After two years of extensive evaluation of various affiliation models, the Littleton Regional Healthcare (LRH) Board of Trustees has chosen Dartmouth Health (DH) as its preferred partner. LRH and DH have signed a letter of intent, which serves as the next step toward LRH joining the Dartmouth Health system.
The signing of the LOI by LRH and DH represents a key step forward in the affiliation process that will include substantial due diligence and regulatory review of the transaction by the New Hampshire Attorney General’s Office, LRH said in a press release.
LRH and DH share a strong commitment to providing high-quality, accessible healthcare, and both organizations are confident that coming together will enable LRH to maintain current programs and services while allowing it to grow to support the region’s future health care needs.
LRH President & CEO, Robert Nutter (left), shakes hands with Dartmouth Health President & CEO, Dr. Joanne Conroy (right), during a Dartmouth Health leadership visit to LRH on Friday, September 12, 2025 (Photo courtesy of LRH)
In early 2023, Littleton Regional Healthcare announced it had entered into a comprehensive and intentional process, led by its board of trustees, to evaluate the potential benefits of affiliating with a larger health care system. This lengthy process involved many steps, including a request for proposals, thorough review of responses, and careful selection of a preferred future partner that best aligns with the organization’s mission, vision, and values.
The LRH Board of Trustees set future-focused criteria for any potential partner to ensure affiliation would support LRH’s long-term sustainability and preserve LRH’s role as the trusted local health care provider for generations to come.
LRH and DH have a long and broad history of collaboration, with a focus on keeping care close to home and bringing more services to the greater North Country region. The two organizations have existing clinical service agreements in place in areas such as cardiology, dermatology, oncology, and sleep medicine, as well as several programs that support telemedicine provider-to-provider consultation.
“This decision marks a major step forward for Littleton Regional Healthcare and for the communities we serve. After careful review, discussion, and community-focused decision-making, our Board of Trustees has selected Dartmouth Health as our future system partner, and we are beginning exclusive negotiations toward full membership,” noted Robert Nutter, president and chief executive officer of LRH said in a statement.
“Dartmouth Health and LRH share a crucial goal: providing the highest quality, easily accessible healthcare to a rural population,” said Joanne M. Conroy, MD, CEO and president of Dartmouth Health, said in the press release. “We have seen in recent years the increasing challenges for rural health care providers, and we know we are stronger together. We still have to go through the regulatory process, but I am totally confident that this partnership is in the best interest of LRH and the patients they serve, and we look forward to welcoming LRH into the Dartmouth Health family, strengthening both organizations in the process.”
LRH will hold a community listening session on Oct. 22 at 5 p.m. for patients and the community. This session, hosted at LRH, will involve both LRH and DH leadership and serve as an opportunity to hear directly from the community about the transaction and how it can benefit those served by LRH.
“We began this process with very specific goals in mind – a continued focus on the quality, compassion, and personal touch patients expect from LRH, maintaining and expanding access to premier healthcare services, and ensuring our organization is well-positioned to serve this region well into the future,” Nutter said. “We firmly believe DH is the right partner that allows us to achieve these goals. By joining Dartmouth Health, we are not just preparing for the future, we are building a stronger, healthier future for our community together.”
After two years of extensive evaluation of various affiliation models, the Littleton Regional Healthcare (LRH) Board of Trustees has chosen Dartmouth Health (DH) as its preferred partner. LRH and DH have signed a letter of intent, which serves as the next step toward LRH joining the Dartmouth Health system.
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