With the release of the Charitable Trusts Unit (CTU) report regarding North Country Healthcare, I
want to speak directly to our staff, patients, families, community partners, board members, and
neighbors across the North Country.
I know many people have had questions about NCH over the past year. Some of those questions
have been about access to primary care. Some have been about leadership changes,
communication, local voice, and whether community concerns were being heard. Those are fair
things for a community to care about. Rural healthcare is deeply personal. It is not just about
buildings, services, or systems. It is about neighbors, families, longtime relationships, and ensuring
that care will be here when people need it.
CTU conducted a thorough review. In several important areas, CTU found that NCH’s actions were
reasonable and appropriate. The report found that NCH took sufficient steps to notify patients and
support transfer of care during a provider transition. It also recognized something we experience
every day: recruiting primary care providers in rural New Hampshire is difficult. Even with those
challenges, CTU found that NCH is taking reasonable steps to recruit and strengthen our primary
care workforce.
The report also found no breach of fiduciary duty related to the selection of NCH’s external revenue
cycle partner. CTU found that the contract did not create a conflict of interest, did not involve selfdealing, and that no NCH board members or executives had a direct or indirect financial interest in
the vendor. CTU also found no breach of fiduciary duty related to executive compensation review,
while noting the importance of continued attention to how compensation review processes are
applied.
These findings affirm the important work already underway across NCH: supporting patients
through transitions, recruiting providers in a challenging rural healthcare environment, managing
complex operational decisions, and maintaining appropriate review processes. We will continue to
build on that work.
The report identifies areas where NCH has follow-up work to do. CTU found a breach of duty related
to bylaw adherence with regard to the removal process of an affiliate president and by not actively
recruiting and installing a full-time, permanent affiliate president. CTU further concluded that
these changes led to challenges in the governance process at the affiliate. As a result of CTU’s
findings, CTU and NCH have agreed upon a set of conditions that NCH will implement. We respect
the CTU’s review process and accept the CTU’s recent findings. As part of that process, NCH will
work with an independent board governance consultant, continue public listening sessions and
Community Conversations, support required board education, follow governing documents, and
share information through the appropriate public channels. The agreement also includes
reimbursement of CTU’s review costs.
These next steps are formal requirements, and we take them seriously. Throughout this process,
NCH will continue pursuing innovative and responsible strategies designed to strengthen our
system, stabilize operations, and preserve local healthcare services for the communities we serve.
At a time when rural healthcare systems across the country are facing unprecedented financial and
operational pressures, maintaining access to care requires thoughtful innovation and strategic
integration. The conditions that once allowed independent rural hospitals to thrive have
fundamentally changed, and long-term sustainability increasingly depends on collaboration,
shared infrastructure, and coordinated system-wide approaches to care delivery.
Our core commitment remains unchanged: to keep all three affiliated hospitals operational,
protect access to care close to home, and build a healthcare system capable of meeting the needs
of the region for generations to come.
We are looking forward to continuing our listening sessions and always striving to improve how we
communicate. NCH will continue holding listening sessions on a quarterly basis. As part of this
process, sessions will include opportunities connected to each Affiliate location and remote
participation options. Upcoming Community Conversations will be posted on this page as dates,
times, locations, and remote access details are finalized.
NCH is committed to moving forward with accountability, transparency, and confidence. We
remain focused on delivering high-quality, compassionate care to the communities that depend on
us. Our patients, residents, families, and communities continue to rely on NCH, and we will meet
that responsibility with strength, stability, and purpose.
Across our hospitals, clinics, home health and hospice services, offices, kitchens, hallways, front
desks, and community programs, NCH staff will continue to show up for the people of the North
Country, today, tomorrow and in the years ahead. Their work matters, and I am grateful for it.
We are proud to be your healthcare system – the North Country’s healthcare system. We are
committed to earning the trust you place in us each day, and we are excited about the work that lies
ahead.
Tom Mee, RN, BSN, MBA
CEO, North Country Healthcare
For the latest updates on the NCH CTU response, please click here.