Windsor
Perras, who will step into the top job on Jan. 11, previously worked for 12 years as a primary care and hospital care doctor at Dartmouth-Hitchcock, which gained final say over governance, finance and management issues at Mt. Ascutney through an affiliation deal completed in July 2014.
Perras’ appointment came after “months of collaborative work between the (Mt. Ascutney) Board of Trustees and senior leadership of Dartmouth-Hitchcock Health (D-HH) to determine the right leadership for the Hospital,” according to the release.
Perras will fill a vacancy created by the departure of Gay Landstrom, who in June took on dual management roles as chief nurse at D-H’s holding company and interim chief executive at Mt. Ascutney. Landstrom is returning to Michigan to become the top nurse at a Catholic health system, she said in an interview on Tuesday.
Landstrom took the helm at Mt. Ascutney after former Chief Executive Kevin Donovan left to become chief executive at LRGHealthcare, the Laconia-based operator of two hospitals in central New Hampshire.
Landstrom said she had expected to remain at Mt. Ascutney for four to six months and then resume her full-time role as a D-H nursing executive, but the recent death of her father had prompted her to return her home state to be closer to her family.
Mt. Ascutney Board Chairman Donna Van Fleet said in the release that Perras was “the right person to lead Mt. Ascutney … into the next chapter of our history.” Van Fleet said Perras was admired by staff, senior leaders and trustees at Mt. Ascutney and D-H.
As chief medical officer, Perras said, he has been “an advocate for Mt. Ascutney within the system to make sure we have close coordination of clinical care at D-H as well as at its affiliates.” He will continue in that role in addition to doing the CEO job but that will require handing off some responsibilities, he said. As a result, he said, a wall of his office is now “filled with Post-it notes of things that we’re going to have to redistribute.”
Affiliation eases the flow of patients between D-H and Mt. Ascutney, which is now the largest recipient of swing bed patients – those who no longer need acute care but are not yet ready to be sent home or discharged to a nursing facility — from D-H’s Lebanon campus, Perras said. Mt. Ascutney received about 600 swing bed patients from D-H in the past 18 months, he said.
Affiliation also smooths the flow of medical staff, back-office support and human resources services from the larger hospital to its smaller affiliate, according to Perras.
Mt. Ascutney, which receives enhanced compensation from the Medicare program through a program that aims to ensure the survival of small rural hospitals, expects to receive a $1.2 million “system allocation” payment from D-H for the current fiscal year that will offset an expected operating deficit of the same size, the hospital recently told Vermont regulators. The hospital’s budget anticipates net patient care revenue of $47.7 million for the year that runs through June.
Mt. Ascutney’s announcement of the impending executive turnover came eight days after D-H Chief Executive James Weinstein announced his own decision to depart at the end of June. Landstrom was one of seven executive vice presidents listed on the “leadership” page of D-H’s website Tuesday. Two other executives with that rank — Robin Kilfeather-Mackey, was also chief financial officer, and John Birkmeyer, who was chief academic officer — have left D-H since July.
Landstrom left a larger hospital system to become D-H’s top nurse in July 2014. A year later, she told a D-H publication that she wanted to unify D-H nursing operations that had been “organized in silos around inpatient and outpatient settings.”
In a recent presentation, Karen Clements, the top nurse at D-H’s flagship facility in Lebanon, said she would appoint a director for inpatient nursing and another for outpatient nursing. Clements could not be reached for comment on Tuesday.
Landstrom said she did not view the appointments as a reversal of the effort to break down silos but as “more of a shrinking of the leadership team.”
Clements will serve as interim chief nursing officer for the D-H system during a search for a permanent replacement for Landstrom, spokesman Rick Adams said.
D-H, like many of its peer health systems in northern New England and across the country, has struggled to find nurses. Currently, D-H employs more than 1,800 nurses at its Lebanon campus and at its clinics, Adams said. On Tuesday, D-H’s nurse recruitment page listed 110 vacancies, including 72 full-time positions, nine half-time positions and 21 per diem or temporary positions.
The expense of filling vacant positions, including in nursing, with temporary or contract employees has been cited by D-H as a factor that contributed to some of its recent financial woes.
Contact Rick Jurgens at rjurgens@vnews.com or 603-727-3229.