Dartmouth Health moves to add another hospital

Dartmouth Health is poised to add another rural hospital to the academic health system.

Dartmouth is planning to acquire Littleton Regional Healthcare, a 25-bed critical access hospital in western New Hampshire. Dartmouth and Littleton announced last week that they had signed a letter of intent to come together.

Littleton has spent the past two years looking for a partner and said Dartmouth is the most appealing health system.

Joanne M. Conroy, MD, president and chief executive officer of Dartmouth Health, noted the difficulties facing rural hospitals and said the deal would ensure Littleton’s long-term viability.

“We have seen in recent years the increasing challenges for rural healthcare providers, and we know we are stronger together,” Conroy said in a statement. “We still have to go through the regulatory process, but I am totally confident that this partnership is in the best interest of LRH and the patients they serve, and we look forward to welcoming LRH into the Dartmouth Health family, strengthening both organizations in the process.”

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New Hampshire state officials, including the attorney general’s office, must review the transaction before it can be completed.

Littleton Regional Healthcare’s board began exploring the possibility of forming a partnership with a larger health system in 2023.

Robert Nutter, president and CEO of Littleton, said the health system’s board engaged in extensive discussions before choosing Dartmouth and negotiating to join the system. Nutter said the system wanted to get access to more healthcare services while preserving “the quality, compassion, and personal touch patients expect from LRH.”

“We firmly believe DH is the right partner that allows us to achieve these goals,” Nutter said in a statement. “By joining Dartmouth Health, we are not just preparing for the future, we are building a stronger, healthier future for our community together,” he added.”

Littleton serves patients in New Hampshire’s “North Country” and part of Vermont, and the system sees 60,000 patients annually.

Based in Lebanon, New Hampshire, Dartmouth Health is the state’s only academic medical center.

Dartmouth has added two other hospitals to the system in the past two years. In July 2024, Dartmouth Health added Valley Regional Hospital in Claremont, N.H., to the system. Dartmouth also added Southwestern Vermont Medical Center (SVMC) to the health system in 2023.

Other rural hospitals have been looking to join larger systems or find other partnerships as they face serious financial difficulties. About half of America’s rural hospitals are already losing money, and almost one-third are at risk of closure, according to analysts.

In a 2023 interview with Chief Healthcare Executive®, Conroy said some rural hospitals are barely hanging on, and some are only surviving by reducing services, such as labor and delivery.

“In New Hampshire, we have some areas that have become maternity deserts, because women have to travel more than two hours to deliver their babies,” Conroy said in 2023. “They can't afford to actually continue to offer services that lose money, their margins are so thin. So it's kind of a double whammy.”

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