NCH|LRH battle erupts
As tension and temperaments flare over recent news of litigation between North Country Healthcare and Littleton Regional Healthcare, the future of health services in the North Country of NH remains uncertain. Both parties have sued each other over the February news of LRH’s intent to depart the NCH group of Critical Access Hospitals in Grafton and Coos counties.
On Wednesday, GNTV received an internal memo from Gail Clark, Director of Development, Marketing & Community Relations at Littleton Regional Healthcare. Clark often sends us press releases that help inform the public of the events and activities. They often include news of events occurring at the Hospital and within their organization. The internal memo was addressed to LRH staff . It was a response to the recent article placed in the Littleton Courier. The focus was in regards to the recent litigation between the healthcare organizations.
In turn, on Thursday, we received a statement from James Patry, Systems Director, Marketing at Androscoggin Valley Hospital in Berlin. The statement from North Country Healthcare outlined their position on the subject. In the opening lines, Patry states “We welcome the intervention of the New Hampshire State Attorney General on Littleton Regional Hospital’s (LRH) intention to withdraw affiliation with North Country Healthcare (NCH).”
Review of documents
While speaking briefly today with Tara Giles, the Littleton Courier reporter that penned the article LRH’s split from NCH prompts litigation that LRH called into question, she stated that the two lawsuits have just under 1000 pages combined of documentation outlining how each party feels the other is in the wrong.
With no immediate solution in the near future, access to certain services not currently available at the remaining NCH group of hospitals remains unclear. Currently, users of each hospital have access to the network of services provided under the single healthcare system implemented under the NCH umbrella. If the removal of LRH from NCH also means the removal of critical services from the affiliation, the ease of access to these services for patients at the remaining NCH locations remains in flux. Listed below are the the statements from each entity we were asked to publish. We welcome your feedback in the comments section below.
Littleton Regional Healthcare
May 8, 2019
Dear LRH Team,
Littleton Regional Healthcare is disappointed in the misleading statements made in a recent press release issued by North Country Healthcare and reported in the media (“LRH’s split from NCHC prompts litigation,” Littleton Courier, May 8, 2019). We believe the press release misrepresents important aspects of LRH’s contractual right to withdraw from NCH.
North Country Healthcare was formed as a result of an Affiliation Agreement among Littleton Regional Healthcare, Androscoggin Valley Hospital in Berlin, Weeks Medical Center in Lancaster, and Upper Connecticut Valley Hospital in Colebrook, following an extensive negotiation process and a review by the New Hampshire Director of Charitable Trusts.
Affiliation Agreement
The Affiliation Agreement includes a contractual right for any of the four hospitals to withdraw from the affiliation, without any need to give cause or to justify its decision to withdraw. However, that withdrawal right can be exercised only during the 90-day period following the third anniversary of the affiliation; that is, between April 1 and June 30 of this year. Failure to provide notice during this limited 90-day period would result in permanent affiliation. During the negotiations leading up to the affiliation, each of the four hospitals insisted on the right to withdraw without a showing of cause.
This issue was fully aired and discussed in public meetings held in connection with the approval of the affiliation. In the words of NCH’s legal counsel at the time, the participating hospitals insisted on the right to withdraw without cause because requiring a showing of cause “would very likely lead to prolonged disputes with a hospital which had expressed its desire not to be part of the Affiliation.”
LRH Review
After a careful review by our Board of Trustees about the effectiveness of the Affiliation to date, and of LRH’s future strategic opportunities, our Board determined that the interests of the greater Littleton community would best be served by LRH’s withdrawal from the affiliation. Following the February 18 vote of LRH’s Board to withdraw, LRH provided NCH with “pre-notice” of our intent to give a formal withdrawal notice after April 1. Immediately, LRH was met with repeated threats of litigation. In accordance with the Affiliation Agreement, on April 4, LRH gave formal notice to NCH and the other hospitals of our decision to withdraw.
Unfortunately, NCH and the three Coos County hospitals have refused to accept LRH’s decision to exercise its contractual right to withdraw. All attempts by LRH management and Trustees to work with NCH on an orderly withdrawal plan not only were refused, but were met with threats of litigation. LRH was left with no choice but to ask the court simply to enforce our clear contractual right to withdraw. Sadly, NCH and the other hospitals responded by suing not only LRH, but also individual members of LRH’s management and Board of Trustees.
LRH does not believe the position of NCH and the other hospitals is well founded. Out of respect for the ongoing court process, LRH will not comment further on the details of the pending litigation. However, contrary to the impressions that NCH attempted to create in its press release, LRH is confident that we have acted responsibly and in accordance with our rights, using the process to which each hospital previously agreed in the Affiliation Agreement.
North Country Healthcare
Statement from North Country Healthcare – May, 2019
We welcome the intervention of the New Hampshire State Attorney General on Littleton Regional Hospital’s (LRH) intention to withdraw affiliation with North Country Healthcare (NCH). The process to create NCH was open and public, and any proposed changes to its structure should also be transparent, intentional and public. We will participate fully and honor the results of an open and public process. Our Hospitals worked cooperatively for two years to hold community forums, create a business plan, and get approval from the New Hampshire State Attorney General to affiliate in 2016.
Notice Served
In late February 2019, Littleton Regional Hospital (LRH) served notice of their intention to withdraw from their affiliation with North Country Healthcare and took legal actions in order to accelerate that withdrawal to pursue “new opportunities.” This violated our Affiliation Agreement (to which all NCH members are legally bound). Our Agreement clearly states that an accelerated or alternative withdrawal process is not allowed. The terms of the Agreement were specifically designed so all parties would follow a fair and equitable negotiation process that would allow enough time to smoothly unwind the integration that has taken place over the last several years.
For that reason, NCH is disappointed that LRH has taken their dispute to the courts and chose not to follow the agreed-upon departure guidelines. These guidelines include a 4-month period for review and negotiation.
After they approached us with their intention to leave, we recommended holding a meeting of the LRH and NCH Boards in the interest of resolving this issue with open and transparent communication. LRH opted not to participate, and then filed suit.
Suit / Counter-suit
In light of that LRH lawsuit, North County Healthcare filed a counter-suit in Coös County Court against Littleton Regional Hospital for failing to live up to our affiliation agreement, negotiating in bad faith, and taking unilateral actions that go against the spirit of collaboration of our Affiliates in providing improved, efficiently-delivered healthcare to the citizens of the North Country.
The Affiliation of Androscoggin Valley Hospital, Upper Connecticut Valley Hospital, Weeks Medical Center and LRH began in 2014 under the premise that the whole is greater than the sum of its parts, and by working together, we could improve the delivery of healthcare to the North Country – and we have. All Hospitals worked cooperatively for two years to hold community forums, create a business plan, and obtain approval from the New Hampshire State Attorney General to affiliate in 2016. In early 2018, NCH was pleased to add North Country Home Health and Hospice to the affiliation, and provide even more resources to our integrated healthcare system.
Dispute resolution
NCH will continue to work towards dispute resolution, and we hope to engage LRH in transparent and productive discussions, towards the goal of continued collaborative healthcare in the North Country. We continue to respect and value LRH’s leadership within the Affiliation, and their substantial contributions to the health of the region’s communities.
Every day, our employees and medical staff strive to serve families across the North Country. We are proud of what we are accomplishing, and we care deeply about the communities we serve. That is what drives us. The actions of LRH will not deter us from our Mission: to assure consistent, high quality, accessible, and integrated healthcare across the communities we serve.
To that end, we will continue to work with the State of New Hampshire to advocate for the communities that rely on NCH and the valuable integrated healthcare solution it offers. No matter where this path leads, we will use that vision to guide us.