Category: Q&A

Power of one

VNA merger expands home health, hospice services

Visiting nurse associations Concord Regional VNA and Central New Hampshire VNA & Hospice have merged to form what is now the Granite VNA, providing certified home health care and hospice care to 82 communities throughout the greater Concord area and central New Hampshire. President and CEO Beth Slepian, formerly the president and CEO of Concord Regional VNA, discussed the merger.

Why was Granite VNA formed?

Industry-wide, [VNA] organizations have been looking at how to be sustainable for the long term. … Over the last five years, and even longer than that, home care and hospice has become challenging because of Medicare payment cuts; our fees are reduced. … We provide over $5 million in community benefits, which is unreimbursed … and we’re seeing our reimbursements declining. We’re also seeing [an increase] in patients to care for. Our biggest costs are labor wages and benefits; how will we be able to continue to both support our workforce and provide those community benefits? … Both Concord Regional VNA and Central VNA & Hospice were very strong financially; neither had to embark on this journey now, but we were looking toward the future to make sure that we could leverage scale and volume to meet the needs of the entity in the long term.

How will the merger improve health care in the state?

In the Lakes Region, Central New Hampshire VNA did not have IV-certified nurses, and that’s something we’re looking to bring to that area. We have more wound care nurses and certified lymphedema therapists in the Capital region that [were part of] Concord Regional VNA, so we’ll be able to spread them throughout our entire service area. We’re expanding the maternal child health services that we provide in the Lakes Region. [Central VNA] had a program, but it was small, so we’re staffing that to address the pediatric and maternal health needs of mothers and babies. … Finally, we’ll be able to spread our community education programs [like] Powerful Tools for Caregivers [and] Better Choices Better Health throughout the communities we serve, based on an assessment [of their needs].

Who will benefit most from these expanded health care services?

More people are receiving care in their homes now than ever before. … We have an aging population in New Hampshire, and an expanding group of people requiring care, [including] patients who have chronic illnesses like diabetes and congestive heart failure, have had joint replacements or an accident, or need IV therapy. We’ll also be able to give patients in the remoter areas of New Hampshire greater access to visiting nurses and home care and specialty care.

How is Granite VNA operating as of now?

The main office is located in Concord, with two branches in Laconia and Wolfeboro. … We now have five home care teams, two hospice teams and a hospice house. We’re currently still operating on two different electronic health records, and once we’re on one, we’ll be able to really resource all 82 towns that we serve with one workforce.

Did the pandemic impact the merger process?

It was hard, as we went through the pandemic, continuing to care for our communities while also working toward this big project … but we persevered … and methodically worked our way through the process to integration. … Discussions [about the merger] had been happening for a year prior [to the pandemic], and they were very collaborative discussions; we were working closely together to create this new entity, so [by the time the pandemic happened] we had already formed a relationship and could support each other and share knowledge and processes on how to handle the new [pandemic] rules.

How has Granite VNA taken care of its staff throughout the merger?

Mergers are not successful when not enough work is done on creating a new [workplace] culture. That’s why we created a new name, instead of keeping either [organization’s] name, and a new identity. It’s really important to us that as we go through this integration it’s a shared experience and a shared new culture for everyone. … We actually [have a] consultant who is working with both organizations to bring them together … and [help them] acknowledge what each is feeling and really understand each other.

What do you anticipate will be the biggest challenge for Granite VNA?

Workforce, workforce, workforce. [Health care organizations] are all competing for the same people [to employ]. We would hire as many nurses as we could find right now, but it’s really hard. We’re doing what we can … and we’re trying to get creative. We have a nurse graduate program so that we can train nurse graduates … and that’s a slow but steady build of our workforce.

Featured photo: Beth Slepian

Shawna Deeley

Shawna Deeley was a cook at The Village Cafe in Bradford when the pandemic forced its shutdown last year. After learning that the cafe would not be reopening, Deeley and her husband, Bill Yulov, decided to use their stimulus checks to invest in a brand new business venture — she now runs The Russian Dumpling Co. (find them on Facebook and Instagram @therussiandumplingco), a food trailer offering traditional Russian comfort options made from scratch. The concept, Deeley said, was inspired by Yulov’s family’s recipes — items include Russian-style pierogi with a few varying ingredient fillings, like potato scallion and cheddar, or sweet potato, mushroom and onion; as well as pelmeni, or Russian dumplings stuffed with beef, chicken or mushroom. Borscht, a traditional beetroot-based stew that can be served hot or cold, is also available with or without steak, along with carrots, cabbage, garlic and onion. Deeley said The Russian Dumpling Co. is one of the regular featured vendors at the Northlands Live drive-in concert series every Friday and Saturday at the Cheshire Fairground (247 Monadnock Hwy., Swanzey) and is also available for private events.

What is your must-have kitchen item?

I feel like I’m constantly walking around holding my spatula.

What would you have for your last meal?

I love Vietnamese pho. I used to live in Seattle and places that had pho were on pretty much every corner.

What is your favorite local restaurant?

I would say Moritomo [Japanese Steak House & Sushi Bar] in Concord. They have really awesome sushi. There’s also a tiny place in Brookline called Juanita’s that does amazing Mexican food.

What celebrity would you like to see ordering from your food trailer?

Keanu Reeves. I feel like he’d be such a fun guy to talk to.

What is your favorite thing on your menu?

I think the chicken pelmeni is my favorite. They’re dumplings with ground chicken and herbs in them that are almost like little raviolis.

What is the biggest food trend in New Hampshire right now?

I feel like I see a lot of little Mexican places all over the place now.

What is your favorite thing to cook at home?

We make homemade pizzas quite often. One of my favorite ones that we do has the lox smoked salmon. We put that on a pizza with cherry tomatoes and maybe spinach or arugula and it’s the bomb.

Sirniki (Russian farmer’s cheese pancakes)
From the kitchen of Shawna Deeley of The Russian Dumpling Co.

1 pound farmer’s cheese or cottage cheese
½ cup flour
2 eggs
3 Tablespoons vegetable oil or other cooking oil
¼ cup sugar
Pinch of salt
½ cup raisins (optional)

Combine ingredients in a mixer or by hand, then form the batter into little cakes in a saute pan at low to medium-level heat. Serve with butter, honey, sour cream or your favorite jam or compote.

Food & Drink

Summer farmers markets

• Bedford Farmers Market will be Tuesdays, from 3 to 6 p.m., in the parking lot of Wicked Good Butchah (209 Route 101), starting June 15. Visit bedfordfarmersmarketnh.org.

• Concord Farmers Market is Saturdays, from 8:30 a.m. to noon, on Capitol Street. Visit concordfarmersmarket.com.

• Derry Homegrown Farm & Artisan Market is Wednesdays, 3 to 7 p.m., at 1 W. Broadway. Visit derryhomegrown.org.

• Milford Farmers Market is Saturdays, from 10 a.m. to 1 p.m., at 300 Elm Street in Milford. Visit milfordnhfarmersmarket.com.

• New Boston Farmers Market will be Saturdays, from 10 a.m. to 1 p.m., on the corner of Route 13 and Meetinghouse Hill Road, June 12 through Oct. 9. Visit newbostonfarmersmarket.webs.com.

• Salem Farmers Market is Sundays, from 10 a.m. to 2 p.m., at Tuscan Village South (12 Via Toscana Drive, Salem). Visit salemnhfarmersmarket.org.

• Warner Area Farmers Market is Saturdays, from 9 a.m. to 1 p.m., on the Warner Town Hall lawn. Visit warnerfarmersmarket.org.

• Weare Real Food Farmers Market will be outdoors on Saturdays, from 10 a.m. to 3 p.m., at 65 N. Stark Hwy. in Weare. Visit wearerfm.com.

Featured photo: Sirniki (Russian farmer’s cheese pancakes). Courtesy of Shawna Deeley.

On The Job – Tom Betteridge

Tom Betteridge

Mechanical engineer

Tom Betteridge is vice president of mechanical engineering at Turner Building Science and Design, a Concord-based team of engineers specializing in creating safe, comfortable and energy-efficient indoor environments.

Explain your job and what it entails.

I work with clients to solve their building issues having to do with heating and cooling, indoor air quality and ventilation. … I work primarily at the desk, designing mechanical systems and generating drawings and blueprints and specifications for the construction [workers]. … Then I’ll go to the construction site to verify that the construction was done properly.

How long have you had this job?

A little over two and a half years.

What led you to this career field?

I was really good at math and science in high school, and I enjoyed understanding physics and how things are put together. That drove me to go to engineering school. There, I really enjoyed thermodynamics as a course curriculum. After [school], I had an opportunity to join an engineering consulting firm. … I used to work for a national firm and traveled all over the country, and I realized I wanted to spend more time at home with my family and have a bigger impact locally. Turner gives me the ability to do that, so I [took a job there].

What kind of education or training did you need?

You need a bachelor’s degree in mechanical engineering, and you need to sit for two eight-hour exams: a fundamentals of engineering exam, which you typically take around graduation from college, and then, after a four-year internship, a professional engineering exam. If you pass those exams, you become a licensed professional engineer, and you become legally liable for the designs you produce.

What is your typical at-work uniform or attire?

Business casual.

How has your job changed over the last year?

A lot of our [work] lately has been dealing with Covid-related building issues, [designing systems for] clients wanting to make sure their buildings are safe for their staff.

What do you wish you’d known at the beginning of your career?

It doesn’t get easier. Even when you learn how to do the tasks better and more efficiently, that gets boring, so you strive for the next challenge, and the challenges keep growing. But embrace those challenges, because when you look back, you realize you’ve accomplished more than you ever thought you would.

What do you wish other people knew about your job?

Because I work so much on the technical side of things, it’s hard to put things into layman’s terms for people, but if someone is willing to have a conversation and ask additional questions to gain clarity, they end up learning something, and I end up learning how to see things from a different perspective.

What was the first job you ever had?

I worked as an electrical contractor for a small electrician firm. I did that from when I was 15 years old through college.

What’s the best piece of work-related advice you’ve ever received?

Get to know your boss’s boss. It’s not about trying to step over your boss; it’s about getting a bigger perspective and being able to look past what your supervisor needs from you to see what their boss requires of them.

Five favorites
Favorite book: Leaders Eat Last by Simon Sinek
Favorite movie: Top Gun
Favorite music: Mostly rock and alternative
Favorite food: Mexican
Favorite thing about NH: The outdoors

Featured photo: Tom Betteridge

Standout citizen

Health director commended for pandemic leadership

Manchester Public Health Director Anna Thomas is the recipient of the Greater Manchester Chamber’s Citizen of the Year award, which recognizes individuals who have demonstrated leadership, vision and civic pride while making significant contributions toward the betterment of the Manchester community.

How did it feel, being named Citizen of the Year?

I’m honored and humbled, but there are so many people in the community who should be recognized for their contributions; [the recognition] really can’t go to just one person. I see it as more of a ‘citizenry of the year’ than a ‘citizen of the year’ award, because everyone has sacrificed and done their part to be part of the solution during this pandemic.

What did you find to be the most successful or effective part of your approach to the pandemic?

Throughout Covid, our decision-making has been very data-driven and evidence-based. We monitor the data on a daily basis and use science and the best research we have available to be very strategic about what we do. … Another [successful approach] has been pooling resources and collaborating to solve community issues. Our individual programs are excellent, but we know we can make a bigger impact by leveraging the strength of multiple programs working together.

Is there anything that you learned or that surprised you about public health over the last year?

I’ve learned how much politics can enter the world of public health. When you’re making decisions dealing with [protecting] human life, sometimes you’re stepping on people’s individual choice or civil liberty. A lot of people don’t want to be told what to do by the government; they want to be informed and then left to make their own decisions. I respect everyone’s individual choice, but unfortunately, during a pandemic or any kind of public health emergency where one person’s choice can impact the health and well-being of others, executive orders have to be made. … It’s certainly not the first time I’ve seen how public health issues can tug on people’s ideologies and philosophies, but in this pandemic, I’ve seen it played out much more significantly.

How would you describe your leadership style?

It’s very team-based. I don’t believe in being the dictator at the top saying, ‘This is the way it’s going to be.’ No one is an expert on everything; everyone has different skill sets. Innovation and creativity comes from having multiple perspectives. … Working on a large population level, we have to have perspectives from all sides to give us a bigger picture for how to inform our process and make the most well-rounded decisions that we can so we can serve the entire community.

What is the biggest challenge you face in your position?

One of the challenges is the sheer magnitude of people we’re trying to reach. … Manchester is the largest city north of Boston; it’s an urban center, and the work we do really falls under the umbrella of urban health, which comes with an entirely different level of priorities … than the suburban and rural communities that [make up] the majority of New Hampshire. … That’s why we have a division focused on family and neighborhood health. Different neighborhoods have different needs and different strengths, so just like the state [narrows down] public health to a community level, we as a city look at how we can tailor our services to meet the needs in specific neighborhoods.

What is your focus right now for Manchester’s public health?

It changes day to day, sometimes even minute to minute. It’s still all about Covid, for the most part. … We’ve moved away from the community-based testing that we’ve been doing throughout the pandemic, and now we’re heavily focused on getting people vaccinated and back on their feet. … We’re also trying to get back to [addressing] more of the basic public health [issues] that we did prior to the pandemic … [such as] school health; … refugee health; … infectious diseases other than Covid, like HIV, STDs and TB; … environmental health, [like] testing mosquitoes for Triple E and West Nile virus; water sampling; … septic inspections; … assessments of [buildings with] lead, mold or bed bugs; … community dental care; …home visits with expectant mothers; [and] opioids and addiction. … We’re also doing a lot of work in the arena of mental and behavioral health, and we actually have a behavioral health specialist on staff now.

What should people know about the current public health situation?

They can be optimistic and hopeful about the future. We’re at a better place now. Things are definitely taking a turn for the better, and there’s a lot to look forward to.

Featured photo: Anna Thomas

Marie Sacco

Marie Sacco of Salem is the owner of The Sandwich Monstahh ([email protected], and on Facebook and Instagram), a food trailer she launched in April that specializes in homemade gourmet sandwiches, soups, sides, appetizers and desserts incorporating a variety of Italian and New England-themed flavors. Sacco, who grew up in Swampscott, Mass., just outside of Boston, said much of The Sandwich Monstahh’s menu is inspired by what she grew up eating and what her mother and grandmother would often cook. Popular items include eggplant or meatball Parmesan subs, as well as steak bombs, chicken cutlets, homemade egg rolls and more. The trailer is bright green, in tribute to the Green Monster at Boston’s Fenway Park. You can find The Sandwich Monstahh at the Derry-Salem Elks Lodge (39 Shadow Lake Road, Salem) on Thursdays from 5 to 8 p.m., as well as occasionally at a few local breweries, including Rockingham Brewing Co. and From the Barrel Brewing Co., both of 1 Corporate Park Drive in Derry.

What is your must-have kitchen item?

It sounds crazy, but if I don’t have a pair of tongs I’m lost.

What would you have for your last meal?

For me, I would say a really good New York strip steak, with a baked potato and Brussels sprouts, and also a red wine.

What is your favorite local restaurant?

Trattoria Amalfi, which is a little restaurant right here in Salem. They are amazing. We’re there once a month at least.

What celebrity would you like to see ordering from your menu?

Gordon Ramsay, a hundred percent. His food is unbelievable, and all of his ideas about food are straight on. I actually try to model a lot of what I do around his cooking techniques and ideas.

What is your favorite thing on your menu?

The eggplant Parm sandwich, because it’s such a part of my childhood.

What is the biggest food trend in New Hampshire right now?

I feel like egg rolls are really popular right now. You can throw literally anything into an egg roll as long as you serve it with a good sauce accompaniment that makes sense.

What is your favorite thing to cook at home?

Breakfast is so fun to cook. I like to do eggs and some sort of protein, either bacon and sausage … and then some cut-up fruit or maybe homemade muffins.

Homemade cannoli dip
From the kitchen of Marie Sacco of The Sandwich Monstahh food trailer

16 ounces dessert ricotta
4 ounces cream cheese
½ cup sugar
1 squeeze fresh lemon juice
1 squeeze fresh orange juice
1 teaspoon anise extract
1 teaspoon lemon zest
1 teaspoon orange zest

In a mixer, blend cream cheese at room temperature with juices, anise extract, zests and sugar. Mix on high speed until smooth. Add ricotta and mix until combined. Refrigerate for one hour. Sprinkle chopped pistachios, shaved chocolate or mini chocolate chips on top. Serve with pizzelles dusted with powdered sugar, cannoli chips or crushed up cannoli shells.

Featured photo: Marie Sacco

On The Job – Missy Gaffney

Missy Gaffney

Esthetician and business owner

Missy Gaffney is an esthetician and owner of three health and beauty businesses — The Skin & Body Spa, The Hair Company and The Medical Skin Clinic — all located in Nashua.

Explain your job.

It’s different every day. I could be interviewing [potential employees], proofing or brainstorming marketing plans, ordering [products] or meeting with the managers and delegating [tasks]. … I constantly have my face around at all the different businesses, interacting with all of our employees and making sure everything is perfect for the clients.

How long have you had this job?

We’ve had The Skin & Body Spa for almost 14 years, The Hair Company for almost six years, and The Medical Skin Clinic for almost two years.

What led you to this career field and your current job?

I struggled with acne myself as a kid, so my mom would bring me to get facials and get good skin care products to help my skin, and I really noticed such a huge difference. I always had the dream of one day being an esthetician and helping people like myself [improve] their skin and boost their confidence. I worked as an esthetician for other [businesses] for years, but I always had a vision of opening my own, and that I could [run] it really well.

What kind of education or training did you need?

I have a bachelor of science degree, and then I went to esthetics school for 450 hours. … I was constantly going to continuing education classes after that, and still go to a lot of conferences on spa management and business management.

What is your typical at-work uniform or attire?

Business-casual.

How has your job changed over the last year?

We’ve had to really home in on what we need to do to create a safe and comfortable environment for our clients as well as our team members, without getting too overwhelmed. It has taken a lot of patience and research and being proactive to make sure that we always have all the right policies and the proper PPE.

What do you wish you’d known at the beginning of your career?

To not get worked up over every little thing that goes wrong. There are always going to be problems, and there are always going to be solutions. Think, ‘How am I going to solve this?’ instead of stressing out about it.

What do you wish other people knew about your job?

Some people are scared [to go to a spa] because they think it’s going to be a snobby environment, but I would want them to know that they never have to worry; we’re very non-judgmental, and very good at putting people at ease and making them feel very welcome.

What was the first job you ever had?

Working in a clothing store, folding clothes.

What’s the best piece of work-related advice you’ve ever received?

When you’re stressing about something, ask yourself, ‘Is this really going to matter in five years?’ If it’s not, it’s easier to let it go.

Five favorites
Favorite book: Tuesdays with Morrie
Favorite movie: The Sound of Music
Favorite music: Folk
Favorite food: Japanese
Favorite thing about NH: All the options; I can get to a little historic town, skiing [destination], Boston or the beach without a lot of [travel] time.

Featured photo: Missy Gaffney

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