CTU Report & NCH Response

A Message from NCH

North Country Healthcare (NCH) acknowledges the release of the Charitable Trusts Unit (CTU) report regarding our organization. NCH accepts the CTU findings, and we are committed to implementing the agreed-upon conditions with transparency, accountability, and a continued focus on strengthening our organization and the communities we serve.

The CTU reviewed several matters related to NCH, including patient notification regarding primary care; compliance with governing documents relative to proposed changes to the composition of affiliated hospital boards; NCH’s contracting process for revenue cycle management services; turnover on the Weeks Medical Center board; and the NCH board’s process in determining executive compensation.

CTU found no breach of fiduciary duty regarding primary care. Specifically, CTU found that NCH undertook sufficient steps to notify primary care patients about the departure of their physician and is undertaking reasonable steps to further the recruitment of its primary care workforce.

CTU found no breach of fiduciary duty regarding NCH’s selection and contracting process for revenue cycle management services. They concluded that NCH’s contract with a revenue cycle partner did not create a conflict of interest and did not involve self-dealing.

CTU found no breach of fiduciary duty regarding executive compensation, determining that NCH compensation is compliant with IRS regulations, and that executive compensation is benchmarked and evaluated pursuant to policy and regulation.

CTU found that NCH violated its fiduciary duties by failing to follow the affiliate bylaws in connection with the removal process of an affiliate president and by not actively recruiting and installing a full-time, permanent affiliate President.

While not a focus of their review, the CTU noted that the financial standing of the hospital affiliates has improved significantly since coming together to form NCH and that the amount of charity care provided by each hospital affiliate has increased annually since the affiliation. They further noted that NCH is financially healthy and that by operating as a system we offer a level of financial stability to the Affiliates. Our strength as a system positions us well to deliver quality care throughout the North Country for years to come.

The report identifies opportunities to strengthen governance processes, organizational alignment, and communication. NCH is well-positioned to address these areas and has already begun implementing enhancements designed to support long-term organizational stability, accountability, and operational excellence.

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.

We respect the review process and accept the CTU’s recent findings. We are actively working to implement the agreed upon recommendations. 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.

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. As a regional healthcare system headquartered in, and serving, northern New Hampshire, NCH remains financially stable, operationally strong, and deeply committed to its mission of ensuring access to high-quality healthcare close to home. This page will serve as a central location for public information related to the CTU report, NCH’s response, Community Conversations, implementation updates, and related resources.