AG: ‘Certain Issues…Warrant Further Review' Of North Country Healthcare

By PAULA TRACY, InDepthNH

WHITEFIELD, NH — North Country Healthcare, the nonprofit hospital system under review by the Attorney General's Charitable Trusts Unit, has announced a new series of "Community Listening Sessions" in 2026 while "further review" of citizen complaints is ongoing.

The Attorney General's Office on Tuesday released a letter sent to Brooke Belanger, NCH's chief legal officer, late last month to InDepthNH.org, that details the status of the investigation into board governance, availability of primary care providers, contracting decisions, layoffs, and executive compensation.

Mary Ann Dempsey, the Attorney General's Charitable Trusts Unit Director, said in the letter: “The CTU has consistently exercised its oversight role over North Country Healthcare, Inc., as a New Hampshire non-profit healthcare entity."

She said while NCH disputes the "factual bases underlying these complaints and media articles and has provided the New Hampshire Department of Justice's Charitable Trusts Unit ("CTU") with
information when requested, these complaints have persisted and created a level of distrust
within the communities NCH serves.

"CTU believes that certain issues within our jurisdiction warrant further review," Dempsey wrote.

"CTU's review is intended to resolve factual discrepancies in information provided to CTU regarding primary care recruitment and NCH executive compensation as well as to address CTU's independent concerns related to the NCH board's due diligence in contracting for revenue cycle services," Dempsey wrote.

The Charitable Trusts Unit also retains concerns about certain board governance issues, including substantial turnover in the Weeks Medical Center board over the past two years alongside NCH's recent discussion with CTU of its intent to restructure its and its affiliated hospitals' board compositions in the future.

"We would strongly encourage NCH to pause any proposed changes to the NCH or affiliated hospital boards while CTU's review is pending," Dempsey wrote.

After a primary care doctor for 1,100 patients was fired by the health care system last May and has not been replaced in whole, patients became more concerned when it announced it would be outsourcing about 41 non-patient facing positions.

A group of about 70 individuals petitioned the Attorney General's Office to ensure that NCH is operating in accordance with its charitable purpose, financial stewardship, and commitment to public benefit as required by law.

A NCH statement issued Monday said it welcomes the attorney general's process "and views it as an opportunity to reaffirm our values of accountability and community trust. At the same time, we are preparing to launch a new series of Community Listening Sessions in early 2026.

"These sessions will be an opportunity for NCH to highlight the work we do day in and day out to ensure that our patients receive excellent healthcare close to home as well as provide an opportunity for patients, community members, and care partners to share their perspectives on health priorities, barriers to care, and opportunities for improvement.

"Together, these efforts reflect the same goal: to strengthen trust, listen deeply, and ensure that North Country Healthcare continues to meet the evolving needs of the communities we serve," it read.

This came as a surprise to Becky More of Lancaster, a patient who lost her primary care provider and one of the group whose members are looking for answers from the Attorney General's Office.

She said it sounds more like a talking session rather than an interest in gaining insight into real concerns of the communities NCH serves.

While the Attorney General's Office has said it will likely issue a public report, it will not be providing public updates, and More said she understands that.

There are five areas of investigation, according to Dempsey's Oct. 27 letter to Belanger, which states: "our review will include investigation into at least the following: (1) the accuracy of information NCH and citizens have provided to CTU regarding NCH's notice to patients about a departing primary care physician and recruitment of primary care healthcare providers;
(2) NCH's compliance with the Affiliation Agreement and proposed changes to the composition of affiliated hospital boards;
(3) NCH's contracting process for revenue cycle services and in particular claims that NCH fiduciaries had undisclosed conflicts of interest;
(4) the substantial turnover on the Weeks Medical Center board; and
(5) the NCH board's process in determining compensation for executive officers."

Dempsey said the Charitable Trusts Unit will send a series of written requests for information for NCH to complete. "CTU also anticipates conducting interviews with individual boards as well as present and former board members," Dempsey wrote.

COMPENSATION

NCH's CEO Thomas Mee earned $706,230 plus $18,318 in other income, according to federal data reviewed for 2024.

The nonprofit North Country Healthcare operates Upper Connecticut Valley Hospital in Colebrook, Weeks Memorial Hospital in Lancaster, Androscoggin Valley Hospital in Berlin and North Country Home Health and Hospice and is the region's largest employer. It is listed as having 59 hospital beds throughout the three facilities.

North Country Healthcare officials said they expect the outsourcing of its revenue cycle management team to a Colorado-based firm is expected to impact about 41 jobs when it is completed by the early part of 2026, though there are hopes that some who are in those positions can be reassigned.

Last Friday, James Patry, NCH vice president for marketing and community relations, wrote that "to date, there has been one employee displaced, ten were told this week their positions would be eliminated in January, rather in October as we originally anticipated, and up to 30 more roles could be eliminated in early 2026."

Those in the latter category would be jobs in non-patient-facing health information management and release of information departments, he said.

"We hope to keep many of these people in roles within NCH. We do not expect any further roles to be impacted beyond the ones outlined here," he said.

Patry explained in the letter to staff "we originally anticipated that patient financial services and patient access staff changes would be completed by October. However, we have updated the timeline for the changes, and these staff members will continue in their roles until early in the calendar year 2026."

He also addressed the rollout of the information on the outsourcing in September and told staff "we want to acknowledge that our initial communications should have been better. We’ve heard your feedback and are taking steps to improve transparency and share information in a timely and clear way."

Some patients and community leaders have expressed concern that some of the job functions will be outsourced to H2 Hartzler Healthcare, based in Colorado Springs, Colorado, which is owned by Matt Hartzler, who is not an employee of North Country Healthcare but a consultant for revenue cycle for NCH.

Patry said that Matt Hartzler had no involvement in the decision granting his company the business and that Hartzler Healthcare was one of a number of entities that were vetted.

Patry said NCH will continue to ramp up operations with H2 and work in parallel with current staff. The transition timeline has been lengthened.

The staff memo said there would be a number of benefits to that including impacted staff can use this time to apply for other roles within NCH and externally.

"As these individuals transition into new roles, there will be no gap in operations because H2 staff will be in place," the staff memo said.

"We will get the benefit of the H2 staff expertise. We have seen a number of examples in recent weeks of just how challenging it can be to successfully secure prior authorizations. H2 will be picking up authorizations - this allows us to rely on their expertise and keep our staff focused on patient care," it read.

State Sen. David Rochefort, R-Littleton, is by profession a pharmacist who grew up in the North Country who has been spearheading efforts to get answers from the state, along with Executive Councilor Joe Kenney, R-Wakefield.

Rochefort said Friday he is losing sleep over this issue and what his constituents are facing in terms of healthcare needs. He said from talking with former board members and patients, "I really worry that this may be yet another case where the North Country is left holding the bag."

"They (NCH executives) have assured me it's not. But one side is telling me 'no, no there is nothing to see here' but at the same token we have people who were in positions of decision making at one point and they are saying otherwise.

"I've lost sleep over it. It really concerns me so that is why I am really hoping the CTU investigation (at the Attorney General's) is thorough and comprehensive and I am trusting they will do a good job but at the same token I am considering legislation that would maybe tighten some of these controls up and at the very least include some reporting for the public to answer some questions. But I am anxious about it. I am nervous about it," Rochefort said.

More is a former Weeks Board member and resident of Lancaster. She said she followed her mother, Martha Weeks Sherrill, to the board along with her grandfather, Sinclair Weeks who built Weeks in 1946 because there was no real hospital building in the community.

"They built it on behalf of the community," she said, and the board for the hospital was to represent that community and its needs.

"All of a sudden you've got corporate people who are calling all the shots and the board is irrelevant," she said Monday. More said the board members were not given adequate information from the corporate people to make decisions and they resigned.

"I hope the AG's investigation opens and puts light on the financial situation and looks into whether or not the hospitals are truly representing the communities that they allegedly serve. It is that service piece. They are not particularly interested in that," she said of NCH.

More was one of 1,100 patients of Dr. Elizabeth Cooley, who was a primary care doctor at Weeks Medical Center. She said in May, Dr. Cooley was terminated without reason and is now not practicing medicine, though still in the community.

More said she has not been replaced despite NCH saying "they hired so and so who was only coming in once a week and is semi-retired."

She was among the 70 people who got together to ask the Attorney General's Office to get involved to find out what happened through its charitable trust division. More said the Weeks Board has since resigned except for three and only one lives in the catchment area of the North Country.

"Board governance is an issue," More said. "Rumor is that they are going to get rid of the individual hospital board and just have an NCH board."

Asked about the planned listening sessions and whether that could be beneficial, she said the statement was "written by their general counsel and they will do most of the talking. In New Hampshire, we don't have any accountability. The only thing we have is the Charitable Trusts Unit," for oversight.

"For one thing, they described it as a listening session but what I read is 'we are going to do the talking' and I don't know whether they listen. It is not evident. Although this potential review has triggered a more serious reply than has come to date," More said.

"If you look back at the sequence of events and how things happened, the layoffs have been a surprise and have not been handled well at all. Those laid off do not have other jobs. They were told to come to a mandatory meeting," she said.

When the Charitable Trusts Unit releases its report, she will be looking at who they spoke with, More said.

NCH serves more than 50 communities in Grafton and Coos Counties, which are all part of the nonprofit affiliation.

"My biggest fear is that the community is not going to get the health care it needs desperately," More said. "There is a lot of care needed here. Granted this is not a huge population center but area wise we are spread out.

"I am concerned about the compensation issue...NCH has a bloated administrative roster but not enough doctors. I think you need MDs to make sure people are up to speed on new information, research," More said.

This article first appeared on InDepthNH.org and is republished here under a Creative Commons license.