LEBANON — Dartmouth Health has laid off 124 employees and eliminated 303 open positions across Dartmouth Hitchcock Medical Center in Lebanon and the Dartmouth Hitchcock Clinics Southern Region.
In an announcement issued at 5:32 p.m. on Tuesday, the health system justified the job cuts as a means to “improve long-term sustainability.”
Dartmouth Health, a Lebanon-based nonprofit organization with more than $1 billion in assets, previously faced a $63.5 million deficit, the Valley News reported in June.
Changes include the restructuring of executive roles and administrative leadership positions, as well as the elimination of select programs, the organization said.
The health system doesn’t expect “these employment actions to negatively impact patients, as they have been carefully planned with patient needs at top consideration.”
Rising operating expenses, which have grown by 12%, are outpacing patient revenues, Dartmouth Health said.
“Labor, supply and drug costs continue to rise, while insurance companies are paying less and taking longer to pay,” officials said in a prepared statement.
The current pace of expenses, DH said, “is unsustainable and further adjustments were necessary.”
“The employees affected by these changes have made meaningful contributions to Dartmouth Health, our patients and our communities,” Dr. Joanne Conroy, CEO and president of Dartmouth Health, said in a statement. “Some have spent many years serving this organization. The decision to eliminate a position or program does not diminish the value of the work these colleagues have done and the contributions they have made.”
The layoffs were limited to Dartmouth Hitchcock Medical Center and Dartmouth Hitchcock Clinics Southern Region, according to Audra Burns, director of media relations at Dartmouth Health
Of the 124 eliminated positions, 113 were from DHMC, which has just over 10,000 positions, she added.
“Along with DHMC and DHC, and most healthcare organizations throughout the region and country, all DH members are facing financial challenges,” Burns stated.
A Tuesday letter from Dartmouth Health to employees, obtained by the Valley News, stated: “Although these position eliminations were mostly at Dartmouth Hitchcock Medical Center and Dartmouth Hitchcock Southern Region, the elimination of certain statewide shared services means today’s action also impacts members systemwide.”
“The decision to eliminate a position or program does not diminish the value of the work these colleagues have done and the contributions they have made,” the letter continued.
Impacted programs include Tele-ICU and Tele-ED — services that DH said weren’t sustainable at their current scale without outside funding.
“Leadership is working closely with affected facilities, of which more than half are Dartmouth Health members, to ensure alternative patient care plans are in place,” DH stated. “This decision presents an opportunity to review and further understand how to continue to integrate clinically in these areas across Dartmouth Health.”
Also impacted is the New England Alliance for Health (NEAH), which was established in 2009 to support collaboration among community hospitals, behavioral health centers, and home health agencies in Northern New England, and has evolved due to the growth of the health system.
In addition to these programs, the health system decided that outside vendors are able to deliver more employee training more “cost-effectively” than by continuing the Lean Six Sigma Yellow Belt and Green Belt employee training program.
“In April, DH created an Acceleration to Transformation Office to quickly identify ways to improve financial health while protecting patient care through a thorough review of every major area of operations,” DH stated.
The Acceleration to Transformation Office is tasked with reviewing capital spending, contracts, billing, supplies, programs, workflows, and other operating costs.
DH shared changes already implemented by the office since its formation: “reduction of travel and conference participation, reduced reliance on traveler positions, and strategic continuation of capital spending and construction work to expand patient capacity to meet demand.”
“In an effort to be fully transparent, I shared with our employees in July that the ATO would be reviewing staffing models and today’s eliminations are a result of that informed work,” Conroy said in the news release. “Eliminating positions is among the most difficult decisions any organization can make, given the impact on our colleagues and their families.”
Nevertheless, she went on, “difficult choices are necessary to ensure Dartmouth Health is sustainable and well-positioned for the future, while continuing to fulfill our mission and serve those who depend on us.”
Last year, DH, the largest private employer in New Hampshire, announced a hiring pause amid threats to Medicaid and research funding, the Valley News previously reported.
In June 2023, Dartmouth Hitchcock Medical Center and Dartmouth Hitchcock Clinics laid off 75 workers and eliminated about 100 vacant positions to address a budget deficit.
On Tuesday’s announcement of the health system’s latest restructuring efforts, DH pledged its commitment “to implementing the best-practice financial resiliency program moving forward and to ongoing review of position and program structures to ensure sustainability and successful management of operations.”
“Impacted employees will be offered resources, transition support and opportunities to pursue other roles within the health system,” the news release stated.
One Dartmouth Health employee who was laid off Tuesday said, as of Wednesday afternoon, she still hadn’t received information from her former employer of over 20 years regarding resources and severance.
She was told during her termination meeting on Tuesday that she would receive it that same day. She questioned the organization’s financial footing if it has to resort to getting rid of its employees.
John Garrigan, general counsel for the New Hampshire Department of Labor, said his agency was aware of the layoffs, but it didn’t reach the threshold for a WARN notice that is triggered when 250 or more employees are affected.
“The Department of Labor will not be taking action at this time, however other state agencies, such as the Department of Business and Economic Affairs, may be coordinating responsive services for the affected employees,” Garrigan said.
In a similar blow across the border, University of Vermont Health announced major workforce reductions on the same day as Dartmouth Health, including the layoffs of 199 staffers and the closure of two patient care units, VTDigger reported.
“The dismantling of healthcare by the federal government is really taking a blow to rural hospitals, and we are seeing the effects now here in Vermont and New Hampshire,” Vermont State Senator Joe Major told the Valley News in a phone interview.
With Dartmouth Health, he expressed concern for Mount Ascutney Hospital and Health Center in Windsor, which is part of the Dartmouth Health system.
“We’re having to look at how to revamp our complete system,” he said.
Major, serving the Windsor District, pointed to the disheartening example of Vermont Governor Phil Scott’s veto in June of S.190, a healthcare bill designed to fast-track premium savings for public school employees and people buying plans on Vermont’s Affordable Care Act marketplace.
“Healthcare has to be the number one priority of Vermont and New Hampshire, because it has tentacles into everything: housing, education, affordability,” he said.
With Dartmouth Health’s financial concerns, New Hampshire State Senator Sue Prentiss, representing District 5, said the layoffs weren’t a complete surprise but found some consolation in learning that bedside patient care services weren’t among the cuts.
Healthcare systems throughout the state are under more constraints with Medicaid cuts, Prentiss said.
“We’ve got to start with our federal delegation to make sure that the fee schedule for Medicare is exactly what it needs to be for all the different healthcare professions,” Prentiss said. “Then we can pull ourselves inside of the state and say, ‘how are we reimbursing for Medicaid, which we are directly responsible for.’”
If you were affected by Tuesday’s layoffs at Dartmouth Health, the Valley News wants to hear from you. Contact reporter Alex Ebrahimi at aebrahimi@vnews.com or 603-727-3212.
