Small NH hospital remains relevant as others struggle to survive

WOODSVILLE, N.H. (WCAX) Rural hospitals around the country have been struggling to make ends meet, including the Springfield Hospital, which is expected to file for bankruptcy. But the Cottage Hospital in Woodsville, New Hampshire appears to be bucking that trend.

As Maria Ryan chats with an orthopedic doctor at Cottage Hospital, she has one more reason to be proud of the work being done here. The hospital CEO was recently awarded the Louis Gorin Award for Outstanding Achievement in Rural Health Care. "I really believe it was because of the innovation and creativity of Cottage Hospital," Ryan said.

But being a small hospital comes with a lot of challenges. "We are never going to do brain surgery, we are never going to do big spine surgery, but what we do, we are going to do it really well," Ryan said.

As rural hospitals across the country continue to struggle, the focus here has shifted to specialty care. A new facility across the street houses a host of different services. "Specialists that other people don't have, so people are going to drive far distances to come see our podiatrist, our rheumatologist, our endocrinologist, our orthopedic," Ryan said.

Another big investment is the Ray of Hope Geriatric Behavioral Health Unit. It's a ten-bed locked down psychiatric unit named after the late Ray Burton, a beloved executive councilman from New Hampshire's North Country. "It was made for a region that was devoid of mental health services. So we have been full since day one and we get patients from Vermont, New Hampshire, Massachusetts, Maine," Ryan said.

While the unit is helping to pay the bills, other services have been cut, including the birthing center, which closed a couple of years ago. Ryan says she looks outside a lot every day to see how many cars are in the parking lot and that making budget is a constant concern. One way the facility keeps costs down is through payroll for the organization's 300 employees. "It's a love of doing something different, doing it better, but not getting paid as maybe another institution can pay you," Ryan said.

Looking forward, she says the goal is to expand outpatient services, bringing health care into nearby towns to improve outcomes while saving on overhead costs. "Whether it's physical therapy, rehabilitation, perhaps even urgent care -- something that they don't need a hospital acute care setting -- but we want to meet their needs in their communities," Ryan said.

She says the community also plays a crucial role and that in order for the facility to be successful in the long term, patients have to support it.