has encouragedparticipation by Dental Staff members in the affairs of theHospital, in the maintenence of good medical records, andin the evaluation of dental care and treatment of hospitalpatients.Mrs. Albert E. Anderson who, as President of The Nashoba

Community Hospital Auxiliary, performed a splendid servicefor the Hospital and community by her objective, clear, andimaginative approach to the position of President.None of the things recounted in this Report would have had

any real value or significance without the true and whole-hearted support and cooperation given by all members of thepersonnel team of the Hospital. To each one of them I extendmy sincere and personal thanks.

May 8, 1967 Robert V. FayMay 8, 1967 Administrator

Surgery'In 15 minutesl Mrs. Viola Noyes (RN) and Mrs.June Paradis assist the regularly assigned O.R. personnelto ready the Groton Unit's operating suite for emergencysurgery.

i

TREASURER'S REPORTThe following is the audited

Financial Statement of TheNashoba Community Hospitalfor the year ending Septem-ber 30, 1966. As you canreadily see from the figures,operating a Hospital such asthis is big business.

The total operating expensefor the 12-month period was$944,181.02. This includessalaries, commissions, sup-plies, and all other expenses.For the same period the totaloperating income was $866,-459.42 and with depreciationfigured in we ended up with anet operating deficit of $101,-782. 75. In other words it cost$101,782.75 more to supplyHospital services to thecommunity than we receivedin earnings for services ren-dered.The non-operating income we

receive, which is made upmostly of contributions frominterested citizens, organ-izations and industries in thecommunity, income from in-

May 8, 1967

vestments, and the hospitalAuxiliary, makes it possiblefor us to balance our booksand make necessary.improve-ments in patient care andequipment. For the periodco-vered by this report the netnon-operating income - was$103,647.44, making a net in-come gain for the year of$28,864.69. This shows howimportant each one of ourcontributions is, no matterhow small or large it may be.The Hospital Auxiliary con-

tributed $8,812.51 during theperiod to special projects andoperating expenses, of theHospital. This is a wonderfulexample of hard work and de-dication on the part of manyindividuals.With your continued support

The Nashoba Community Ho-spital will continue to furnishthe finest in health care tothepeole of our community.

Sidney F. MasonTreasurer

Smallpox Hazard Doctor Elizabeth K. Lewis, volunteerEmployee Medical Health Advisor for the Hospital, admin-isters a routine smallpox inoculation to the Director ofNursing, Mrs. Sylvia Noddin (RN).

Med. Staff Pres. Cont.years. The advent of Medi- ment. A large part of the re-care required that we form a- sponsibility as to the successnew committee known as the or -ailure of The NashobaUtilization Review commit- . Community Hospital restedontee; its purpose- to ensure -'the -Administrator and histhe proper use of our Hospital ability to blend the Personnelbeds i.e. to make these beds -of- tw6 Hospitals into oneavailable to all people of the "organization. He has accom-community in need of acute plished this, and in most in-Hospital care and for only as stances without loss of har-long as this type of care is mony. I believe that the suc-required. The influence of this cess of consolidation hasbeencommittee now applies to all - established and- one indicat-Hospital beds and not just., ion was the receipt -of .. ourthose occupied by Medicare 3-year accreditation.-': The.patients. The success of this Medical Staff appreciatesthe-committee is dependent not vital role of an.Administrat-1only on its members but on the or in these achievemetsi-f .-entire staff. - After 5 years. as President

The new. Doctor-Finding.' . of the Hospital Tistees, 'Mr.Committee under the-.chair- :Nathani'-Boditch.' has,manship of- Doctor David A. earned. - many -ti mes? over-Wiklund has been active in an the ' right to ' retireattempt to recruit new physi- for life. I doubt that any fut-cians.The committee - - was- ure' President- will- have tSenhanced by the addition of serve in more difficult times.Mr. - .Nathaniel Bowditch, His qualities of patience, fair-Trusteee Representative. We ness, and unstinting devotionrecognize a specific need for to the Hospital interests guid-Doctors in Littleton, Ayer and ed all of us calmly thru ",thisShirley and will continue in period of transition. Theou search to solve these Medical Staff will always beneeds. grateful for what he has done..

A Testimonial Dinner was We will continue to workheld on March 1, 1967, for closely with the Trustees andDoctor Joseph A. McLean in to support the new Presidentrecognition of 35 years of towards the day when we can-service to the community .and finally lay the cornerstone ofHospital. The attendance of -our new Hospital.over 30 members of the Finally, on behalf of theattending and consulting staffs Staff I want to thank the Wo-was the best indication of men's Auxiliary for their con-gratitude and appreciation to- tributions of Medical equip-ward a retiring Associate. ment during the past year andWe again commend Mr. Fay also indicate our appreciation

for the skillful administration to all. of the Hospital personneland tactful mediation that he who worked with us each dayhas demonstrated during the and without whom there couldpast two years of readjust- be no Hospital.

ZFRTr0-L- 9') ^. //opk-i.sBertrand B. Hopkins, MDPresident - Medical StaffMay 8, 1967

TO AtMBL m WO

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fc.7M.ol

THE 26000,06COMMUNTY HOSPIAL -66.602269 26 2922--d. E .... 0.. 1 62 .98 60.- 620 6"a2Year6,nd0dsalt..6.0 30, 1966,

ion-oPEHmzsG cCO ... '

" Donatian:

Subscrlptin ffIceHo.pltal Auxllly*Donatod Co4nodltli - Hoplt1l AulllryTuna Grs nti .

Tranfers from TmParary Funds

76,124.71,.19,334.64 "8,812.51

. , $106,195.5324,550.13

S . 4.0-.,49

Less: nn-Operating Expanes :Fund Raising Uxpen ... 3,413.36Micellaoneous Expanses 689.1Interest 77.24 4179.71

Nat on-Op rating Incoe. s 1 7.4 -Le.s: pratng efct - Schedule 0-1 1017B.75

t Inc far the Year Ended September 30, 1966 64.69Add: Depreciation Included In Operating Expense 44061.15

Deduct: Prior ,Year'. lu. Cross Sattlm 6nt S 1,674.95 2,9a.4

Tranfer t Plant Fund for:N. Equlpment 55,299.16Payment of ortgag 1e 0. 66 94.13

General Fund Balance at October 1, 1965 245001Gen.ral Fund Balance at September 30, 1966 1250,991.87

S 4 ,minor canges have been pads for purposes of clarficatlon; totalsa. not6 ffooted. S.M.)

C*0OS RC02 sUpri. SVICE0ST 90 PATINTS1

I *lm Bom -

6o..tk..ZA .g

0*6121207

aw2o0s i" os. ar sm.i0 o p7 iT

06000*2 0m7lll;.F !

0at6Mt62A1 10,o..P Il. Ag-cy ll -.t lowm266102 .5002 1A1200.

h.ee. C.*

P0looI- f6or bt.1A*-o .1

29291,6. 0202obz9. p .009

029 00 RM00 3SERVICES 90 PAIM2"

L..., op2 02lg1 Ad26p0000l.2 6.07.21.6620 0 ,mos ram. - 2S0.1 B-2NIT B t Ftodi t F lEAuo 1

Add Ota11 DoaCITft Ino D STIm o I0,TA20221nO96 0.82«« 010069220 2072029 292 926191 300 070.00 0.96

$570,556.706.667.M0

1579,224.20

1 36,690.6011,794.00

9,655.5094,630.1

104,645 456,906.009,524.451,245.00

2 903.606,622.61

14,579.192,09.089

1917,724.79

I 20,578.706,274.791,804.83

(2,773.18)3,674.63

- 2,01.0416060.00

1649.:42

1944,181.024.061.25 38.i42.1

Mrs. Ruth Hiller (OTR), a member of the Easter Seal So-clety's Traveling Rehabilitation Team, instructs patient Rich-ard Scribner in proper use of weight-lifting equipmentdesigned to assist !patients in recovery from conditionswhere accident or illness has damaged motion in the upper .extremities. The area shown has been equipped for Occup-ational Therapy procedures. .....

TREASURER'S REPORTTMrU A IIYIII ADV -

4 The following is the report by.the Treasurei of thehashobaCommunity Hospital Auxiliary of donations madeto ;: TheNashoba Community Hospital between May 1966 andAprillf967.

1. Portable Recovery Cart for Groton Unit.,. 525.002. Contribution toward cost dofremodelling and . .

equipping new Pediatrc Unli . . 542.943. Equipmenitand inital.suppesfor estalhm -

- of PAESmear seiicelinlthe Laboratory 267.44. Lobby and 3.Offices (iGrofdfUnit; arpeti13

oflobbypiaintineofentiearea 5ialaap2 of fiberglass draperi essiid. isceli:saeous de-.

corating expenses "','.. - 383"S 5. Patient Lift (hydraifid. .

6. Patient TreatmenandiExaminingRoom ,Ayer,-. INursing Unit - cost'ofiemodelingold Infant

'6 ;oirmula Room -7.8:; "6;'6;.-.-.". .'--..06.S7 Cntribution towardSpring conditioning aof the

S -, grounds of both units - : 522.008, Educational Fund--or Ispital,3ersonnelto .9-- -

S.attendhospital and related institutes andse - ..- ,..minars .... 01 42-

9. Contribution to Hospital's 1966 Development -SFund (see also 2 and-6 above) .. 00.00-

10. Valueof Food' receivedon Donation Day -- Octoberi18, 1966 "-- . *** 911-.00

11. Presents to patients in Hospital on Christ- -mas day, 1966 62.50

1 12. Two subscriptions to "Boston Globe" daily -'and "The Herald" daily; one of each 'for -patients- in the Ayer and Groton Units.(pad in-year) : -' ' 77.00

13. Small Refrigerator for Patient Nourish- -ment Area n -Groton Obstetrical Department '69.88

14. Service Pins for Volunteers -9.6015. Physical Rehabilitation'Unit - Donation to -

Hospital for the difference between payments -.actually made by patients for treatments(occupational therapy and speech therapy)and the amount of subsidy given to the Hospitalby the Easter Seal Society for maintenance of'the services of a Traveling Rehabilitation Teamon a tentative, minimum 3-year basis 1941.85

TOTAL 7874.22

Mary T. Sawyer.May 8, 1967 Treasurer

Groton Unit Nursing Station: Some minor adjustments werealso made in Groton in order to enlarge the charting areaavailable for members of the nursing staff. Mrs. Hilja Mak-sym (RN) uses new charting space while Mrs. Anna Kopec(RN), Relief Evening Nursing Supervisor, checks medicationsWard Secretary, Mrs. Avis Sheehan, answers on the "Red"phone; a direct telephone installation between the GrotonUnit and the Groton Police Tower. This phone is used as a two-way alert concerning emergencies, disasters, and the like.Equipment in the corridor outside Room #64 is the portableRecovery Cart donated by The Nashoba Community HospitalAuxiliary. Oil painting on the wall in Room #64 was donatedby Evening Nursing Supervisor Constance Stalling (RN) andher husband, Albert.

TNCH Aux. Cont.accomplished with the coop-eration and support of manypeople - the Board of Trust-ees, our Administrator, Ro-bert V. Fay, the Hospital per-sonnel for their willing andcheerful help in so many In-stances, and those inthe com-munity at large who have re-sponded so enthusiastically toour endeavors.Special mention must be

May 8, 1967'

made of the officers of theGeneral Auxiliary, the chair-men of the Town Units and

.their officers, and to all spec-ial committees.As Auxiliary President, one

of the major rewards hasbeen my association with thesefine women.Again, well done and may we

continue our efforts, whereverwe can to be useful to theHospital and its role in thecommunity.

Frances'H. AndersonPresident

No more claustrophobial With removal of the wall behindthe nursing station in the Ayer Unit working space has beenenlarged, light is much improved, the noise level has beenconsiderably reduced, and ventilation should no longer bea critical problem. Pictured here at the desk are the Ward -Secretary (Mrs. Nancy Colburn) and the head nurse (Mrs.-Barbara McGough, RN); an aide (Mrs. Phyllis -Press6n)".checks orders in a patient's record while a Medical StaffConsultant (Henry St. John Smith, M.D.) reviews his pat-ient's chart. The old pediatric unit (left side of the pcture)has been converted to an observation room' and a two-robrmadult unit. . . -

- - - - - - - - - - - - - - - - - --- - I- - :_:i9.i:- 6.:: : : - I*

4S.TO

il

Defibrillator - Doctor Elizabeth K. Lewis demonstrates useof life - saving equipment on "patient" (David B. Priest)in the Emergency Room. Mrs. Dorothy Fielden(RN) adjusts thecontrols of the deilr-illator as directed by Doctor Lewis.

And this is Medica3Recordsl Elizabeth Lizotte is transcribingdoctor's notes into apd tlent's chart while Mrs. Mary Fogden isdrawing off an enlarged ph6tographic copy of one sheet of apatient's record which hlad been microfilmed several years ago.Shortly, all patients' records through September 1964willhavebeen microfilmed.

DENTAL STAFF 1966-67

- Officers - Dental StaffPRESIDENTVICE-PRESIDENrSECRETARY

Benjamin F. Lawton DMDJohn A. Fleming, DMD

-- Robert E. Marriott, DDS

Deni l Staff - ActiveBenjaaira K. Ammenwerth, DMD.Alden Gi Brown, MD.John E. Fleming, DMD.David . Hopkins, DMD.Benjaailra F. Lawton, DMD.George W. Lynch, DMD.Robert .. Marriott, DDS.Philip A McGuane, DMD.James 1. Picone, DDS.Philip B. Temple, DDS.

Dental Staff - ConsultingLawreace R. Brenner, DMD.Daniel J, Holland, DMD.CharleslE. McGowan, DMD.Robert Xoynihan, DMD.Roderick W. Lewis, DMD.

MEDICAL STAFF.1966-67Officers - Medical Staff

PRESIDENT Betrand B. Hopkins, MDVICE-PRESIDENT William N. Stecher, MDSECRETARY Douglas S. Callander, MD

Medical Staff - Active .Douglas S. Callander, MD.Donald E. Currier, MD.Lester L. Graves, MD.Jeffrey H. Harris, MD.Betrand B. Hopkins, MD.Edward B. Hopkins, MD.Elizabeth K. Lewis, MD.F. Woodward Lewis, MD,Alexandra W. Pittelli, MD.Charles T. Porter, MD.Robert T. Silvery, MD.William N. Stecher, MD.James C. Stevens, MD.David A. Wiklund, MD.

Medical Staff - HonoraryJames D. Christie, MD.Joseph A. McLean, MD.

Medical Staff - CourtesyEdgar D. Bell, MD.Robert S. Borden, MD.Henry S. Harvey, MD.Joseph E. Humphries, MD.Leah T. Myers, MD.

Medical Staff - Consulting

Charles Averill, MD. Boston, SurgeryH.T. Ballantine Jr., MD, Boston, NeurosurgeryRichard A. Bartlett, MD, Clinton, MedicineNorman W. Beberman, MD, Fitchburg: OrthopedicsCyril A. Bergman, MD, Fitchburg, PediatricsHerman L. Block, MD, Fitchburg, CardiologyDonnell W. Boardman, MD, Acten, Internal MedicineArlie V. Bock, MD, Harvard, Internal MedicineJohn M. R. Bruner, MD, Groton, AnesthesiaCharles F. Chandler, MD. Clinton, General SurgeryRalph E. Cole. MD. Chelmsford_ Internal MedicineSidney Curelop, MD, Nashua, N.H., CardiologyRobert E. Farrand, MD, Fitchburg, Thoracic SurgeryStuart S. Fay, MD, Fitchburg, OphthalmologyRobert S. Goldberg, MD, Leominster, RadiologySamuel C. Golden, MD, Fitchburg, Otolaryngologyand Ophthal-

molog)Richard A. Guenther, MD, Clinton, General SurgeryWilliam B. Havey, MD, Leominster, ObstetricsE. Parker Hayden, MD, Boston, SurgeryFelix Heimberg, MD, Fitchburg, OrthopedicsVincent J. Hickey, MD, Nashua, N.H., SurgeryMaurice Huckins Jr., MD, Chelmsford, SurgeryJohn J. Hunter, MD-Fitchburg, UrologyDieter H. Keller, MD, Gardner, PathologyCharles S. Keuper, MD, Concord, DermatologyJames F. Kiely, MD, Lowell, OrthopedicsBenjamin deE. Lambert, MD, Chelmsford, SurgeryChristopher L. Landry, MD, Lowell, NeurosurgeryRichard J. LaVigne, MD, & Associates,,Fitchburg, RadiologyJohn E. LeDonne,.MD, Fitchburg, Dermatology -Peter Lehndorff, MD, Fitchburg, AnesthesiaHerbert T. Leighton,MD,& B.L.I.Associates, Boston, ObstetricsRoy E. Mabrey, MD, Boston, SurgeryFrancis C.McDonald, MD, Concord, PediatricsEdmund C. Meadows, MD, Leominster, SurgeryRobert E. Nelson, MD, Boston, UrologyFrancis A. O'Toole, MD, Clinton, Otolaryngology & Ophthal-

mologyRichard A. Overholt, MD, & Clinic Associates, Boston,

Thoracic Surgery.uwaru d. Paimer, MU, Brookline, Neurosurgery

Albert M. Pearson, MD, Fitchburg, UrologyWalter Pick, MD, Fitchburg, PediatricsErskine R. Pickwick, MD, Fitchburg, RadiologyRobert A. Rice, MD, Fitchburg, MedicineAaron I. Simon, MD, Fitchburg, OrthopedicsHenry-St. John Smith, MD, Fitchburg, NeurosurgeryH. Judd Sparling, MD, Fitchburg, PathologySeda A. Sparling, MD, Fitchburg, PathologyE. John Steinhilber, MD, Wakefield, PsychiatryRichard E. Stiles, MD, Allston, UrologyKenneth M. Sussman, MD, Fitchburg, ObstetricsWilliam F. Thompson, MD, Chelmsford, SurgeryJ. Bradley Varnum, MD, Chelmsford, MedicineBurnham S. Walker, MD, Ashby, PathologyGeorge M. Walker, MD, Fitchburg, SurgeryRichard C. Webster, MD, & Associates, Brookline

J. Huston Westover, MD, Acton, MedicineCharles A. Wheeler, MD, Leominster, SurgeryPaul D. White, MD, Boston, CardiologyJoseph Winsten, MD, Cambridge, Plastic SurgeryJacob C. Wolterbeek, MD, Fitchburg, Psychiatry.

PlasticSurgery

oy tme Newoorn Nursery In the Ayer unit has been convertedto an adult 4-bed unit. The new adjustable-height beds weredonated: 2 by the Ayer Rotary Club and 2 from the fund

Established in memory of the late Alma F. Humphriss,many years the Hospital's Chief Clerk.

Main Laboratory in Ayer: Technicians Faye Friedrich (left)and Mrs. Marilyn Laitala demonstrate use of various units oflaboratory equipment, most of which have bdeen acquired In thelast 2 years. Unit at right of picture is called a cryostat, and,it is used for so-called rapid diagnoses of frozen tissue sect-ions. Senior Laboratory Technician, Joseph Cullen, can beseen in the background.

THE NASHOBA COMMUNITY HOSPITALS-YER, MASSACHUSETTS

PATIENT STATISTICS

October 1, 1965 -September 30, 1966

INPATIENT . .....

Toti

Tot

6 .. Adult & Pediatric

b. Newborn

OUTPATIENT

Emergency Room VisitsPrivate Ambulatory (non-emergency)

Radiology:PatientsExaminationsFilms

Electrocardiograms

Laboratory Tests

Physical Therapy

PatientsTreatments

Rehabilitation Services (furnished by theTraveling Rehabilitation Team of theEaster Seal Society)

Occupational TherapySpaeech TherapySocial Service

Operations Performed::

MajorMinor

Patients Admittad:

a. Adult & Pediatric

eb Newborn - .-

Oays of Care:

al 2986

25800* 06- :

al 21.-f6S

19,167

2,002

14864965

52156313

17689

900

32484

Mount Wachusett, aboud18 air miles away, as seen by patientlooking toward the southwest from room #66 in the Groton unit.

A new Pediatric Unit forn 6 patients: The space in Ayer orig-inally assigned to the Labor and Delivery Suite and to thePrecaution Nursery, tus been remodeled into a 6-bed ped-iatric unit complete witl its own-nursing station, nourishmentarea, utility room, batlbub room, toilet and washroom. Thethree patient rooms wLl normally accommodate 1,3 and 2beds respectively. I s. Margaret Boyd (RN) on the phonereassures a worried par ent.

Proposed new site ofThe NashobaCommunityHosital in Ayeron the Groton town line. Present plans call for demolition of thehouse and hay barn and use of the dairy barn (one-story buildingat left) for storage of Hospital equipment not needed for every-day operation. Site, purchasedfrom Mrs. Stephen Eliades in lateDecember 1966, contains 40 acres of land, all on the same sideof Washington Street and running to the B. & M. Railroadproperty.

Doctor Richard J. LaVigne and Janet DiSalvatore (RT)inspect the lead "pig" which holds a radium container andradium needles. Doctor Benjamin deF. Lambert has donatedto the Hospital 60 milligrams of radium as a gift in memoryof his father, Doctor John Lambert, who had originally pur-chased the radium early in the 1920's. It was the only radiumavailable for patients in Lowell until the senior Lambert'sdeath in 1949. Doctor LaVigne in turn gave to the Hospitala gift to cover the expense of converting the 60 mgms of radiuminto a modern platinum container and needles. With this doublegift it is now possible for the patient in this Hospital to betreat-"ed By either the interstitial or topical application of radium;a procedure which can be very beneficial in the treatment bfmany types of cancer in various parts of the body."

. : -;I: .... :. ... ~. .:' ' . '''. I . ' . ; . '. ;..;'.':.:c~l: : :.;: : 1 1 :: ::- ;:

Smallpox Hazard! Doctor Elizabeth K. Lewis, volunteerEmployee Medical Health Advisor for the Hospital, admin-isters a routinie smallpox inoculation to the Director ofVmp -al U L-YLoUre- Qu J.vin 1LT*

Me:d Stuaff Pres. Cont.years. The advent of Medi- ment. A large part of the re-care required that we form a: sponsibility as to the successnew committee known as the 'or 4ilure of The 'NashobaUtilization Review commit- Comunity Hospital rested ontee; its purpose to ensure .the,"Administrator and histhe proper use of our Hospital ability to blend the Personndlbeds Le. to make these beds '"f:t1V6 Hospitals, into oIeavailable to all pedpl' of te.'orgailization. He hasaccom-community in need"f ac te :plished*said .n mostin-Hospital care and for only as stances ltoiut:loss of har-long as this type of care is mony.I believe tht -the suc-required. The influence of this . cess of consolidaion hasbeenicommittee now applies to all-.established andione.ii,-idcat-Hospital beds and not: just. Ion was the r6 ei. iof. -iourthose occupied by Medicare -3yea! accreditt 'he.patients. The success of this Medical Staff appejpiate liecommittee is dependent not yial role of an .d at-only on its members but on the -or in these achievementsf'i,entire'staff. After 5 years ,asPesidentThe new Doctor-Findigi'. of the Hospital !-stees;4Mri.

Committee under 'the-char-ii i ie 7,d 'manship of- Doctor David-A. earnedI maiyl e- -Wiklund has been active in an the 'right 'to'" r tireattempt to recruit' new physi- for life. I doubt that any fut-

i ' aereomi'eer 'Presiden wlia-veu treenhanced by 'the addition of serve In more difficult times..Mr. 'Nathaniel Bowditch, His qualities of patience, fair-.:Trusteee Representative. We ness, and unstinting, devotion -recognize a specific need for to the Hospital interests guid-Doctors. in Littleton,Ayer aid ed. all of" us calily th i tliisShirley and will continue in period of transition. . The.oif search to solve these Medical Staff will always beneeds. -. grateful for what he has done.

A Testimonial Dinner was We will conitinue to-.. workheld ,on March 1, 1967, for closely with the Trustees.andDoctor Joseph A. McLean. in to support the new. Presidentrecognition of 35 years -of towards the day when we canservice to the community .and finally lay 'the cornerstone ofHospital. The attendance of our new Hospital.over 30 members of the Finally, on behalf of 'theattending and consulting staffs Staff 1. want to thank the Wo-was the best indication. of men's Auxiliary for their con-gratitude and appreciation to- -tributions of Medical equip-

'ward .a retiring Associate. ment during the past year andWe again commend Mr. Fay also indicate our appreciation.

for the skillful administration to all. of the Hospital personneland tactful mediation that he who worked ;with us eaph dayhas demonstrated during the and without whom there couldpast two years of, readjust- be no Hospital.

May 8, 1967Bertrand B. Hopkins, MDPresident - Medical Staff

TRE.ASURER':SREP RTThe following is the audited: " vestments, and the hospital

Fifancial Statement of 'The Auxiliary;, makesit,;possibleNashoba Community Hospital, for us to balance: our books.for the year ending Septem- and make nece ssaryimprove-ber 30, 1966. As you can ments in, patient care and-readily see from'the figures, equipment. Forithe period co-operating a Hospital such as vered 'by this report the net'this is big busifiess. non-operating income - wasThe: total operating .expense, $103,647.44, making a net in-

for the 12-month period was come gain for the year of$944,181.02. This -includes' $28,864.69. This 'shows howsalaries, commissions, sup- important each one. of ourplies, and all other expenses. contributions is, no matterFor the same period the total - how. small or large it may be.operating income was $866,- The Hospital Auxiliary con-.459,42 and with 'depreciation tributed $8,812.51 duringthe.figured in we ended up with a period to spOcial projects andnet operating deficit of $101,- bperating expenses, of the782. 75. In other words it cost Hospital. This is a wonderful$101,782.75 more to supply example of hard work and de-',Hospital services to'.,- the dication on the part 'of manycommunity :than we received ipdividuals. .in earnings for services ren- With your continued supportdered; The Nashoba Community Ho-

The non-operatingincome we spital will continue to furnishreceive; which: is made up the finest in health care tothemostly of contributions from peo ple of our community.Interested citizens, organ- ' :izations and industries in thecommunity, income from in-

967 (idney. F. Mason.May8, 1 .. Treasurer

TEX MWE188 881M13! 513321

hA aNm 3 1966

ASS39

Mrs. Ruth Hiller .(OTR),a member'of the Easter Seal So-ciety's Traveling Rehabilitation Team, instructs patient Rich- -ard Scribner In proper :use of weight-lifting equipment ,d. i4n' t a4eM , j44 mi At 4n 'i .pA, .rn * fr- c' 4r'.diti f&,...

n.wab. -a ." Pa"'-t: ' 204.967.04 * 77.754.65 where accident or illness has-damaged motion in the upper.Apaouts- *Reciv abl to Ac.ount ' ;" 1 .e.68.. '186,28,4.88 extremities. The area shown has been equipped for Occup-.Oi. .ti . . . . ,1.7o ational Therapy procedures.

TOTML 0388* -TO:

"D A 1 8. 1 W 9365051Cash"T. SPORT,"--17,8537.6: . :. TREASURER S REPORT

Invuatmien - am. £camesd

3 5.70 TNCH AUXILIARY'SI..rstant - at Cues (lailiet'.T aa SQo,514.20)' .483,730.34 ' .

tax', Msat a n, 2 i.a 486,95.04 The following Is the report by the Treasurer of theNashoba"- t. " . . ',791.4, . Community .Hospital Auxiliary 'of ~oations made .o The

ani.dig .enapwww.ts. , 1,222,564.22 Nashoba;CommunityHospitalbetweenlay1966and Arill9~7., .4 pc lonbi. Pa., t M • . . ". - ' ,6 9. . - "'- :-, .... ' 20 5' 400 " ,- 5- - ' , .'..- ..,' ",-* . -, ... -;;

.-A.co... . Portable.RecoveryCart for Groton Unit.525TOL,- 13u- At Cost -M "'Ll.. .oatsI a ue .. . . 2. Contributiontowardcost oemodelligan. . .

.... s . . .......... -e ppingnew Peda, jc.Unit : . . 5" . Equipmentfand'iniu,,iisfOor estal'm

I B LInTI .U, I, An m, TD C ,.-n,; : - of ,P4,Smear se .taboratory .2F3--' C,. 4. Lobby ad 3OfficesoVGonUnit, earpet

A .. ed, Saam. , Fore -n dY en .. 2,30800 ' 'J 'j*D-1 9 : * " .....:.-.' ">:- " ^ ".. ... "- .. ... o- . 9. C otb Deenten- ot e*ir .. ........ . .P'y. Wiebm1o '

.di. ' .. .. ':: 5.. 8 of fiberglass draperies f isceila.eo e " -

a- . an. to a"mLazrmX S- an co.-- rating expenses s- ia*' -_hr_._ _"I-. -

S , *.. ' S,8.5 5. Patient Lift (hydi 47S.l4*3assei : . - .... ' -. . - 6. Patient TreatmentaindBEx lng RoomA er

....lp1 Roo.m '-n "' .' .": - Nn' Unit - costo nemodelhh ..ld. fa- .... t. o:-. E - . . 7 -2.6.. .5 : . .. o,lda-u. Roo:hds- . .nDigtmotsd us az *.2-..R o .s . i o-s •Nurs .. : Formula Room- 7806

t er 2. T- " 486,995 04"" ".. ' ...-".""-.'i'.S .... - 7. Contribution toward Spring conditioning ofthe

___________1 -,1100gr8unds2obboth'units -- - -,200

" - t endtital ndrelatedr-iit ertente a nd8se-THE N ASHOBA COMMUNITY HOSPITAiL II'*. h'ln' ' " a" rae-1 s1u- 1* "dlse _

'LSt: atement rcm - and EM en - .n7al Fund Balanc'A , ' Sv nfminars' 101.42f. t In. .F or the Year nded September 3 . 19w --

F or , ,st or,, - 9. Contribution to Hospital's 1966 DevelopmentSNON-OPERATING INOE:.. : Fund (see also 2 and'6 above) '- - 500.00

'Donetions: .. , . .. .-Value of Food' received on Donation bay -en ion c. -Fund i t Oo -r -October18, 1966 '911.00asit IAnt1li 8,812 51 - 11 Presents O ptiei in Hospital on Christ

- , an.dit as HospitalAuxiliary .- - mas day, 1966 - 62.50n Incoa. . r n 6 : -'12. Two subscriptions to "Bostoni Globe" daily 'Tranfer. from Temporary Funds - , 49 and "The Herald" daily; one of each 'for .

1s8', '* . , 3 patients in the Ayer and Groton Units.'Les: Non-Operating Expense, : - .- - '*c

F"und Raising Expense* : 3,41.3 36'(pid in year) * 77.00 *8aneous

Expense

a 689.11 1 3. ISmall Refrigerator for Patient Nourish- -3 i '7.Net Non-Operating Income 7. 130, 4744- ment Area f1 Groton Obstetrical Department 69.88

L: Oprating Deict - Schedule -1 101782.75 14. Service Pins, for Volunteers 9.60Add: ODepreciation Included in Operating Expenses 44061.15 -'15. Physical Rehabilitation'Unit - Donation 'tb -

Deduct: Prior Year's Blue Coss SttlemInt 3 1,674.95 r 'Hospital for the difference betweenpaymentsN"a Equipment

r55,2

r s99.18 actually made b patients fortratmentsPayment of Mortgage ' . 00 . . (occupational therapy arid speech therapy)

General Fund Balance at October 1, 1965 245 0401 and the amount of subsidy given to the HospitalGeneral Fund Balance at-Septembier 30, 1966 ' S250,991.87 by the Easter Seal Society fof maintenance of

the services of a Traveling Rehabilitation TeamS inor chema hav eben made for purpoas of clarification; totale on a tentative, minimum 3-year basis 194V85areflot of tasted. 2.M.) o a' -iemniu

E40=I00 nM x2131 S1VICE TO P13333,,Boom ad Boardbagenq Boom Pees

DM.2118 10 SPWTAL *1. 881MTO PATiISt,Opeating Room

RLdicloglaboratoryxJrotraoar lolomr?hyil TherPyooUrption&l ThWay

Oxgo TherapyIn3aoTerou The spyMldifl and Surgioal Suppli.

C2oS M31a0S 1SE 88s3CM TO PATzINTS

s50,556.708.667.50

$579,224.20

8 36,890.6011794.00

9,655.5094,638.10

104,6456458,906.oo009,524.451,245.00

11,903.806,622.61

14,579.1928.095.89

1 20,578.706,274.791,804.83

(2,773.18)3,874.83-2,081.0416.o6o0oo

-Kesel Deoftaios from Orn.o aigeContractual AllowacesPublic Agency AlloewancesIndutr~tial Acidet AllowanesaXdicarm Alcuwanema19.. CaeCOurtacy andimcellanscue AlowancesPrevislcn fcr Doubtft1.lcunts

May 8,

TOTAL 787422

7 Mary T. Sawyer.Ireasurer

338. 00.59.917,724.79

A7.anti.0

s Equipment intnme .roton uni .-Laoratoryi s-duemonstraea oySLaboratory Tecetfan-ry^Mtl^lrFlosm.n l fpet'necessary for routine laboratory work, and alsofor emergency

- procedures, including blood transfusions, is available at eachlaboratory locationi . ' ' - -

: ' :- --

of current inflationary- trends and also, .evennmore especiallybecase of the impact of new federal and state legislation.which have increased the minimum wages hospitals4must pay,have liberalized regulations governing payment of overtime,and have removed hospitals and their personnel from some ofthe bargaining restrictions which had typified the health field.

_ As a result, salaries have .moved up' rather rapidly and thecharges to. patients for services rendered havebeen adjustedupward. In- our local, situation, charges have advancedjsome-.what. out of proportion because our continuing low averagebed, occupancy has not furnished, enough leeway to meet in-.creasing salary and other costs and still have enough quali-fied personnel on' duty to meet the peak and emergencydemands for hospital service.

Real progress on .consolidation has been made during thepast year. The pictures included in this report explain manyof the structural changes which, have been made. The new 6-bed pediatric unit, located in part of what used to be.the Ayerobstetrical suite, is working out quite satisfactorily. Exceptfor an occasional emergency almost no pediatric patientshave been admitted to the Groton building. The space occu-pied 'previously in Ayer by the old pediatric unit, a privatepatient's room, and the nursing station has been remodeled ex-tensively. The former infant Formula Room has been convertedto an urgently needed patient treatment and examining room.Many other: changes have also been made with the final resultthat the combined bed complement of both units has been-raised from '81 to 84 beds. This modernizing and remodelingwas made possible by donations which had been made to the1965 Development Fund and by specific cash gifts from TheNashoba Community Hospital Auxiliary. Still under discussionis the feasibility of coordinating all surgery in one unit,as opposed to scheduling surgery on alternate days in thetwo units.Many suggestions have been made, and discarded,as to the best way to unify the Dietary Department.. Thestudy continues, however, and one or two more promisingsolutions are now under consideration.Long-Range Planning, under the 'chairmanship of Vice-

aird lgy

So much has happened In the year 1966-1967 that extensiveuse is being made of pictures in the Annual Report with thehope. that"the subject matter ?may be.visual and more inter-

Sesting and'd that this written report may be1 considerablyshortened for the reader. . -

By far the ipost important event for the hospital and healthfield; .as well as for residents of the entire country,-was' the -actual initiation of, the Federal Medicare Program on July 1,1966.- Itseemed, when the legislation was originally enacted,that the " ead' time"' might ie adequate to:allow for planningS and development of policies and procedures at the federall evel,. but it became apparent early in 1966 that this could notbe.Cthe case. In any event, persons over 65 generally becameSeligible for hospital, medical, and. some other health benefitson July-1, 1966, and hospitals did take care of the Medicarepatients. In our area, there was no great influx of patients andour facilities were not taxed. There were many problemsassociated with prompt identification of patients as eligiblefor Medcare, and the cash position of the Hospitawasextremely tight for several months. By and large, however,

- our difficulties ih these areas have pretty much disappeared-ahd we seem to have taken Medicare in stride. One serioussituation has developed, in this as in most other parts of thecountry, and. that is the lack of certified ECF's (extendedcare facilities) to which patients may be transferred as soonas f-hey no longerrequire the services of. an acute hospital.,This -Hospital's Board of Trustees is aware of the need andhas given approval to a plan for assigning eight or more ofour acute beds in the Groton Unit as an extended' care facility.It is hoped that the details may be settled and the services

- offeredl to the residents of this area by' the early summer.Another, area of broad import to the Hospitaf,is in State

Legislation which is now pending. The many'diff rent cost-!reimbuirsement formulas established by various rate-settingagencies would be -eliminated, and each hospitalin theCom-monwealth would be paid on the basis of a uniform scheduleestablished for each hospital on the basis of its own demon-strated and allowable costs. The status of Blue Cross reim-bursement to Massachusetts hospitals is timder study at thistime,;and;it is expected that a more equitable and reasonableformula may be authorized. by the General Court. and by the

Where will find that reference? Dr. Jeffrey H. Harris, Chair-man, of the Medical Staff Library Committee, is pictured as hemakes use of one of the reference books available in the MedicalStaff Library. Library can be used to enlarge space availablefor major conference room purposes.

President Richard C. Taisey, has made real progress duringthe year. The Board of Trustees authorized the purchase, inDecember 1966, of a magnificent 40-acre site on WashingtonStreet in Ayer, abutting the Groton line. At -the time of thepurchase it was pointed but. that, while the purchase didnot necessarily commit. the Trustees to building a newhospital at any given time, the purchase price was veryfavorable and the site would lend itself admirably to thebuilding of an area health and medical service complex.Work has already begun on demolition of the house and haybarn located on the so-called "Eliades Property" -and onconversion of the dairy barn to a storage building. Thecash, exclusive of current note and mortgage, needed tocomplete this .transaction was taken from the 1966 -Devel-opment Fund. --The second important step taken in long-range planning

was authorization by the Executive. Committee to retainAnthony J. J. Rourke (MD) of New Rochelle, New York, todo a feasibility study. It is expected 'that, once the feasibilitystudy hasbeen accepted; plans may then be- devel6ped for anofficial architectural competition to be conducted in accord-ance- withiules established by the American Institute 'ofArchitects. -

Planning on the "area and state levels has ;received muchattentioni in the past year, and official representatives ofthis Hospital have devoted much time and thought to there-organization' and policies of the Central MassachusettsRegional Hospital Planning Council. The. council has re-cently been incorporated, and new bylaws were .adopted onApril 27, 1967. It is a little too , early to say whether thechanges will meet requiirements of already-enacted FederalP.L. 89-749 and pending State legislation, but progress hasbeen made and it is expected that further bylaw changeswill be made as the need arises. The areas of special con-cein are the percentage of- membership allocated 'to "con-sumers". .of health service, the real meaning- otthe term"c'di ieInsive health ne t~" tathe fanning isto be truly voluntary. . ' '"' "

Another organizational change at the area level, during thepast year, involved the official changing of the name,but notof' the-purposes, from Hospital- Administrators' Club of theWorcester Area to the Worcester Area Council of the Mas-sachusetts Hospital Association. This new designation cor-responds with the names of the other 5 member area coun-cils of the Massachusetts Hospital Association and clearlydifferentiates this area association council from the areaplanning council described above.

The cooperative arrangement between the Hospital and theEaster Seal Society worked out quite satisfactorily in itssecond year, and the contract has recently been signed forthe third. year; which began on April 1st. Under the newcontract. the Hospital will reimburse the Society for 60%of the salary expenses involved in making available to Hos-pital patients (both inpatients and outpatients) the servicesof occupational therapy, speech therapy, medical-social ser-vice, and nursing rehabilitation. With these 1ervices, plusthe Hospital's own Physical Therapy unit, the complementof rehabilitation services available to patients is quite com-plete and made it possible for the Trustees to authorizethe establishment, hopefully in the early summer, of anextended care service. Plans are to assign rooms #51 and#52 in the Groton building to this use. Policies governingadmissions tothe'-ECF, type of nursing care to be avail-able, appropriate utilization of services, and optimum lengthof stay are now being developed.

The Joint Commission on Accreditation of Hospitals sur-veyed both units and issued a 3-year accreditation certificatefor the period beginning September 20, 1966. The biennialState inspection for licensing by the Bureau of HospitalFacilities, was made a week ago, and it is expected that ourlicense will be. renewed soon.

The Hospital has been most fortunate in the past year withthe extremely generous support voluntarily given by membersof the towns served. The 1966 Development Fund Appeal hasalready received donations of almost $41,000.00. The Sub-scription Office (or the Annual Appeal for Maintenance Funds)received, in the fiscal year 1965-1966, a total of $19,280.000from 4555 area residents, a truly remarkable demonstrationof local support and interest. The cash value of gifts madeby The Nashoba Community Hospital Auxiliary, including foodnliadtn + A011 a o r T nl n Ti --- 6-d

i - -- "- " - I

i,4ursing,,fdrsebylV rIEuuur \rukcj

f,

"M NASWBAfollir-

hrtbo'rMr Iftdod Snlmbgpj0, 2966'

__

r 1-lr r -I '' I I -- 'I I Ia~ '1~ n erever nnL" ~ nn nY""~ -~ ~ssllrsgl~s~aslna~gpi~b~E~~I- '_________ _ ________

ADMINIS TR AT 0 RS REP ORT

This Annual Report, although long,cover all that has happened duringis hoped that some idea can be gaand of the people and organizationpossible.This report can be considered re

after officially and personally recogisons: Nathaniel Bowditch who, asworked so 'long, tirelessly, and conbring about "consolidation" and, moit work.

Bertrand B. Hopkins, (MD), who, asStaff, has helped to make straighseemed to become difficult as a reswhich came with Medicare, Utilizatiand the like.

Benjamin F. Lawtoh, (DMD), who, aStaff, has given effective Staff leaderparticipation by Dental Staff membHospital, in the maintenence of goin the evaluation of dental care anpatients.

Mrs. Albert E. Anderson who, as PCommunity Hospital Auxiliary, perfofor the Hospital and community by hiimaginative approach to the position o

None of the things recounted in thisany real value or significance withhearted support and cooperation givepersonnel team of the Hospital. To emy sincere and personal thanks.

May 8, 1967

:: . _::i I

-A VI

OWXRLLL Fm

Icocut. R..ivable - PatientsLea as., -ve for Dobtft2 Aomntiz

Ote .. et.onn ~ r~p

TOM alm0212101 ND 18221NEPORAIT FUNDS

.nant Incom 1d~:nYudZavestmat . Aa=*d2080,1 ?INDzYI FUND 122213Xnv..8asats- aCt .8(NaftefV.1f.8620,514.20),

and mkIprvmmts,-'ftldtngx and ImKrerommfuta

"jar ov.51. t"ipatNot= o Vhilea

020M1 PUNT -18 OASt

TOMTAMOS22

- .... 18.682,16 186,284.8835,2.270

.. .' .: 1 7,8,53.76

. .. 56470" '.483,70.34 . '

486,995.04

S 23,791.421,122,564.22

96,4.44 . . ..S220,659.05

1.090.62 -a.464,495.75

54S.M94.9

Elizabeth K. Lewis, volunteerLdvlsor for the Hospital, admin-inoculation to the Director of

Pres. Cont.ment. A large part of the re-sponsibility as to the success

d-failure of The NashobaComhmuni ty Hospital rested on

-thei-Administrator and his.ability to blend the Personnelof tw6 Hospitals into oi"o rganization. He has accom-plished-'hi -,-;aid .in most in-stances ithout:loss of har-mony. I believe thft the suc-cess of consolidafio has beenestablished nd e indicat-ion was the receipt- of our-3-year. accreditio . TheMedical Staff appreciate -thevital role of an.Adinistat-or in these achievemeits..--After 5 years as-President

of the Hospital TUxstee,Mrliathani~I .Boidltch ha

eared. many times overthe 'right : to. re6irefor life. I doubt that any fut-

.. 6e Presfdentw.Uillliave toserve in more difficult times.His qualities of patience,fair-.ness, and unstinting devotion'to the Hospital interests guid-ed all of us calmly th ruthis

closely with the Trustees andto support the new President

towards the day when we canfinally lay the cornerstone ofour new Hospital.SFinally, on behalf of theSStaff I want to thank the Wo-men's Auxiliary for their con-

tributions of Medical equip-ment during the past year andalso indicate our appreciationto all of the Hospital personnelwho -worked with us each dayand without whom there couldbe no Hospital.

Bertrand B. Hopkins, MDPresident - Medical Staff

TREAS WER'S REPORT.The following .is the audited.

Fidancial Statement of thte-Nashoba Community HosiLL lfor the year ending Septeam-ber 30, 1966. As you - amreadily see from the figures,operating a Hospital sueb aLsthis is big business.The total operating experiSte

for the 12-month period WVas$944,181.02. This incluletssalaries, commissions, sup-plies, and all other expeases.For the same period the toadiloperating income was $SWe,-459,42 and with depreciato$lnfigured in we ended up wittianet operating deficit of $10,1i-782. 75. In other words it cls;t$101,782.75 more to saji yHospital services to . thecommunity than we receiv din earnings for services resl-dered.The non-operating income we

receive, which is made uipmostly of contributions frminterested citizens, organ-izations and industries in thecommunity, income from in-May 8, 1967

vestments, and the hospital,Auxiliary, makes it possiblefor us to balance, our books.and make necessary improve-ments in patient care andequipment. For the period co-vered by this report the netnon-operating income - was$103,647.44, making a net in-.come gain for the year of$28,864.69. This shows howimportant each one of ourcontributions is, no matterhow small or large it may be.The Hospital Auxiliary con-.

tributed $8,812.51 during theperiod to special projects and.operating expenses' of _ theHospital. This is a wonderfulexample of hard work and de-dication on the part of manyindividuals.With your continued support

The Nashoba Community Ho-spital will continue to furnishthe finest in health care to thepeople of our community.

Sidney F. Mason; Treasurer

Mrs. Ruth Hiller (OTR), a .member of the: Easter Seal So-.ciety's Traveling Rehabilitation Team, instructs patient Rich-ard Scribner in proper use of weight-lifting equipment ,designed to assist 'patients in -recovery from conditionswhere accident or illness has -damaged motion in the upperextremities. The area shown has been equipped for Occup-,ational Therapy procedures*. : -

TREASURER'S REPORT

TNCH AUXILIAR Y - -

The following is the report by theTreasurer of theasobaCommunity -Hospital Auxiliary of donations made to TheNashobaCommunity HospitalbetweeiiMay;1966andApril197.

1. Portable Recovery Cart for Groton Unit. ' 525.:2. Contribution toward cost oemdelling and

eq pping new Pedatr Un3. .Equipmentandinditnlbsupplies or etab i

of -PA Smear seie in the Laboraty 27 .4. Lobby and 3 Officeo GroonUnit; ap~ei ~

-- of-16bby, painting of entire grea7'instalk 9 -

of fiberglass draperies, and W llneousd- -

corating expenses - -5. Patient.Lift (hydr ic) -6. PatientTreatmentd x ining RoomAyer

ursing Unit - cost o emodelihgld Infait*- imula Room - - - 780.66

7." ̂ Contiibutlon toward Spring conditioning oifth&- grpunds..,,f-bothkunits ^ -, - 522.00

Satteidlhospital an4 related institutes and-se- - -

. C nars, .-.- , . .... . - ''429. Contribution to Hospital's 1966 Development- - - .

SFund (see also 2 and,6 above): -. - - '500.00-10. Valueof Food' receivedonDonation Day- ' ; .0

11. Presents.,topiatients in Hospital on Christ- -;

- . -' mas day', 1966-: -: ' .. '.6.. 2-.'-* .650"

12. Two subscriptions to 'Boston Globe" daily .and "The Herald" daily; one of each 'for -patients in the Ayer and Giroton Units.- ' . -

- -( pa id in-year)- '-: . "- .'0W ... - .-. -;::.v - - 7...7 :00

13. Small Refrigerator for Patient Nourish- - " -ment Area' l.Groton 'Obstetrical Department 69.88

14. Service Pins for Volunteers " 9.6015. Physical Rehabilitation- Unit - Donation to

Hospital for the difference between payments"actually made by patients for treatments(occupational therapy anid speech therapy)and the amount of subsidy given to the Hospital ,by the Easter- Seal Society fori maintenance of-the services of a Traveling Rehabilitation Teamon a tentative, minimum 3-year basis 1941'85

TOTAL 7874.22

LIDL Lu n, " ' . D U Idid '* 'NEUNAL FUNaDlaNCES

SAoo-uata Pyablo -. rad.e " " " . 23,050.54.:AoawuodS lSrlare, Wg eand Urwatith 21,308.00Pioll-Witbholdlnaf mad aw .. 5,515.28

• - u lund Bala.. . - - 250.991.87Timl oA AL FTD 2 'X r B AN FUuND"AL CS '-,s 300,85.69.

S r - .. ... 18,86.57Prelninoi.nd .E oan.... - ." - .-/ - . "

R.tricted 72,693.85 -unw eilrit-d -02

.... - m *M FUNom mD pn81801Pc- SALE :O _ N ,-., .. . .. - 486,995.04..

" . .. " i . . .. ......... " " " "

THE NASHOM itCOMUNITY HOSPITAL " 'S .Stetaant of Income -. md xpena. and ienaral Fund Balan.

For the Year ENJOed Septmaber 30 196. -

NOR-OPERATINO IDE:

General. 8 -76104 -71-", -Subscription Oflic . .... 1933-4 ' 'Hospital Auxiliary*Donated Commodties - Hal-tI Auxliary 812.51 *TorMi s rants# 5 .- -

inves nt Income " .24,550.13Tranfers from Temporary Fitef '" 408 1., " -.* r'g,."49

Lass: Non-Operating E sc sea .Fund Raaising Experes. 3,413.36Miscellaneoua Expen.m . 689.11:Interest 77.24 4.179.7Nat Non-Operating Income . 130647.44 -

Less: Operating Deficit SCilWjrla B-1 101 782.75Nat Income for the Yeare r 30, 1966 28 86469

Add: Depreciation Included n Operating Expenses 44.l61.15

Deduct: Prior Year' 8s Blu Cro Settleomnt $ 1,674.95Tranafara to Plant fea far: '

Neu Equipment 55,299.18Paymnt of ortgagm 10.000.00 66.974.13

General Fund Balanca at Octobmt i6, 1965 245 040'16General Fund Balance at.Saptebm: 30, 1966 $259917

( * 4 inor changes have bean mroi far purposes of clarification; totalsara not affected. S.M.)

m iu m_ a i Hspim -mi t - \For th e To Modazouam and'10.a6

h~ifos FNeo 1002213 22112021 3 PA~Ejh72poam r R m5006

afsa.; R oS P.aW sE866 TO0PA

Treasurer

'I

because. of tne impact of new feaerai ana .state legislationwhich have increased theminimum 'wages hospitalsimust pay,have-liberalized regulations governing payment of- overtime,and have removed-hospitals and their personnel from some ofthe bargaining restrictions which had typifid the health field.As!a. result,- salaries, have -moved up rather rapidly and theSharges to patients for services rendered have,-been adjustedupward. In our local situation charges have advanced-some-.what, out of proportion because our continuing low averagebed occupancy has not furnished -.enough-: leeway. to meet in-creasing salary and other costs and still have enough quali-fied personnel .on, duty _.-,to -meet -the -peak and emergencydemands for hospital service. - .Real progress on consolidation has been made during the

past year. The pictures included in this report explain manyof the structural changes which, have been made. The new 6-bed pediatric unit, located in .part of what used to be.the Ayerobstetrical suite, is working out quite satisfactorily. Exceptfor an occasional emergency almost no pediatric patientshave been admitted to the Groton building. The space occu-pied 'previously in Ayer by the old pediatric unit. a privatepatient's room, and the nursing station has been remodeled ex-tensively. The former infant Formula Room has been convertedto an urgently needed patient treatment and examining room.Many other: changes have also been made with the final resultthat the combined .bed complement of both units has been

-raised from '81 to 84 beds. This modernizing and remodelingwas made possible by donations which had been made to-the1965 Development'Fand and by specific cash gifts from TheNashoba Community Hospital Auxiliary. Still under discussionis the feasibility of coordinating all surgery in one unit,as opposed to scheduling surgery on alternate days In thetwo unlts.Many suggestions have been made, and discarded,as to the best way to unify the Dietary Department. .Thestudy. continues, however, and one or two. more promnisingsolutions are now under consideration.

,nne-Rnnee Plannine. unridr the hairimanhin 'f i ,A_

-ADMINISTR ATOR".S: R EPORT

+n fr8 ionirncr nio rif~" nu r~x 8~'7 000 00

IU188A~r HDPM

diatkrt.mbr 0.1966

_o

I il I I II I I I

N

:;S .

;m:~~ :

So much has happened in the year 1966-1967 that extensiv6e-::- :use, is being made of pictures in the Annual Report with the

hope/that Cthe -subject matteri may'be visual and more-inter-

Sesting and that this' ritten report ma be considerably'shortened for the reader_By far the *post important event for the hospital andhealthfield;- as well as for residents of the entire country ,was' theactual initiation of-the Federal Medicare Program on July 1,

S1966.-It seemed, when the .legislation was originally enacted,.'that -the 'leadtime" might l]e adequate to allow for planning

S and '"development Of policies and procedures at the federal_ level, but. it became apparent early in 1966 that this could not

bethe case. In any event, persons over 65 generally becameeligible .for 'hospital, medical, and: some other health benefitsSon July 1, 1966, and hospitals did take care of the Medicarepatients. In our area, there was no great influx of patients andour facilities were not taxed. There were many problemsassociated with "prompt identification of patients as eligiblefor Me64care, and the cash position ,of the Hospital, wasextremely tight for several months. By and large, however,

, our difficulties ini these areas have pretty much disappeared'and we seem to have taken Medicare in:'stride. One serioussituation has developed, in this. as in most other parts of thecountry, and: that is the lack of certified ECF's (extendedcare facilities) to which patients may be transferred as soonas-they no longer require the .services of, an acute hospital.,,This- Hospital's, Board of Trustees is aware -of the need andhas.g.v'n":,approval to a plan for .assigning eight or more ofour; acute beds in the Groton Unit as;anextendedcare facility.It -is hoped that the details may be settled and the services,

-offered, to 'the residents of this area -by the early. summer.Anoither "area of broad import to the Hospitais in State-

Legislation which is now pending. The many differentLcost-reimbursement formulas established by varitus rate-setting:agencles would be;eliminiated, and .each- hosita in the.Com -

monwealth would be' paid on the basis of a uniform scheduleestablished for each hospital on the basis of its own demon-strated- and allowable costs. The status of Blue C ross reim-bursement to Massachusetts hospitals :is inder study at thistimei.-and it is 'expected that aimore equitable and reasonable'formttlamay:be ,aUthorid. by -the General Court and by th

- a ,w i ,.^ a a t,*,an*r , n^-.'4 .2* * n p ^i - . * . * " ': i

- -.

President Richard C. Taisey, has made real progress during-.the year. The Board of Trustees authorized the purchase, inDecember 1966i,:of a magnificent 40-acre site on WashingtonStreet in Ayer, abutting the Groton line. At -the time of thepurchase it was pointed out that, while the purchase did

. not necessarily commit. the Trustees to building a newhospital at any given time, the purchase price was veryfavorable and the site would lend itself admirably to thebuilding of an area health and medical service, complex.

>,Work has already begun on demolition of the. house and haybarn located on the so-called 1"Ellades Property' ' -and onconversion, of the -dairy barn to a storage building. Thecash, exclusive of current note and mortgage, needed tocomplete this -transaction was taken from the 1966 -Devel-opment Fund. . .- --

The second Important step taken in long-range planningwas authorization ,by the Executive. Committee to retainAnthony J. J. Rourke (MD) of New' Rochelle, New Y6rk, todo a feasibility :study, It-is expected that- once the-feasibility

: studyp-has been amcepted; plans may then be--developed for anofficial architetural competition to be conducted in accord-

^ance wltf'rues-s established by the American Insitute. 'ofArchitects. ; - ...

Planning o the area and state levels has received muchattention in the past year, and official representatives ofthis Hospital have devoted much time and thought to there-organization' and .policies of the 'Central MassachusettsRegional Hospital Planning Council. The- council lias re-cently been incorporated, and new bylaws werei:adopted onApril _-'27,- 1967. It is a little too, early to say whether thechanges will meet requirements of already-enacted 'FederalP.L. 89-749 and pending State legislation, but progress- hasbeen made and it is expected that further bylaw changeswill be made as the'need arises. The areas of speciil con-cerin- are the percentage of- membershipallocatedtto. Icon-sumers'l -of health servie,: the real meaning -of-ptheterm

- "c IprWfenslve health- eTitlanninff isto be truly v6lutary'.'" - -'-" -Another organizational change at the area leveIL- during 'the

past year, involved the official changing of the name,but notof the purposes, :fromi Hospital- Administrators' Club of theWorcester Area to the Worcester Area7-Council of the Mas-sachusetts Hospital Association. -This new designation cor-responds with the names of the other 5 member area coun-cils of the Massachusetts Hospital Association. i.nd clearlydifferentiates this area association council from the areaplanning council described above.The cooperative arrangement between the Hospital and the

Easter Seal Society worked out quite satisfactorily in itssecond year, and the contract has - recently been signed forthe third year -which began on April. 1st.' Under the.newcontract the Hospital will reimburse the Society' for 60%

f the s-alary expenses involved :in- making available to Hos-pital patients (both inpatients and outpatients), the servicesof. occupational therapy, speech therapy, medical-social ser-vice, and nursing rehabilitation. With these services, plusthe Hospital's own Physical Therapy unit, the complementof rehabilitation services available to patients is quite com-plete and made it possible for the Trustees to authorizethe establishment, hopefully in the early summer, of anextended care service. Plans are to assign rooms #51 and#52 "in the Groton building 'toI this -use. Policies governingadmissions to ,,the-':ECF, 'type of nursing -care to be avail-able, appropriate "utilization of services, and optimum lengthof stay are now being developed.The Joint Commission on Accreditation 'of Hospitals sur-

veyed both units and issued a 3-year accreditation certificatefor' the period beginning September 20, 1966. The biennialState inspection for licensing by the Bureau of HospitalFacilities. was made a week ago, and it is expected that ourlicense will be renewed soon..The Hospital has been most fortunate in ,the past year withthe extremely generous support voluntarily given by membersof the towns served. The 1966 Development Fund Appeal hasalready received donations of almost $41,000.00. The Sub-scription Office (or the Annual Appeal for Maintenance Funds)received, in the fiscal year 1965-1966, a total of $19,280.000from 4555 area residents, a truly remnarlable demonstrationof local support and interest. The cash value of gifts madeby The Nashoba Community. Hospital Auxiliary, including foodvalued at $911 and received on Donation Day - 1966, amountedtn tho incnirincp tnfl nof nnrlv .9n17 Q nn

Where will I find that reference? Dr. Jeffrey H. Harris, Chair-.man of the Medical Staff Library Committee, is pictured as hemakes use of one of the reference books available in the MedicalStaff Library. Library can be used to enlarge space availablefor major conference room purposes., -

VI 'Vices.

\

459,42 and with deprefigured in we'ended upnet operating deficit ofI782.75. 'In other words$101,782.75 'more to:Hospital services to'communitythan we., rein earnings for service

:dered; -The non-operatinginc

receive, which-- is mmostly of contributionsinterested citizens,izations and industriescommunity, income fro

May8, 1967 " -

*2238

siU Ug'211. by1 aiIJs ' . -.

M d. Staff Pres. Cont.years. The advent of Medi ment. A large part of the re-care required that we form a sponsibility as to the successnew committee known as tithe orilure ofThe "Nashoba-Utilization Review commit-.:Coitnunity Hospital rested on,tee; its purpose-'to ensre theAdministrator and hi

'the proper use of our Hospltal ability to blend the: PersonnI:.beds i.e. to make these beds f N6 Hospitals into ofieavailable to all pedple of the organization. He has accom-community in need 6f- acutfe pished . ;arid.in.mostin-Hospital care and for only as stances ithbut loss of har-long as this' type-of care is mony.;-I blieve tfit the suc-required. The influence of this cess'f-.6onsolidatlri hasbeencommittee now applies to allg established 'and .dn e--nicat-Hospital beds and nitjust, io i, was the r .iiptf curthose occupied by -Medicare' 3yea Taccredi hepatients. The success of this Medical Staff 0.:committee* is dependent not vital role of a dn ionly on-its members but on the or in these achiementsentirestaff - ' After 5 year a sentThe , 'new Doctor-Findigi of the Hospital usts Mr.

Committee under 'the-chair-'-Nitc hamanship' of- Doctor DavldtA. aied-many e veWlklund has been active in an the right re ireattemtto recruit newphysi- for life. I doubt that any fut-cians.The tomittee .was ure Presidentwill bhae tenhanced by -the addition of serve in more difficult times.-Mr.--N-Nathanie1 'Bowditch, His qualities of patience, air-.Trusteee Representative; We ness, and unstinting devotionrecognize a specific need for to the Hospital interests guid-Doctors in Littleton, Ayer and ed all of'us'calm ly .thrui'tiifsShirley and will continue-in period of transition. . The,:.oul, search to solve .these Medical Staff will always beneeds. . grateful for what he has done..A Testimonial Dinner was We will continue to-, work

held ,on March 1, 1967, -. for closely with the Trustees andDoctor Joseph A. McLean. in to support the new Presidentrecognition of 35 years of towards the day when we can"service to the community,and finally lay -the cornerstone ofHospital. - The: attendance of our new Hospital.over 30 members of -the Finally, on' behalf of theattending and consulting staffs. Staff I, want -to, thank the Wo-was the best indication. of men's Auxiliary for their con-,gratitude and appreciation to- -tributions .of . Medical equip-,ward a retiring Associate. ment during the past year and

We again commend Mr. Fay also indicate our appreciation.for; the skillful administration to all. of the Hospital personneland tactful mediation that he who -worked with us each dayhas demonstrated during the and without whom .there couldpast two years of readjust- be no Hospital.

Bertrand B. Hopkins, MDMay 8, 1967 - President - Medical Staff

Groton Unit Nursing Station: Some minor adjustments werealso made in Groton in order to enlarge the charting areaavailable for members of the nursing staff. Mrs. Hilja Mak-sym (RN) uses new charting space while Mrs. Anna Kopec(RN), Relief Evening Nursing Supervisor, checks medications.Ward Secretary, Mrs. Avis Sheehan, answers on the "Red"phone; a direct telephone installation between the GrotonUnit and the Groton Police Tower. This phone is used as a two-way alert concerning emergencies, disasters, and the like.Equipment in the corridor outside Room #64 is the portableRecovery Cart donated by The Nashoba Community HospitalAuxiliary. Oil painting on the wall in Room #64 was donatedby Evening Nursing Supervisor Constance Stailing (RN) andher husband, Albert.

'e S' b .30.

$579,224.20

3 36,890.6011,794.009,655.50

94,638.10104,64545

8,906.009,524.451,245.00

11,903.806,622.61

14,579.1928,.095.89

$ 20,578.706,274.791,804.83(2,773.18)3,874.83

-2,081.0416,060.00

maY' , 1967,

/ " " Mary T. Sawyer.Treasurer

318.70.59.917,724.79

ciation tributed $8,812.51 during -the..with- a period to spqcialprojects and -$101,- bperating expenses. of . the -

s it cost - Hospital. This 'isa onderful.supply . example of-hard work and de-;Sthe dication on -the part of manyceived. ipdividuals. : - --'s ren- With your continued support

The Nashoba -Community Ho-omewe , spital will continue to furnishade up the finest'in health care to the

from people of our community.organ- .sin the - .," a-m :i (aidney F. Mason

Treasurer

S'designed;- to assist patients, in -recovery from conditions-As rta on.ml - a.nt. im 204704 * 77754.65 where accident or illness has-damaged motion in the upper

-: I< Bsa....r. w .Bntnownt.u ' * < ... Am 8.6.1 -86,284e88 extremities. The area shown has been equipped for Occup- ,Ot A.ie'. ' -, - -ao * 3,170 ational Therapy. procedures.

Is.3 •76 ...... TREASURER'S REPORT-' .TT "* "" A T i" -:S =' •o , . .e

.i .aamnt. - at atC. '(WaszkoVal a'"V,5U.2o):: ' .48 '1,D3ealatea -' '48,.0 The 'following is the report by theTreasurer of the>Nashoba

.... '. :' .. a : ' " ". Community Hospital Auxiliary of ontions madto hen am9pprOT. vm. m1,2292- NashobaCommunityHospitalbetweet 7ay6

564... .6..in ,loNa -Oi -Ao : . 1. PortablieRecovery Cart for Groton Unit. 52.l -

L..| Ao.==t.iBatrt ^ i *2. Contribution toward cost mdellig ana. A SS. " :... - ..-. .;-. equipping new Pedia.d6 .542 .

3e Equipmt 7 and'iniaupisfor estab u netS*, L1IjnES. ,m .,.O W 274L ,. .f..4,Smear sei Labor 2

o .m -, .- ' - ' ':.:4. :.: '...:;.. Lobby aned 3Off i eonitA._. oo tplio Fnd -B S 23,050.54J, 1- r& eW.....f c*. -. .1 3,0.Ban ... 8.... o, l bby, aiing of e tire,. . 9.•Ct.awo-t B......'.- ... .-. : : . . * 5,515.28 of-i::. . tberglass draperies andnatinD.heo -

20. 3 23o6u1 n 21a21. an4 w3005ac.6 - corating expense '

.m . -. . .. entTreatmentn alon i ,Room .AyeFri o,4-2.od 1u22. - 3. .''1 ,1n Unitd cos odelihg old Infailt

" ̂ .. . .. ..:. ,. : , ... .- - .- '- - . . C'C ont ibutbion toward s pring conditioning f tl12*mt zn, o awa1 g[ounds-of both units _ 1- - 52.0

. . ... *n*- THE NASHOBA CM4UNITY 4HOsPIT t'e'. . . d h tl an4 relate i 'stituts a'nd.se- :''Ststeaa.t. r lncoBa-snd'ena s nd g neal fund malane' '. '.- . minars , .-- - --'- " , - -' - .101.42

S.... For tha Yar Endd .. b.. 3,19 "

". " . Contribution toHosptas 1966 Development

NON -PERTING M . - . - - Fund-(see also 2 and 6 above) - - -- 500.00 -

o rti a on.: ' -... . .. ' . " -1.- Value of Food' received on Donation Day - ' .. ,.." a- ,atn - r " - " : - ..-. Octobe r8, t 166 erae 911.00

topital Auxniary . ' , - , 12.51 - 11. Presents to patients in Hospital on Christ-

. To• rnt ' ' - , *.t 0 on 1 -T w m , y1966 . . 62.50iu s a ' ' d , ..- * -

/ . 1. Two subscriptions to "Boston Globe" dailyTransfers from Temaporary Fund . and "The Herald" daily; one of each 'for .:

S o o r End be , - patientsin the Ayer and Groton Units

- Fund Raising Epanss . 3,413.36 (pi' - 13. ~(rf0in-ear) - ; 1.00

.Miecn.oua Expanas. :.689.11; 13. Small Refrigerator for Patient Nourish- - -

t ot Nen-operotlg mc,.s . - .2 4. . - 2,. ment Areafn -Groton Obstetrical Department 69.88aLs' pt"tngelSded

S ue -10 -966 10178275' 14. Service Pins- for Volunteers ' - - 9.60

Add: Depraciation Included in Operating Expsns 44:061.1 15. Physical Rehabilitation'Unit - Donation t' " " '' Daduct: prior V..yari 'Blu C.rosB Sttlea.nt' ' 1,67498 $"'925"4 -, Hospital for the difference between Ipayments ,-

Tranr,' to pan 1t ue.d for. .55 .299'. . actually made by patients for treatments - I

. • P•yv.nt of Mo .rtgage "... .72'.000 .74. (occupational 'therapy and speech therapy)General Fund Blanc at Octobr 1, 1965 245 and theamount of ubsidyven to theHopitalGnirai Fund Balance at.s pteBtr 30, 1966 ' 2,o;997 . by the Easter-Seal Society for maintenance of'

.. . the services of a Traveling Rehabilitation Team* 4 ochngos hav ban ad for purpos of clarification; tatal - On a tentative, minimum 3-year basis -194 85oro nat affctsd. S..) "'"'.."

' 2 8 2---1- ; \- 24P4 ' - * TOTAL 7874.22

Transfers f om Temporar Fua ndsr~.« - f". 4 a , ., ** . . * ; - . Oaily one ea f : *. ' , :*.*r ,'

3869,823.7816,6iS.64*86;459.42

$944,181.0244.061.1S 98.22.171966 11727

nade of the officers of theGeneral Auxiliary, the chair-nen of the Town Units andheir officers, and to all spec-al committees.As Auxiliary President, onef the major rewards hasbeen my association with theseine women.Again, well done and may weontinue our efforts, whereverre can to be useful to the[ospital and its role in theommunity.

FrancesH. AndersonPresident

No more claustrophobial With removal of the wall behindthe nursing station in the Ayer Unit working space has beenenlarged, light is much improved; the noise level has beenconsiderably reduced, and ventilation should no longer bea critical problem. Pictured here at the desk are the Ward -Secretary (Mrs. Nancy. Colburn) :arid the head nurse (Mrs.Barbara McGough, RN); an aide '(Mrs.. Phyllis; P'ress6on)checks orders in a patient's record while a Medical StaffConsultant (Henry St. John Smith, M.D.) reviews his patient's chart. The old pediatric unit (left side of the picture)has been. converted to an observation room' and a two.-roonmadult unit. . -

Whiplash Injury? In-tlhe Physical Therapy Department- Mrs.Edith Baker (RPT) adjusts controls for patient, Lucille Hamil-ton, to receive treatment on the Cervical Traction equipment.Unit in the right foreground is an ultrasound machine.

K-"--

, - associated with prompt identification of. patients as eligiblef6r-. Meilcare, and the cash position of the Hospitalwas

- extremely tight for several 2months. By and large, however,.:. : our difficulties in these areas ihave pretty much disappeared

'and iwe seem to have takeni Medicare in stride. One serious- situation has developed, in thisi as in most other parts of the'country,- and that,. is the lack f certified ECF's (extendedcare facilities) to which 'patients' may be transferred as soon-

S as tiiey no longer require the services of an acute hospital.'This Hospital's Board of Trustees is aware of the need andha given approval to a plan or assigning: eight or more ofour acute beds in the Groton Unit as- an e.tendedcare facility.It-, is hoped , that the details may be settled and the services,-offered to 'the residents of this area by the early summer.

th-area of broad import to the Hospitalis in StateLegislaition which is--now' pending. The many different cost-relmbursement formulas es~ablished byvarious rae-settngagebied iwould be eliminated, and 'each- hospital in the Com-monwealth would' be paid on the basis of a uniform scheduleestablfshed for each hospital on the basis of its own demon-strated and allowable costs.:The status'of Blue Cross reim-,bursement. to Massachusetts hospitals is umder study at thistime- and it is exuected that a more eauitable and reasonable'

i_

V .'.",'. 2 ~

24212102 4204 2022121 21 CE2 T0 PA421322,Room ao6 Soaptlb2rg.2y Room Fees

Bm111102 FROM SPROULL SERVICES TO PA21ETSeOpeating loomDelivery loOMAnesthesia

Raioliogy'ioo

PIpaloal TherapyOccupatinal therapyoxgen Therapy

X.26oal anxd 23pgloal Supplies

Least Deductions from 0.os. 14rningesCotractual Allomance.Public Agency AllUaaeaIndustrilal Accident AllowancesMedicare AIMoe..Prs. 0ar.Cortesy and 1laene1ansou A llowances.

TTLa OPsz2TNO INCOpMsEa 2 eoe1~o

Operating lops...- Sohedufs, B-2

KID OP322210 23C10 2FOR2TH'E2-TEAR DD SEPTWEB2230.

TNCH Aux. Cont. _Gaccomplished with the coop- reration and support of many .tpeople - the Board of Trust- iees, our Administrator, Ro-bert V. Fay, the Hospital per- osonnel for their willing and bcheerful hblp in so many in- f:stances, and those in the com-munity at large who have re- csponded so enthusiastically to wour endeavors. HSpecial mention must be c

May 8, 1967"

I,'

_FI_____O _

Where willlfind that reference? Dr. Jeffrey H. Harris, Chair-.mnian of the Medical Staff Library Committee, is pictured as hemakes use of one of the reference books available in the MedicalStaff Library. Library can be used to enlarge space availablefor major conference room purposes.

tIhn

.. ... . . . . .

President Richard C. Taisey, has made real progress during:the year. The Board of Trustees authorized the purchase, inDecember 1966, of a magnificent. 40-acre site on WashingtonStreet in Ayer, abutting the Groton, line. At the time of thepurchase it was pointed out .that, while the purchase didnot necessarily commit. the Trustees to building a newhospital at any given time, the purchase price was veryfavorable and the site would lend itself admirably to thebuilding of an area health and medical service complex.Work has already begun on demolition of the house and haybarn located on the so-called "Eliades Property" and onconversion of the dairy barn to a storage building. Thecash, exclusive of current note and- mortgage, needed tocomplete this transaction was taken from the 1966 -Devel-opment Fund.''The second important step taken j in long-range dplanning

was authorization by the Executive, Committee to retainAnthony J. J. Roburke (MD) of New Rochelle, New Yrk, todo a feasibility study. It is expected that- once the feasibilitystudy has been accepted, plans may then be deovel6ped for anofficial architectural competition to-be conducted -in accord-ance- withfirules established by the American Institi te ofArchitects. :

Plarning on- the area and state levels has received muchattention 'in the past year, and official representatives ofthis Hospital hare devoted much time and thought to there-organization and policies of the Central MassachusettsRegional CHospital Planning Council. The council h1i' re-cently been incorporated, and new bylaws were ̂ adopted onApril- 27,- 1967. It is a little too..,early to say whether thechanges will meet requirements 'ofalready-enacted FederalP.L. 89-749 and pending State legislation, but progress hasbeen made and it is expected that further bylaw changeswill be made as the need arises. The areas of special con-cern are the percentage of- membership 'allocatedt f "con-sum ers"'? of health servie, the real meaning of the term"ciip-reiinsive health"' 'vi slid htf nrig isto be truly vboluntary. -' "Another organizational change at the area level during the

past year, Involved the official changing of the name,but nottof he'purposes, from Hospital Administrators' Club of theWorcester Area to the Worcester Area Council of the Mas-sachusetts Hospital Association. This new designation cor-responds with the names of the other 5 member area coun-cils of the Massachusetts Hospital Association and clearlydifferentiates this area association council from the areaplanning council described above.The cooperative arrangement between the Hospital and the

Easter Seal Society worked out quite satisfactorily in itssecond year, and the contract has recently been signed forthe third, year; which began on April 1st. Under the newcontract the Hospital will reimburse the Society for 60%of the salary? expenses involved in making available to Hos-pital patients (both inpatients and outpatients) the servicesof occupational therapy, speech therapy, mhedical-social ser-vice, and nursing rehabilitation. With these services, plusthe Hospital's own Physical Therapy unit, the complementof rehabilitation services available to patients is quite com-plete and made it possible for the Trustees to authorizethe establishment, hopefully in the early summer, of anextended care service. Plans are to assign rooms #51 and#52 in the Groton building to this use. Policies governingadmissions tothe 'ECF, type of nursing care to be avail-able, appropriate 'utilization of services, and optimum lengthof stay are now being developed.The Joint Commission on Accreditation of Hospitals sur-

veyed both units and issued a 3-year accreditation certificatefor the period beginning September 20, 1966. The biennialState inspection for licensing by the Bureau of HospitalFacilities was made a week ago, and it is expected that ourlicense will be renewed soon.The Hospital has been most fortunate in the past year with

the extremely generous support voluntarily given by membersof the towns served. The 1966 Development Fund Appeal hasalready received donations of almost $41,000.00. The Sub-scription Office (or the Annual Appeal for Maintenance Funds)received, in the fiscal year 1965-1966, a total of $19,280.000from 4555 area residents, a truly remarkable demonstrationof local support and interest. The cash value of gifts madeby The Nashoba Community Hospital Auxiliary, including foodvalued at $911 and received on Donation Day - 1966, amountedto the inspiring total of nearly $7,900.00 .

Bequests made to the Hospital in this same period were asfollows: Estate of Miss HelenE. Bigelow of Harvard - $1,000.00(received), Estate of Mrs. Bertrand H. (Bessie B.) Hopkins,late of Ayer - $2,000.00 (received), Estate of Herbert H. Proct-or (on death of his widow, Grace) of Ayer - $20,000.00 (re-ceived), Estate of Frank C. Fletcher of Ayer - $2,000.00 (notyet received), Estate of Alexander H. McDonald of Littleton -$500.00 (not yet received), Estate of Miss Emma A. Bagsterof Harvard - $1,000.00 (not yet received).Other major gifts include: Mrs. Donald (Alma B) Humphriss

Memorial Fund - 2 Adjustable Height Beds: Ayer Rotary Club- 2 Adjustable Height Beds; Groton Rotary Club - IntermittentPositive Pressure Breathing Machine; In memory of DoctorJohn Lambert by his son, Benjamin deF. Lambert (MD)-60milligrams of radium. Richard J. LaVigne, (MD) - cost ofthe conversion of the radium (acknowledged above) intoneedles with modern platinum containers.

Cash donations by 2 Medical Staff Members tothe LaboratoryDevelopment Fund and to the Radiology Development Fund.Items of equipment by Mr. and Mrs. Wendell Nutting of Ayer,Mrs. Monica and Miss Josephine M. BudaofGroton in memoryof Mrs. Betty Caldwell, Mrs. Frank C. Fletcher of Ayer, Mrs.Joseph Croteau of Shirley, Stanley Conant of Littleton, Mr. and

RoberAdmir

i • _. • .

C_

I

u i

-'777-7

Surgery'in 15 minutesl Mrs. ViolJune Paradis assist the regularlyto ready the Groton Unit's operati:surgery.

PAP'- Smear Procedure Mrs. Eva,-nician, processes specimens for Doctfdetermines diagnosis and advises the pof his findings.

of'the Groton School, who, during-tlLaboratory, Radiology, and Medicaland re-arranging of files, the Editor

'FREE PRESS, TOWNSEND TIMES, LCSENTINEL, WORCESTER ,TELEGcooperation in helping the Hospitalon activities and planning. Manyindividuals have also assisted durnspace is limited. To all a sincere "T

We are saddened to report two deatiorary Medical Staff, Harold W. AyreGroton on May 28, 1966, .at theageshort time before his death. Doctor A;who is so often referred to as the"family doctor". He had been ia meof each of the original Hospitals befserved with distinction for severJ. Walter Desmond (DMD) of Shirli

orary Dental Staff, died in Arizonathe age of 71. To him is due theDental -Staff at a time when coinpthis couiitry had seperate dental stainterested in the welfare of his .jnamed "Dentist of the Year" onlyaft

This Annual Report, although long,cover' all that has happened"during tis hoped that some idea can be gaand of the people and organizationspossible.This report can be considered re

after officially and personally recogrsons: Nathaniel Bowditch who, asworked so long, tirelessly;' and con.bring about "consolidation"- and, moit work. ' -

Bertrand B. Hopkins, (MD), who, asStaff, has helped to make straighlseemed to become difficult as a reswhich came with Medicare, Utilizatiand the like.

Benjamin F. Lawton, (DMD), who, aStaff, has given effective Staff leaderparticipation by Dental Staff memtHospital, in the maintenence of goIn the evaluation of dental care anpatients.

Mrs. Albert E. Anderson who, as FCommunity Hospital Auxiliary, perfofor the Hospital and community byimaginative approach to the position oNone of the things recounted in this

any real value or significance witthearted support and cooperation givepersonnel team of the Hospital. Tomy sincere and personal thanks.

.4

of current inflationary trends and also, even more especially,because of the impact of new federal and state legislationSWhich haveincreased the minimum wages hospitals-must pay,have- liberalized regulations governing payment of- overtime,and have removed hospitals and their personnel from some ofthe bargaining restrictions which had typified the health field.As a result, salaries. have: moved up/rather rapidly and thecharges to patients for services rendered have been adjustedupward. In our local situation, charges have advancedsome--

. what, out of proportion because our continuing low averagebed occupancy has not furnished enough- leeway to meet in-creasing salary and other costs and still haveenough quali-fled personnel .on duty ..to :meet the peak and emergencydemands for hospital service. ' .

Real progress on .consolidation has been made during thepast year. The pictures included in this report explain manyof the structural changes which have been made. The new 6-bed pediatric unit, located in part of what used to be.the Ayerobstetrical suite, is working out quite satisfactorily. Exceptfor an occasional emergency almost no pediatric patientshave been admitted to the Groton building. The space occu-

S pied 'previously in Ayer by the old pediatric unit, a privatepatient's room, and the nursing station has been remodeled ex-tensively. The former infant Formula Room has been convertedto an urgently needed patient treatment and examining room.Many other: changes have also been made with the final resultthat the combined bed complement of both units has been....raised from -81 to 84 beds. This modernizing and remodelingwas made possible by donations which had been made to the1965 Development Fand and by specific cash'gifts from TheNashoba Community Hospital Auxiliary. Still under discussionis the feasibility of coordinating all surgery in one unit,as opposed to scheduling surgery on alternate days in thetwo units.Many suggestions have been made, and discarded,as to the best way to unify the Dietary Department.. Thestudy continues, however, and one or two more promnisingsolutions are now under consideration.Long-Range Planning, under the bhairmanship of Vice- May 8, 1967

May 8, 1967

Elizabeth K. Lewis, volunteerAdvisor for the Hospital, admin-x inoculation to the Director of

Bertrand B. Hopkins, MDPresident - Medical Staff

on: Some minor adjustments wereorder to enlarge the charting areathe nursing staff. Mrs. HiljaMak-ing space while Mrs. Anna Kopecng Supervisor, checks medications.s Sheehan, answers on the "Red"

installation between the GrotonTower. This phone is used as a two-,rgencies, disasters, and the like.outside Room #64 is the portableThe Nashoba Community Hospitalthe wall in Room #64 was donatedvisor Constance Stalling (RN) and

459,42 and iwith depreciationfigured in ?we ended up with anet operating deficit of $101,-782E.75. In other words it cost$101,782.75 more to supplyHospital' services to- :thecommunity than we receivedin earnings for services ren-:dered - -

The non-operatingincome wereceive, which is made upmostly of contributions frominterested citizens, organ-izations and industries in thecommunity, income from in-

A. SL.0mb. 2 1966

AM%=2

tributed $8,812.51 during theperiod to special. projectsandoperating expenses. of theHospital. This is a wvonderfuexample of hard work and de-dication on -the part of manyindividuals. . .With your. continued support

The Nashoba Community Ho-spital will continue to furnishthe finest in health care totthepe ole of our community.

C-idney F. MasonTreasurer

a

Mrs. Ruth Hiller (OTR), a member of the Eabter Seal S - - ' eciety's Traveling Rehabilitation-Team, instructs patient Rich- sard Scribner In' proper .use, of weight-lifting equipment b

4 our

S • aS "• . -. - • 77.754.65

l Rou e f ar ssaobtftl Aount. '- 18.62.16 186,284.88S . 35211.70

Pow.a 0aa L rae2 . .. . .D. - .0 .6

"S .-"---, .- , / ... , -. , . 85 - -* ..2;8.'5-3 7

- ORA tm _ , -B."'. 1,8 .1 -7 3D. .

] 0ia .PIAn .lno e - 18,862.57

320U2 S - ^, -- . -o -. -.. . " . . 5, .64.70./.."PRol at - atos t 'o .Tal, S. .620,54.2.0) . 483,730.34 - ,

Re. l tatd . . .. . , " - 2.700.00

toLL 8 M g 2 TF I ASSIS S 486,995.04

.. a .md «aa I c 8m237m n l " 2,79.42 s

ilgte ea d Impov m V' 1,122,564.22Siz -PSlAnt ' 96,430.44 - .Mejor Noeabl.Biment 220,659.05

TO.AL .P. . ._ -- At C. .l.464t49575.Lem Acamiulate B.p ition 54194.9

L ML A T3 s, *UPr2m,. An M2222iilgc*S

. Ao .. t. P l . .. . .. .. . . 23,050.54Anoed..I S rs, ageslad . aoc .mee 21,308.00:

" Eninoll .nltbnhdldIng en a. nuz .. o .* '.5,51528inarOal'AFind 2.00u. ' - . 250.991.87- TO& 86.OSrEfL JUN iAEIL 2 U E3 JUrDNE r Bu6Ic22 3 300,865.69-

Soa i B. . 'l . - ;. . . . . . .,

2o . 2i 1 JUNE PRRCPI .P ,- - - .AL. E: -486995.04

THE NASHO8A COMUNITY HOSPITALStatgmant of:Incom -and Exens, 'and enraj.1Fud Balance, - -

For the Year Ended Seoteber 3O 196 -

?dOW-OPERATINS INCM0:E.

TOTAL 7874.22lbthetoml o Romtinbawop

S 36,890.6011,794.009,655.5094,638.10

104,645458,906.009,524.451,245.00

11,903.806,622.6114,579.1928,095.89

$570,556.708.667. 50

$579,224.20

May 8 I f7M y eTreasurer

$917,724.79

$ 20,578.706,274.791,804.83

(2,773.18)3,874.83

-2,081.0416.06.00 47.901.01

16.63%.64886,459.42

"944,181.02166 l0.061.1 988.2.71966 101.7827

TNCH Aux. Cont. made of the officers of theSGeneral Auxiliary, the chair-

accomplished with the coop- men of the Town Units anderation and support of many .their officers, and to all spec-people - the Board of Trust- ial committees.ees, our Administrator, Ro- - As Auxiliary President, onebert V. Fay, the Hospitalper- of the major rewards hassonnel for their willing and been my association with thesecheerful help in so many in- fine women.stances, and those in the corn- Again, well done and may wemunity at large who have re- continue our efforts, whereversponded so enthusiastically to we can to be useful to theour endeavors. Hospital and its role in theSpecial mention must be community.

Frances'H. AndersonMay 8, 1967' President'

of currebecause.which hhave -libSand havthe bargAs a rechargesupward.what outbed:occcreasingfled peidemands' Real ppast yeaof the sbed pediobstetricfor anhave beEpled prcpatient'stensiveljto an urMany otthat the-raised fwas ma1965 DeNashobais theas oppogtwo unitas to tstudy. ccsolutionsLong-R

No more claustrophobia! With removal of the wall behindthe nursing station in the Ayer Unit working space has beenenlarged, light is much improved, the noise level has beenconsiderably reduced, and ventilation should no longer bea critical problem. Pictured here at the desk are the Ward -Secretary (Mrs. Nancy. Colburn) and the head nurse (Mrs.*Barbara McGough, RN); an aide (Mrs. ;Phyllis Pr essdn )'checks orders in a patient's record while,* a Medical StaffConsultant (Henry St. John Smith, M.D.) reviews his pat-ient's chart. The old 'pediatric unit (left side of the p ture)'has been converted to an observation room' and a two-roomf'adult unit. .' - .

WhiplaiEdith Baton, toUnit in t

t inflationarytrends analsoevenmore especially WorcesterArea to the Worcester Area-Council of the Mas-of the impact of new federal and state legislation sachusetts Hospital Association. This new designation cor-ve ' increase the minimum wages hospltalsmust pay responds with the names of the other 5 member area coun-

eralized regulations governing payment of overtime, cils of the Massachusetts Hospital Association, and clearlye removed hospitals and their personnel from some.of differentiates this area association council from the areaaining restrictons which had typified the health field planning council described above.estit, -salarieshave o d up rather rapidly and the The cooperative arrangement between the Hospital and theto patients for services rendered have been adjusted Easter Seal Society worked out quite satisfactorily in itsIn, our localsi tuation, charges.have. advancesome-, second year, and the contract has-recently been signed for

of propoation because"ur continuing low average the third: year- which began on April :lst. Under the.newpancy has not furnished enough- leeway .to meet in- contract, the Hospital wlllreimburse the Society for 60%salary .and, other costs and still have enough quali of the salary expenset:involved 'In making available to HRos- .sonnel on' duty to mee the peak and emergency pital patients (both' inpatients and outpatients) the servicesfor hospital ser ice. - - '. of occupational therapy, speech therapy, mhedical-social ser-

rogress on consolidation has been made during the vice, and nursing rehabilitation. With these services, plusr. The pictures included this report explain many the Hospital's own Physical Therapy unit, the complementtructural changes which have been made. The new 6- of rehabilitation services available to patients s quite com-atric unit, located inpartof what used to bethe Ayer plete and made it possible for the Trustees to authorizec al suite, mesworking out quite satisfactorily. Except the establishment, hopefully in the early summer, of anoccasional emerency alost no pediatric patients extended care service. Plans are to assign rooms #51 and3e admitted to the Groton building. The space occu- #52 in the Groton building to this :use. Policies governingevidusly in Ayer by the old pediatric unit, a private admissions to the ECF, type of nursing care to be avail-

room, and the nursing station has been remodeled ex- able, appropriate utilization of services, and optimum lengthk. The former infant Formula Room has been convertedgently needed patient treatment and examining room. The Joint Commission on Accreditation of Hospitals sur-her: changes have also been made with the final result veyed .both units and issued a 3-year accreditation certificatecombined 'bed complement of both units has been for' the period beginning September 20, 1966. The biennial

rom 81 to 84 beds. This modernizing and remodeling State inspection for licensing by the Bureau of Hospitalde possible by donations which had been made to the Facilities was made a week ago, and it is expected that ourvelopnentFand and by specific cash gifts from The license will be renewed soon.Community Hospital Auxiliary. Still under discussion The Hospital has been most fortunate in the past year with

feasibility of coordinating all surgery in one unit the extremely generous support voluntarily given by memberssed to scheduling surgery on alternate days in the of the towns served. The 1966 Development Fund Appeal hassMe es wgston he beetad Darnd .d re already received donations of almost $41,000.00. The Sub-

he best, way to unify the 'Dietary Department.i, The scription' Office (or the Annual Appeal for Maintenance Funds)sare now under cnsideraon. more promising received, in the fiscal year 1965-1966, a total of $19,280.000

aifrom 4555 area residents, a truly remarkable demonstrationange Planning, under the hairmanship of Vice.- o o f o raqnrfnd minf .f h... . n VaUns ?L 4r. mr-a

by The Nashoba Community Hospital Auxiliary, including foodvalued at $911 and received on Donation Day - 1966, amountedto the inspiring total of nearly $7,900.00.

Bequests made to the Hospital in this 'same period were asfollows: Estate of Miss HelenE. Bigelow of Harvard - $1,000.00(received), Estate of Mrs. Bertrand H. (Bessie B.) Hopkins,late of Ayer - $2,000.00 (received), Estate of Herbert H. Proct-or (on death of his widow, Grace) of Ayer - $20,000.00 (re-ceived), Estate of Frank C. Fletcher of Ayer - $2,000.00 (notyet received), Estate of Alexander H. McDonald of Littleton -$500.00 (not yet received), Estate of Miss Emma A. Bagsterof Harvard - $1;000.00 (not yet received).Other major gifts include: Mrs. Donald (Alma B) Humphriss

Memorial Fund - 2 Adjustable Height Beds; Ayer Rotary Club- 2 Adjustable Height Beds; Groton Rotary Club - IntermittentPositive Pressure Breathing Machine; In memory of DoctorJohn Lambert by his son, Benjamin deF. Lambert (MD)-60milligrams of radium. Richard J. LaVigne, (MD) - cost ofthe conversion of the radium (acknowledged above) intoneedles with modern platinum containers.Cash donations by 2 Medical Staff Members to the Laboratory

Da~1n~+ ~iAaA4n41nDA1evelopment- iunu au to the taiuolougy 'eveiopment Fund.h Injry? In Physical Therapy Department Mrs. Items of equipment by Mr. and Mrs. Wendell Nutting of Ayer,

ker (RPT) adjusts controls for patient,. LucilleHamil- Mrs. Monica and Miss Josephinie M. BudaofGroton in memoryreceive treatment .onthe Cervical Traction equipment, of Mrs. Betty Caldwell, Mrs. Frank C. Fletcher ofAyer, Mrs.he rightforeground is an ultrasound machine. . Joseph Croteau of Shirley, Stanley Conant of Littleton, Mr. and

"This Annual Report, although long, does not, by any means,cover all that has happened during this eventful year,,'but itis' hoped that some idea can be gained of accomplishmentsand of -the people and organizations who made these things'possible. ' - " -

This report can be considered reasonably complete 'onlyafter ,officially and personally recognizing the following per-sons: Nathaniel' Bowditch who, as President and friend,worked so' long, tirelessly, 'and constructively in:helping tobring about "consolidation"' and, more important, in makingit.work..

Bertrand B. Hopkins, (MD), who, as President of the MedicalStaff, has helped to make straight the many ways whichseemed to becobme difficult as a result of the many changeswhich .came with Medicare, Utilization Review Committees,and the like.

'Benjamin F. Lawtoh, (DMD), who, as President of the DentalStaff, has given effective Staff leadership and has encouragedparticipation by Dental Staff members in the affairs of theHospital, in the maintenence of good medical records, andin the evaluation of dental, care and treatment of hospitalpatients.

Mrs. Albert E. Anderson who, as President of The NashobaCommunity Hospital Auxiliary, performed a splendid servicefor the Hospital and community by her objective, clear, andimaginative approach to the position of President.None of the things recounted in this Report would have had

any real value or significance without the true and whole-hearted support and cooperation given by all members of thepersonnel team of the Hospital. To each one of them I extendmy sincere and personal thanks.

May 8, 1967 Robert V. FayMay 8, 1967 Administrator

Surgery 'in 15 minutes! Mrs. Viola Noyes (RN) and Mrs.June Paradis assist the regularly assigned O.R. personnelto ready the Groton Unit's operating suite for emergencysurgery.

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4: 11 •

Room and BoardEmergeny Room Fo.s

ELroNRS PROM 2920361 SERVICES2TO0PATIIPStopeating RoomDeivry IRo=

RasdioloJU'Laboratory

Php.1om1 PheayOcuptonl TherapyOxygen Ph-pyIntavenous TheapyMedical and Surgical1 Supplies

GR0OSS a22105 Max 29M2022 20PAITSLoarns Dductionfrom Gross aroning..

Cotatual iAloancesPuiblic Agency AllownesIndstrial Acidnt AllowancesMdicare Allowanes7... CaeCmt.,y and MiscellaneosAllowacesProvision for Doubtful Accounts

322 X1309 PROM SERVICES T0 PA?ZIWSAdds Otkaproptal Income

MAL OPE0RATING 0 hOKELoans Operating Expenses and Dpeiations

Ope.4Ung Ropne. - Shdule B-2Deproesiton

1EP OPERATU DmrCIT FOR TER TRAR 2ENDED2SEPTEMBER00.

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-Donton: - .. . .... .. .. 10.-Value of Food' received-on Donation Day- .Subscription a ' - S-do'nP. - - ctober ,18, 1966 -- ' ' - 91'1.00Hospital Auxi - Hoptl Auili 881251 * 11, Presents.to patients in Hospital on Christ- ' :

.uonited Comodltie s - Hospital Auxiliary 543.47 ..... . j , . rt * " * * - -,*.. -. . * ,, *, -'- ...-Tonants* . .. mas day, 1966 .... " - " 62.50

InvOTeA •Inc« . .,153... - 12. Two subscriptions to "Boston Globe" daily -Transfers from Temporary Funds . : :-. and "The Herald" daily; one of each 'for

- ;- ' 34,827.i5 patients in the Ayer and Groton Units. -L os: on-Oprating Expunoses, : . (pd in-year)-' ' 77.00S Fd Raising Expensae s.3,413.36' ' - for Patient. Nourh .. U

ms.anou. Expen..e 6- 89. 11 . 13. Small Refrigerator for Patient Nourish-

NeNon-prangncoe "-- 4744 ment Area Groton Obstetrical Department 69.88 -Less: Operating Deficit - Schedul , 1 101,7875 14. Service Pins for Volunteers :9.60

Not Incom, for the Year Ended September 30, 1966 s 28:864.69 . -- * 'TONI -- flr V.lonteert ' "9.60Add: Depreciation Included in Operating Expensese 4 -' 15. iysicalRehabil1tationUnit-Donatont "

Deduct: Prior Year's BlueCross ettlmsnt 1,64.95 9- 25. 4 ; Hospital for thedifference between payments

uTra ipnr tPlant Fn r: 299' ' actually-made by patients for treatments' ' ' ,SP.ant of ortgge. - . a0 66 974.13 (occupational therapy and speech therapy) - "

General Fund Balance at October 1. 1965 24.5040!6 and the amount of subsidy iven to the HospitalG.naral Fund B.lance at September 30, 1966 so,9.7 - by the Easter Seal Society for maintenance of' -

'the services of a Traveling Rehabilitation Team* m

1 inor change. havuebeen made for purposes of clarification; totals on a tentative, minimum 3-year basis 194-1.85are not affected. S.N.) " ,. n _u -- i• ...

IOSPIUL

annESUOS aN RUTE M.H.TOP St.

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at the Hospital; a group of volunteers from among the stadnis,.of- the Groton School, who,; during the winter, assistedus inLaboratory, Radiology, and Medical Records wih the filingand re-arranging of files; the Editors of the PUBLIC SPIRIT,.FREE PRESS TOWNSEND TIMES, LOWELL SUN, FITCHBURG.SENTINEL, WORCESTER, TELEGRAM for their ~ener uscooperation In helping the Hospital keep its-public up toiate_on activities and planning. Many other organizatou7 andindividuals have also assisted during-the year, but again ourspace is limited. To all a sincere "Thank You." "

We are saddened to report two deaths. A member of the Hon-orary Medicaf Staff, Harold W. Ayres (MD) of Groton,;die4dcinGrpton on 'May 28, 1966, at the age of 84. Active up to a ve:y-short time before his death, Doctor Ayres typified the physicianwho Is so often referried to as the "country doctor" and!~hee-"family. doctor". -H. had been "a member of the Medical Sff'.of each of the original Hospitals before consolidation and, hadserved with distinction for several terms as President.

J. Walter Desmond (DMD) of Shirley, a member of the Hon-orary Dental Staff, died in Arizona on February 25, 1967, atthe age of 71. To him is due .the credit of having formedaDental-Staff -at a time when' comparatively few hospitals inthis' couitry h ad- seperate dental staff organizations. Alwaysinterested in the welfare -of his patients,' he had been well

-named "Dentist of tlie Year" onlyafewyears before his death.

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