Exeter Hospital’s decision last year to abruptly end neurology, children’s dental and several other services left many patients scrambling.
Now, the hospital will have to give the state at least six months’ notice before making any such changes, under an agreement the hospital and state officials reached earlier this year.
Late last summer, Exeter Hospital told patients that its Core Physicians practice would stop offering neurology, pediatric dentistry, podiatry and allergy and immunology care within weeks – angering many patients, who suddenly had to figure out where to go for care.
Around the same time, the hospital announced it was shutting down a paramedic intercept program that many area towns had relied on for advanced medical support in emergencies.
The changes prompted a review from the New Hampshire Attorney General’s Office, which had approved Exeter Hospital’s sale to Massachusetts-based Beth Israel Lahey Health in 2023. Beth Israel Lahey had committed to keeping certain services open as a condition of that deal.
According to the agreement between the state and the hospital, which was dated March 31st and provided to NHPR last week, the review determined that none of the discontinued services were “specifically covered” by the sale terms.
But regulators faulted the hospital for a “flawed” process that “caused public concern and patient confusion.”
“Exeter did not provide adequate and timely communications to all those affected by the services involved and did not implement the service terminations in a way that properly protected patients and the public,” the agreement states, noting that hundreds of Medicaid patients were at risk of losing access to pediatric dental and podiatry services.
The hospital also acknowledged “errors” in its initial communications with the Attorney General’s Office, which understated how many patients and communities the cuts would affect.
Speaking to reporters last week, Attorney General John Formella said the agreement is meant to avoid a repeat of last year. The six months’ notice requirement will give his office enough time to review any future cuts before they take effect.
“What we realized in going through the review is that once it's announced that services are ending, it's very, very difficult to put them back together,” he said. “Even if we wanted to say ‘You have to continue this service,’ it's not possible. So we couldn't really put the genie back in the bottle.”
Formella said all the state can do in a situation like that is make sure the hospital helps patients transition to other care.
According to the agreement’s statement of facts, Exeter Hospital improved its communications with patients and took steps to ease the transition to other providers after the state intervened. That includes arranging free transportation to appointments elsewhere; selling the pediatric dental practice so that it could stay open and keep seeing patients; and ensuring neurology patients – some of whom lived at the county nursing home – could shift to other practices.
In the event of any future service discontinuances, Exeter Hospital will have to give patients a “reasonable period of time” and actively help them transition to other care, the agreement says.
The hospital also agreed to pay $2 million and donate equipment to help the town of Plaistow stand up a new paramedic intercept service in place of the old one.
Exeter Hospital President Debra Cresta said in a statement that the cuts were meant to “to better align resources to programs Exeter is uniquely qualified to provide to ensure our long-term sustainability.”
“We worked closely with impacted patients to ensure smooth transitions to other providers and services,” she said, adding that the hospital worked closely with the Attorney General’s Office during that process.
