I agree with the tunnels extending to the Ohio River. A facility of this size would have probably needed a LOT of supplies in it's early years, before it became self-sufficient, and as anyone who lives in the area would know, winter is a bad time to move anything, with the ice and snow, this combined with the location, I would say that they got a lot of supplies off the river, especially in the colder months.
Ddoctor DETH
Location: Dixmont State Hospital Gallery: Departure