Dartmouth Hitchcock continues to see finances improve

Dartmouth-Hitchcock Medical Center in Lebanon,  as seen from the air on Dec. 9, 2017.

Dartmouth-Hitchcock Medical Center in Lebanon, as seen from the air on Dec. 9, 2017. Charles Hatcher / Valley News


Valley News Staff Writer

Published: 11-30-2023 1:16 PM

LEBANON — Dartmouth Health continues to see a financial loss on operations, but the red ink has subsided substantially since last year, according to filings with bondholders last week.

For the first quarter of fiscal year 2024, which ended Sept. 30, DH saw an operating loss of $8.2 million, or 1%. For the same quarter last year, losses exceeded $40 million.

The Nov. 22 filing attributes the Lebanon-based health system’s fiscal improvement to the implementation of a performance improvement plan, or PIP, a year ago. The goal of the plan was to achieve break-even performance this fiscal year, which will end June 30, 2024.

“We will continue to explore all options to improve our financial performance,” said Daniel Jantzen, DH’s CFO, who noted that DH is the largest provider of health care services in New Hampshire and the second largest in Vermont.

The system logged a loss of about $45.3 million on a budget of $3.15 billion for the fiscal year that ended June 30.

Jantzen noted that DH — which in the Upper Valley includes Dartmouth Hitchcock Medical Center in Lebanon, Alice Peck Day Memorial Hospital in Lebanon, Mt. Ascutney Hospital and Health Center in Windsor, New London Hospital and the Visiting Nurse Association and Hospice of Vermont and New Hampshire — still is recovering from the effects of the COVID-19 pandemic, which he described as “one of the most turbulent periods U.S. health care providers have experienced.”

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Beyond the Upper Valley, DH has clinics in southern New Hampshire and also includes Cheshire Medical Center in Keene, N.H., and Southwestern Vermont Healthcare Corporation, which is based in Bennington, Vt., and joined the system in July, expanding DH’s reach in to eastern New York state and northwestern Massachusetts.

The goals of DH’s performance improvement plan include improving productivity, access and throughput, workforce-related initiatives, as well as redesigning systems. The effort included a layoff of 75 workers and the elimination of 100 open positions in June.

“There are currently no plans for additional layoffs to improve our financial performance,” DH spokeswoman Audra Burns said in a Monday email.

Excluding costs associated with Southwestern Vermont Health Care, which joined the DH system in July, workforce costs for the quarter ending Sept. 30 were $3.5 million less than the same quarter last year. The filing attributes this difference to the PIP and to lower rates for contracted labor, such as traveling nurses, than the same period in the prior fiscal year.

Overall, including SVHC, expenses were up about 10% to $844 million for the first quarter of the year, over the same period last year.

Excluding SVHC expenses, the system saw an increase in expenses of $19.6 million, or 2.5%.

Meanwhile, revenues were up nearly 15%, or $107.5 million, compared with the same quarter last year. That was partially aided by SVHC’s membership, as well as by growth in patient volumes, contracted payment rates and higher inpatient acuity at DHMC, the system’s flagship academic medical center.

DHMC opened a new $150 million patient pavilion with 64 beds in May. At the same time, 36 existing patient beds were closed for renovation, but as of Nov. 15, 30 of those have reopened. The remaining six are expected to reopen by the end of the fiscal year. System wide, ambulatory appointments were up nearly 3% over the same quarter the prior year and surgical cases were up 1%.

However, the system has struggled to return discharges to pre-COVID levels. This is partly due to inpatient capacity issues at facilities such as nursing homes and rehabilitation facilities. Those places have had their own staffing shortages, difficulties discharging patients and increasing lengths of stay since the beginning of the pandemic, the DH filing said.

DH also is seeking to add Valley Regional Hospital in Claremont to the fold in a transaction that is currently undergoing a state regulatory review. The system aims to finalize that integration in early 2024.

Nora Doyle-Burr can be reached at ndoyleburr@vnews.com or 603-727-3213.