APD, Dartmouth-Hitchcock to Seek Approval for Affiliation from NH Attorney General


The Trustees of Alice Peck Day Memorial Hospital (APD) expect to submit formal documents to the state of New Hampshire seeking approval for an affiliation with Dartmouth-Hitchcock Health (D-HH), which would make APD part of the Dartmouth-Hitchcock Health system.

The documents will be filed in early September  2015, with the Charitable Trusts Unit and Consumer Protection and Antitrust Bureau. They outline the rationale for affiliation as well as an overview about how the two organizations will work together once the affiliation is finalized.

APD and D-H announced their intention to affiliate in January 2014, following a strategic planning process initiated by APD’s Trustees. Since then, representatives from both organizations have been meeting regularly to work through specific elements of the relationship and to complete due diligence. With that work completed, the next step is the request for formal approval of the affiliation from the state of New Hampshire.

 “Health care is changing dramatically and we continue to believe that an affiliation with D-H represents the best way for APD to continue to exist and serve the Upper Valley,” said President and CEO Sue Mooney, MD, MS, FACOG. “Affiliation is the best of both worlds. It means we can continue to exist as a small community hospital that provides very personal, high-quality care. It also means we can participate with D-H and other affiliates in new payment models and work to create true value for our patients.”     

 “For several generations, Alice Peck Day has held a very special place in Lebanon and the Upper Valley, and we’re committed to ensuring its success through this partnership,” said Dartmouth-Hitchcock CEO and President Dr. James N. Weinstein. “Our teams have identified those areas where we can be most effective in delivering care to residents of the region; by working together, we believe we can make our two organizations even stronger, more effective and more responsive to the people we serve, as we work toward our mutual goal of creating a sustainable health system, improving the lives of the people and communities we serve, for generations to come.”

APD and D-H expect to begin to work, as soon as the affiliation  is finalized, on  integrating their emergency, hospitalist, and obstetrical services.

The vision for integration of obstetrical services under the affiliation sees APD continuing to provide pre- and post-natal care, as well as potentially providing birthing services to very low-acuity patients under the umbrella of a single Obstetrical program. Achieving this will take considerable effort by both parties involving complex clinical, regulatory, and financial issues that will require time to address. 

“We are appointing APD and D-H providers and staff to committees to identify and address the many issues required for creation of an integrated obstetrical service. During this process, APD does not expect to make any major changes to its obstetrical services,” said Mooney.

“APD has a long and proud role in the community in terms of birthing services, and our hope is to continue to be able to offer these services in partnership with D-H so that the entire community is well-served. However, there are also many variables involved in this process, enough to make the final outcome uncertain. During this time, as with any other integration efforts, we pledge to be transparent with APD providers, staff, patients, and community members,” Mooney said.

“I will personally be involved in overseeing the obstetric integration process, and am committed to ensuring the result is good for patients, providers, and the community,” said Dr. Mooney who, prior to assuming leadership roles at APD, worked as an obstetrician at APD’s Women’s Care Center.

The affiliation will also enable D-H to more easily transfer low-acuity patients to the Donald Faulkner Dickey Medical-Surgical wing at APD, which in turn will mean that D-H will be able to meet an increasing demand for beds for high-acuity patients. Realizing this vision will require integration of the D-H and APD hospitalist programs as well as better coordination of the two institutions’ emergency departments.

The affiliation agreement is not expected to result in any immediate changes in the operation of APD Lifecare, the corporate entity which oversees the assisted-living facility (Harvest Hill) and the independent-living facility (The Woodlands) on the APD campus. For the remainder of FY15 and for FY16, Lifecare employees will continue to receive the same benefits as APD employees. Lifecare residents will continue to access their healthcare as patients at APD. APD and APD Lifecare will continue to be an obligated group for bonds that the group assumed several years ago. Looking ahead, the Trustees of APD Lifecare and its Senior Leadership Team expect to pursue opportunities to ensure that Harvest Hill and The Woodlands remain sustainable. 

Following the  filing with the Director of Charitable Trusts, APD will hold a community meeting for members of the public to provide an opportunity for public comment on the proposed affiliation. The exact date, time, and location for each meeting will be announced shortly and will be published on the APD website.

Any interested party may submit comments regarding this proposed affiliation to either Peter Glenshaw at or Rick Adams at

If the agreement is approved, APD will become the fifth hospital formally affiliated with Dartmouth-Hitchcock Health, joining Mary Hitchcock Memorial Hospital in Lebanon, NH,  New London Hospital in New London, NH, Mt. Ascutney Hospital and Health Center in Windsor, VT, and Cheshire Medical Center in Keene, NH.