Highlighting Commitment to Access, Growth, and Quality
On the evening of Tuesday, January 27, Littleton Regional Healthcare (LRH) held its 119th Annual Meeting to reflect on its 2025 Fiscal Year and highlight areas of focus for the year ahead. The meeting, which featured speakers from LRH’s Board of Trustees, focused on what LRH accomplished during its 2025 Fiscal Year (October 1, 2024 – September 30, 2025) to fulfill its mission of providing quality, accessible healthcare.
Robert Nutter, LRH President and Chief Executive Officer, opened the evening by welcoming those in attendance and thanking everyone who contributes to LRH’s success. Before the program began, Nutter highlighted a major milestone for the organization, celebrating the 25th anniversary of relocating from Cottage Street and opening its doors at 600 St. Johnsbury Road. Nutter reflected on the past quarter of a century by comparing volumes and financial indicators from then to now, including 8,298 emergency department visits then compared to 11,207, plus an additional 22,2026 urgent care visits in 2025 (which did not exist 25 years ago), 348,566 laboratory tests performed then compared to 1,008,416 last year, and a workforce that’s grown from 406 to 644, alongside a Medical Staff roster of 76 to 341 presently.
“Over the past 25 years, LRH has transitioned from a small community hospital to a regional hub and has experienced significant growth,” noted Nutter. He also highlighted major developments for the organization over the past 25 years, including receiving its Critical Access Hospital designation in the early 2000s, two expansions of its Medical Office Building, opening two urgent care clinics and a retail pharmacy, surviving a multi-year global pandemic, and opening its biomass plant, which provides geothermal energy for the entire St. Johnsbury Road campus, among others.
Ashley Garrison, Chair of LRH’s Board of Trustees, then took the podium to report on behalf of the Board, sharing the 2025 Board of Trustees roster and inviting those in attendance to stand. Garrison then announced the latest milestone in LRH’s affiliation journey: the approval of an integration agreement, which marks LRH’s next step toward becoming a member of the Dartmouth Health system. The integration agreement has been approved by both Boards and sets the terms and conditions for the proposed affiliation. The next phase of the process includes regulatory review and clearance.
Garrison spoke about the Board’s focus over the years. “Across all our work, one goal has been consistent: ensuring stability, sustainability, and access to high-quality care, and sustaining that goal for generations to come,” she noted. That focus has made LRH a cornerstone of the North Country, according to Garrison. “Not because of our size, but because of our role. We are a trusted provider of care, an essential community institution, and a stabilizing force for the region,” she added.
While speaking in more depth about LRH’s proposed affiliation with Dartmouth Health, Garrison explained that the Board strove to “balance our history with our vision, present realities with future needs, and independence with sustainability.”
Next, the President of the LRH Medical Staff, Dr. Eric Emig, explained that the Medical Staff is the entity responsible for overseeing the quality of medical care at LRH. Under the Board, the LRH Medical Staff provides professional and technical expertise to advise the Board in pursuing quality care consistent with applicable standards and hospital resources. He highlighted newly employed providers in 2025, in areas such as primary care, emergency medicine, orthopedics, pain management, and sleep medicine, “who share our dedication to delivering only the highest quality care,” noted Emig.
Jeff Woodward, the Treasurer of LRH’s Board of Trustees, provided a Treasurer Report. Woodward stressed that LRH is financially strong and continues to see increased patient volumes in most care areas, with 138,412 total patient visits in FY2025. Visuals shown during this part of the presentation reflected this growth, reporting net revenue of $114 million, a 4% increase from the year prior. Woodward also highlighted continued workforce growth, with a 14% increase in total employees. He noted that reducing the use of agency staff remains a management focus, as it is a costly alternative, leading to a 33% decrease in contracted labor since 2023.
With the addition of new providers, Woodward highlighted growth in specific specialty clinics, including a 170% increase in general surgery, driven by tripling the number of surgeons, and a 368% increase in pain management, driven by doubling the number of available providers. LRH’s growth was evident across the organization. Woodward noted that rehabilitation services (physical therapy, occupational therapy, and speech therapy) have grown steadily by 6% over the past two years, while laboratory volume has increased by 57% thanks to investments in state-of-the-art analyzers. Record-breaking volumes in radiology have resulted in an overall growth of 65%.
Audrey Goudie, Chair of the Quality Committee, began her report by outlining the Quality Committee’s role and primary responsibilities. “Quality is not an abstract concept at LRH; it is how we show up every day. It reflects trust, accountability, and the care we deliver when it matters most,” noted Goudie. “Strong quality outcomes do not happen by accident. They are the result of dedicated providers and committed staff in a culture that puts patients first,” she added. Goudie explained that LRH has recently strengthened that culture by expanding the quality team, establishing a formal reporting structure, and becoming more data-driven than ever. She spoke about quality improvement initiatives in 2025, including a daily multidisciplinary safety huddle and environment-of-care rounds. “More than ever, everyone at LRH is responsible for quality,” noted Goudie. That shared accountability – from frontline staff to leadership to the Board – has made certain achievements possible, according to Goudie. The most significant highlight is LRH receiving its level III trauma designation from the State of New Hampshire. LRH is the only level III Critical Access Hospital in the entire state and the only level III in the region. LRH’s recent trauma status demonstrates its “overall pledge to deliver safe, patient-centered care and to be a regional resource to support trauma cases,” stated Goudie.
LRH President and Chief Executive Officer returned to the podium to review operational highlights of 2025, including its volunteer program celebrating its 50th anniversary; the installation of a secure prescription locker in LRH’s Lincoln Urgent Care; the expansion of LRH’s rehabilitation services in Franconia with a newly designed pediatric space; the upgrade of its infant security system; conducting a community health needs assessment with local partners; and expanding its ambulance pilot program for inter-facility transportation.
Jeff Woodward, in his capacity as Chair of LRH’s Strategic Planning Committee, then returned to discuss LRH’s journey of affiliation. Woodward reminded the audience that this board-driven process began in 2019, paused due to the COVID-19 pandemic, and resumed in 2023, when LRH re-engaged strategic planning consultants to evaluate potential pathways for continued success and sustainability. It was ultimately decided that partnering with a larger healthcare system would be the best option for LRH. LRH’s drivers for affiliation included keeping care close to home, expanding clinical programs and services, enhancing the regional standard of care, improving recruitment and retention efforts, and ensuring investment in facilities and technology, among others.
Following a thorough Request for Proposals process and careful review, Dartmouth Health was selected as LRH’s preferred partner, and both parties executed a Letter of Intent in the early fall of 2025. “Maintaining local control and LRH’s quality standards were high priorities of the Board,” noted Woodward. “The cultural alignment with Dartmouth Health was clear, and a natural fit given our long history, shared values, and mutually high standards,” he added.
“Throughout this process, it has become increasingly clear that affiliation is the best path forward for LRH. The landscape of rural healthcare continues to evolve, but we share a mutual commitment to supporting rural health needs,” stated Woodward. LRH has previously shared that it has a long history of clinical and administrative collaboration with Dartmouth Health. “Joining the Dartmouth Health system creates an opportunity to better coordinate care for patients across the continuum of their needs,” added Woodward.
Samuel Talcott, Treasurer of the LRH Auxiliary, gave a brief report, followed by a special presentation to Jeff Woodward for his 12 years of service on the LRH Boards of Trustees. A recording of Littleton Regional Healthcare’s 119th Annual Meeting will be available on its website in the coming days.
[photo caption: Ashley Garrison, Chair of LRH Board of Trustees, presents during LRH’s 119th Annual Meeting]
