A retired New Hampshire judge with deep North Country roots will spend the coming year keeping watch over how one of the region’s most important hospital systems governs itself. Attorney General John Formella announced Tuesday that he has selected retired Circuit Court Administrative Judge David D. King to serve as an independent governance consultant for North Country Healthcare, the nonprofit hospital system in Coös County that recently came under scrutiny from his office.
The appointment, first reported by the New Hampshire Bulletin, is a direct result of a review by the Attorney General’s Charitable Trusts Unit that found governance deficiencies inside the system. For residents of the North Country, where hospital access is already stretched thin and every facility counts, the move represents an attempt to restore trust in institutions that thousands of people depend on for care.
How the Review Started
Late last year, the Charitable Trusts Unit, the team within the Attorney General’s Office responsible for approving hospital mergers, launched a review into North Country Healthcare. The central question was whether the system was abiding by the 2016 affiliation agreement that allowed its hospitals to merge in the first place.
The review was inspired by complaints from an organized group of Weeks Medical Center patients. Among other things, investigators examined whether the boards of directors at affiliate hospitals were being improperly overridden by executives at the parent company, a concern that struck at the heart of how the system was originally promised to operate.
North Country Healthcare was formed in 2016 through the merger of Androscoggin Valley Hospital in Berlin, Weeks Medical Center in Lancaster, and Upper Connecticut Valley Hospital in Colebrook. Littleton Regional Healthcare was initially part of the plan but ultimately pulled out. At the time, the arrangement was hailed as a first-of-its-kind model in which each affiliate hospital would keep some independence through its own board of directors, even as the hospitals pooled resources. Community members and former executives have grown worried that the system was drifting away from that founding promise.
What the State Found
Earlier this month, the unit released its findings. It determined that North Country Healthcare breached its fiduciary duties when it fired Weeks Medical Center President Michael Lee and then failed to recruit a full-time replacement. Lee declined to speak with the Bulletin for its story because he signed a non-disclosure agreement when he left the system.
The report also cited North Country Healthcare for what it described as communications failures during the system’s growing tensions with community members over recent months. Importantly, though, the unit said that aside from Lee’s termination it “did not find legal violations as to the other issues reviewed.” In other words, the state identified a serious governance problem and a breakdown in trust, but stopped short of finding widespread illegality.
As part of the findings, the Charitable Trusts Unit announced an agreement with North Country Healthcare. Under that agreement, the system must cooperate with and pay for an independent board governance consultant selected by the attorney general. It must also provide all board members with annual training on their duties, and it must hold off on any board governance restructuring plans while the oversight period plays out.
Who Is David King
The man stepping into that oversight role brings an unusually local resume. King grew up in Colebrook, the same town where Upper Connecticut Valley Hospital is based. From 1990 through 2007, he served as the presiding judge of the Coös County Probate Court, and he has served on the board of Upper Connecticut Valley Hospital itself. For roughly two decades he was associated with the Colebrook law firm of Waystack and King before his judicial service. He has also served on several nonprofit boards in the North Country.
Under the agreement, King will oversee the training and recruitment of new directors, attend board meetings, and write quarterly reports that will be made public. That public reporting requirement is significant. It means the same community members whose complaints triggered the review will be able to read, in King’s own words, whether the system is following through on its commitments.
His specific duties include overseeing the recruitment of new Weeks Medical Center board members, the recruitment of a Weeks Medical Center affiliate president to replace the leadership gap that drew scrutiny, and a series of quarterly public listening sessions that North Country Healthcare will hold over the next year.
The System Responds
North Country Healthcare has publicly welcomed the appointment. “Judge King is a highly respected North Country native, jurist, and community leader whose commitment to our region is well known,” CEO Tom Mee said in a statement to the Bulletin. “We appreciate his willingness to serve in this role and look forward to working with him. We view this as an opportunity to thoughtfully review our governance practices and strengthen our Board and leadership team.”
That conciliatory tone matters in a dispute that has at times turned tense. By embracing an outside monitor rather than resisting one, the system’s leadership is signaling that it intends to rebuild credibility with the communities it serves rather than fight the state’s conclusions.
Why It Matters for the North Country
Health care access in northern New Hampshire is a perennial worry, and the stakes of getting governance right are higher in a region with few alternatives. When a rural patient cannot easily drive to another hospital, the quality and stability of the local system is not an abstraction. It determines whether a community can recruit doctors, keep an emergency room staffed, and trust that decisions are being made with local needs in mind.
The North Country has been at the center of several recent health care debates, from the strain that Medicaid changes place on rural providers to the broader effort to shore up the region’s care infrastructure. Readers can find the background to this case in our earlier coverage of how the Attorney General’s office found that North Country Healthcare breached its fiduciary duties and needed changes. The funding pressures shaping rural systems are explored in our reporting on the Dartmouth Health rural grant and Medicaid cuts and on the Go North rural health program. The governance questions raised here also echo concerns seen elsewhere in the state, including in our coverage of the Exeter Hospital merger and worries about declining care.
King’s appointment does not resolve every concern raised by Weeks Medical Center patients, and the real test will come in the quarterly reports and listening sessions scheduled over the next year. But it establishes a clear, accountable process with a trusted local figure at the center. For a region that has spent months questioning whether its hospitals were still being run with community interests first, that structure is the foundation on which trust can be rebuilt.
For related coverage, see our reporting on Rare Powassan Virus Leaves New Hampshire Man Critically Ill.
