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CLARMONT – Valley Regional Hospital is one of five hospitals in New Hampshire that are not yet part of a larger health system, but that’s about to change.
At the end of last month, he announced that he has Claremont’s Valley Regional They signed a letter of interest With Dartmouth Health and Windsor Mt. Ascutney Hospital and Health Center, along with another member of the DH system.
According to the letter, Valley Regional will join the Lebanon-based practice, the state’s largest private employer, and will be co-managed by Mt Ascutney CEO Dr. Joseph Peras. Valley Regional Interim CEO Dr. Jocelyn Capel will serve as Chief Medical Officer of both hospitals, and Mt. Ascutney CFO David Sanville will serve in this capacity for both organizations.
The two smaller hospitals will have “mostly mirror” boards, including up to five representatives from each of the three organizations.
On Thursday night, hospital leaders held a public hearing at the Claremont Savings Bank on Broad Street to make their case.
“I like to say that Valley Regional Hospital is small but mighty,” Capel said at Thursday’s session, which was attended by about 50 people, most of whom are employed by health care organizations. But she said the hospital, which has 21 staffed beds and 350 staff, can’t do it alone. It already relies on partnerships to provide specialty care in the Sullivan County city of about 13,000, which “has a flat and declining population,” she said.
Kappel, who previously sold Frisby Memorial Hospital in Rochester, N.H., to the for-profit chain, said consolidation in rural health care is essential for small hospitals to survive.
“It’s really, really hard to be an independent rural hospital,” she said, noting that more than 136 rural hospitals have closed nationally in the past 10 years. She said she appreciates the Valley Regional Board being proactive in seeking a partner.
DH is the right partner, she said, because in rural areas, “geography is destiny.”
The letter of intent, signed in December, describes a “long and extensive history of cooperation” between Valley Region and DH. DH provides cardiology, oncology, pathology and radiology services in the Valley Region. The New England Alliance for Health is a shared services organization that is part of the Valley Regional DH system. Valley Regional and MT Ascutney have partnered in areas such as rehabilitation and laboratory management services.
Once completed, the new relationship will allow for a “tighter integration” of clinical, administrative and financial resources to achieve operational efficiencies to maintain “cost-effective and high-quality clinical services in their rural communities.”
If the transaction moves forward, requiring regulatory approval from both states’ attorneys, Valley Regional will become the fourth community access hospital to come under the DH umbrella. In addition to Mount Ascutney, the system includes Alice Peck Day Memorial Hospital in Lebanon and New London Hospital, as well as the larger Cheshire Medical Center in Keene and visiting nurse and hospice for Vermont and New Hampshire.
A few other Upper Valley hospitals remain independent: Gifford Medical Center in Randolph; Cottage Hospital in Woodsville; and Springfield (Vt.) Hospital.
Leaders of small hospitals that have joined the DHS system credit their membership with helping them cope with the COVID-19 pandemic, enabling them to bring specialty services home and better communication between providers at different facilities in a shared medical record.
“The benefits of being affiliated with Dartmouth-Hitchcock Medical Center (DHMC) have expanded the services we can offer, meaning our population can access the same world-class care at NLH in specialties such as dermatology and oncology – without the burden of driving 30 miles away,” said New. London Hospital chief executive Tom Mannion said in a recent community newsletter: “Over the past few years, the benefits have extended beyond services to include integration into the same electronic medical record platform, which has ensured continuity of care for our patients.”
Dr. Sue Mooney, CEO of Alice Peck Day, also called the shared medical record a “total game changer in how we care for patients,” noting that providers should not siphon off records from other hospitals. Hospitals in the DH system standardize their lab equipment so they all have the same reference range so tests don’t have to be repeated when a patient moves from one hospital to another, Mooney said.
Given its proximity to DHMC, APD shares professional staff with the academic medical center, including hospitalists and emergency room physicians.
“As a result, we’ve seen the ability to care for a wider range of sick patients,” Mooney said. “This was really for the benefit of the community. I think that’s the biggest change.
Each year, before the merger, APD saw about 6,300 emergency department visits, but now it’s up to 9,000, Mooney said. Patient stays increased from 15 patients to 17 on average per day. In addition, the operating rooms, CT scan and magnetic resonance imaging machines are doing more work than before.
Everything is a little busy,” Mooney said.
By allowing more and sicker patients to receive care outside of the 396-bed DHMC, it helps reduce pressure on the academic medical center, which is often full.
“If every small rural hospital started reducing services or closing its doors,[we]wouldn’t be able to accommodate them at an academic medical center in Lebanon,” DHS CEO Dr. Joanne Conroy said at Thursday’s hearing.
Peras said Mit Askutni joined the DHN system in 2014 “when it was in dire straits.”
While Peras DH “didn’t come down with a bag of money to save us,” MT Ascutney provided the knowledge and resources they needed to “get to a better place.”
Claremont resident Bernie Folta, a retired walker who said he had recently been a patient at all three hospitals in connection with Thursday’s discussion, questioned hospital leaders.
He said, and hospital officials confirmed, that Valley Regional has an ownership stake in Summercrest Senior Living Community in Newport and should be discussed as part of the partnership. In the year A loan from the U.S. Department of Agriculture in 2017 will allow Valley Regional Hospital to refinance long-term debt incurred during a 2010 renovation and expansion, he said.
“This is a big deal,” Folta said. There are many surprises.
Still, in an interview after the session, Folta said he understands the pressure Valley Regional is under these days.
Regarding the relationship, Folta said, “I think it’s inevitable.”
In addition to the attorneys general of the twin states, the merger requires approval by the boards of the three organizations.
Right now, the companies are each doing their own due diligence, or as Capel puts it, “proving that we really want to marry each other.”
Nora Doyle-Burr can be reached at ndoyleburr@vnews.com or 603-727-3213.
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