Claremont-Valley Regional Hospital is one of five hospitals in New Hampshire not yet part of the larger healthcare system, but that may be about to change.

Late last month, Claremont’s Valley Regional announced it had signed a letter of intent with Dartmouth Health and Windsor’s Mt. Ascutney Hospital and Health Center, another member of the DH system.

As outlined in the letter, Valley Regional will join the Lebanon-based system of the state’s largest private employer and will be co-managed by Mt. Ascutney’s current CEO, Dr. Joseph Perras. Interim CEO of Valley Regional, Dr. Jocelyn Caple, served as chief medical officer of both hospitals, and David Sanville, his CFO of Mt. Ascutney, served as chief medical officer of both organizations.

The two smaller hospitals will have “mostly mirror” boards with as many as five representatives from each of the three organizations.

Hospital leaders held a hearing Thursday night at the Claremont Savings Bank on Broad Street in Claremont to give their views.

“I would like to say that Valley Regional Hospital is small but mighty,” said Caple at Thursday’s session, which was attended by about 50 people. But she said the hospital, which has 21 beds and 350 employees, just can’t keep up. We already rely on partnerships to provide specialty care in the city of Sullivan County, which has approximately 13,000 people. In the region, she said, “the population is flat and slightly declining.”

Local healthcare integration is necessary for small hospitals to survive, said Caple, who led the sale of Frisbee Memorial Hospital in Rochester, New Hampshire, to a commercial chain.

“Being an independent rural hospital is really, really hard,” she said, noting that more than 136 rural hospitals nationwide have closed over the past decade. He said he applauds the board for actively seeking partners.

DH is the right partner, she said. Because in rural areas “geography is destiny”.

The Memorandum of Understanding, signed in December, marks a “long and broad history of cooperation” between Valley Regional and DH. DH provides cardiology, oncology, pathology, and radiology services at Valley Regional. Valley Regional belongs to the New England Alliance for Health, a shared services organization that is part of the DH system. Valley Regional and Mt. Ascutney also collaborate in areas such as rehabilitation and laboratory management services.

Once the new relationship is finally established, it will be necessary to “allocate clinical, administrative, and financial resources with the aim of achieving operational efficiencies to maintain “cost-effective, high-quality clinical services in rural communities.” allows for tighter integration.

If the deal, which requires regulatory approval from both state attorneys general, goes through, Valley Regional will become the fourth community access hospital to come under the DH umbrella. In addition to Mount Ascutney, the system also includes Lebanon’s Alispek Day Memorial Hospital and New His London Hospital, Keene’s larger Cheshire Medical Center, and visiting nurses and hospices in Vermont and New Hampshire.

The remaining Upper Valley Hospitals will remain independent. Randolph’s Gifford Medical Center. Cottage Hospital in Woodsville. and Springfield (Vermont) Hospital.

Leaders of smaller hospitals already participating in the DH system said their membership helped them weather the COVID-19 pandemic, enabled them to deliver specialized services closer to home, and shared medical records to connect different facilities. We believe that communication between providers can be improved.

“The advantage of partnering with Dartmouth-Hitchcock Medical Center (DHMC) has driven the services we are able to offer, meaning the people we serve can go to dermatology and oncology clinics without the burden of driving. It means you can access the same world-class care as NLH in academics and other specialties: 30 miles away,” said New London Hospital CEO Tom Mannion in a recent community newsletter. “Over the past few years, the benefits have expanded beyond the service to include integration into the same electronic health record his platform, which enhances seamless continuity across the patient care system. I did.”

Dr. Sue Mooney, CEO of Alice Peck Day, also points to shared medical records as “completely changing the way patients are cared for,” with healthcare providers no longer having to track records from other hospitals. I pointed out that there is no DH System hospitals standardize their lab equipment so that they all have the same reference range, so tests don’t have to be redone when patients move from one hospital to another, Mooney said.

Due to its proximity to DHMC, APD shares its professional staff, including hospitalists and emergency physicians, with its academic medical center.

“As a result, we’ve only seen the ability to treat patients with more medical conditions,” Mooney said.

Prior to the partnership, APD had about 6,300 emergency room visits each year, but now that number is up to 9,000, Mooney said. Hospitalizations have also increased from an average of 15 a day to now 17. Additionally, operating rooms, CT scans, and magnetic resonance imaging equipment are all doing more work than before.

Everything is getting a little busy,” said Mooney.

By allowing more patients with medical conditions to receive care outside of the 396-bed DHMC, it helps reduce the strain on often-overcrowded academic medical centers.

DH CEO Dr. Joanne Conroy said at a hearing session Thursday, “If all the small rural hospitals had to scale back services or close their doors, We could not accommodate them in one academic medical center in Lebanon.

Mount Ascutney joined the DH system in 2014 when it was in “pretty dire circumstances,” Perras said.

Perras said the DH “didn’t bring a lot of money to save us”, but he had the expertise and resources Mount Ascutney needed “to lead us to a better place”. provided.

Bernie Folta, a retired Claremont resident, stood with a walker and said he had recently become a patient at all three hospitals involved in Thursday’s debate, putting questions to hospital leaders.

He said, as hospital officials acknowledged, the Valley Regional owns a stake in Newport’s Summercrest Senior Living Community and will have to discuss that as part of the partnership. A loan Valley Regional received from the U.S. Department of Agriculture in 2017, which allowed the hospital to restructure long-term debt incurred during its 2010 renovation and expansion, is also part of the partnership negotiations. Said I needed it.

“This is a big deal,” Folta said. “There are so many little things that make me wonder.”

Still, in a post-session interview, Folta said he understands the pressure Valley Regional is under these days.

Regarding the affiliation, Folta said, “I think it’s unavoidable.”

In addition to the Twin States Attorney General, membership requires approval by the boards of directors of the three organizations.

For now, the organizations are each doing their own due diligence or, as Caple puts it, “making sure we really want to marry each other.”

Nora Doyle-Burr can be reached at ndoyleburr@vnews.com or 603-727-3213.