Dartmouth Health to Buy Littleton Hospital

Littleton Regional Healthcare said on September 12, 2025 that it had chosen Dartmouth Health as its preferred partner and signed a letter of intent to join the Lebanon, New Hampshire-based system. The move would bring the 25-bed critical access hospital in Littleton into one of northern New England’s largest health networks, pending due diligence and state review. Robert Nutter, president and chief executive of Littleton Regional Healthcare, said the hospital’s board had spent two years evaluating affiliation options before entering exclusive negotiations. Dartmouth Health chief executive Joanne M. Conroy said the two organizations shared a goal of keeping care accessible for rural patients. ### Why is this not done yet? The September 12, 2025 letter of intent is a preliminary step, not a completed sale. Dartmouth Health and Littleton Regional Healthcare said the affiliation process would include substantial due diligence and regulatory review by the New Hampshire Attorney General’s Office. (dartmouth-health.org) The New Hampshire Department of Justice said on April 20, 2026 that Littleton Hospital Association, which does business as Littleton Regional Healthcare, and Dartmouth-Hitchcock Health had submitted notice of a proposed transaction under RSA 7:19-b. The Director of Charitable Trusts has 180 days to review the proposal, the department said, and that review includes public comments and input from the state health and insurance departments. (dartmouth-health.org) ### What exactly is Littleton Regional Healthcare? Littleton Regional Healthcare is a 25-bed critical access hospital in New Hampshire’s North Country that serves about 60,000 patients a year and employs more than 500 people, according to reporting that cited the organizations’ announcement. The hospital began looking for a larger-system partner in early 2023. (doj.nh.gov) Littleton Regional Healthcare said its board used a formal selection process that included a request for proposals, review of responses and a choice of the partner it said best fit the hospital’s mission, vision and values. Nutter said the board was seeking broader access to services while preserving the “quality, compassion, and personal touch” patients expect locally. (nhpr.org) ### What does Dartmouth Health already do with Littleton? Dartmouth Health said the two organizations already have clinical service agreements in cardiology, dermatology, oncology and sleep medicine. The system also said the relationship includes telemedicine provider-to-provider consultation programs aimed at keeping care closer to home in the North Country. (dartmouth-health.org) Dartmouth Health has been adding regional hospitals in recent years. Chief Healthcare Executive reported that Dartmouth Health added Southwestern Vermont Medical Center in 2023 and Valley Regional Hospital in Claremont, New Hampshire, in July 2024. ### What are Dartmouth leaders saying about rural access? (dartmouth-health.org) Joanne M. Conroy said in the September 2025 announcement that rural providers face increasing challenges and that the two systems would be stronger together. In the same announcement, she said Dartmouth Health and Littleton Regional Healthcare shared a goal of providing “the highest quality, easily accessible healthcare to a rural population.” (chiefhealthcareexecutive.com) Jennifer Gilkie, Dartmouth Health’s chief communications and marketing officer, said in a June 2026 interview with Chief Healthcare Executive that the system is trying to make care easier to reach across a wide rural footprint. That article said Dartmouth has been working on access issues including transportation, digital tools and systemwide coordination, and it also noted a recent rebrand of its home-care arm as Dartmouth Health Home Care. (dartmouth-health.org) ### Will patients see immediate changes in Littleton? The public documents so far do not set out an immediate timetable for service-line changes at Littleton. The organizations have said the deal is intended to maintain current programs and services while supporting future growth, but specific post-closing operational changes would likely depend on the integration agreement and the outcome of the state review. (chiefhealthcareexecutive.com) That is an inference based on the announced process and the state filing. The Department of Justice page says transaction documents on file include an integration agreement, financial statements and a community health needs assessment. The same page says members of the public can submit comments to the Charitable Trusts Unit while the review is underway. (dartmouth-health.org) ### What happens next, and when? April 20, 2026 is the date New Hampshire’s Charitable Trusts Unit said it received notice of the proposed transaction. Under the statute cited by the state, the review period runs 180 days from that filing, which would place the end of that window in mid-October 2026, barring any change in the process. That timing is a calculation from the state’s filing date and review period. (doj.nh.gov) New Hampshire residents who want to weigh in can send comments to the Director of Charitable Trusts by email or mail, according to the Department of Justice posting. Until that review is complete, the proposed affiliation remains a pending transaction between Littleton Regional Healthcare and Dartmouth-Hitchcock Health, the legal name used in the state filing. (doj.nh.gov)