When Richard “Dick” Levy’s wife, Susan, received a terminal diagnosis of a progressive brain disorder a decade ago, he became her primary caregiver. Doctors estimated Susan had between three and five years left to live.
“I figured, we have a great healthcare system; we could beat it,” Levy said Tuesday. “What I didn’t know after 58 years in the healthcare industry what I was facing ahead of me to taking care of my wife.”
She ultimately lived seven years with Lewy body dementia until 2023. Her husband of nearly six decades administered home care throughout her illness at their home in California.
Seeking ways to ease that process for future families, Levy donated $20 million to Dartmouth Health and the Geisel School of Medicine at Dartmouth for the establishment of at-home primary care and palliative services and a Family Caregiver Institute to offer resources and train new members of the caregiver force, he and the two institutions announced Tuesday.
Levy, a Dartmouth alum, hopes the newly created Dartmouth Health At Home initiative, made up of these programs, will provide a different framework for rural healthcare, especially with the Granite State’s aging population.
“I was an amateur. I didn’t know how to do any of the things. I had to learn, and I mean, it was a lot of trial and error learning how to do it,” said Levy, who earned his PhD in nuclear chemistry from the University of California and went on to become the CEO of a biotech firm specializing in radiation oncology equipment. “The Dartmouth program would have been exceptionally important for me, and not only for me.”
The caregiver institute will train future home health aides — including family members like Levy — while connecting them with resources and aides.
Around one quarter of adults in the United States, or 63 million people, function as a caregiver, according to a study released last year by the National Alliance for Caregiving and AARP. This number marked an increase of caregivers by almost 50% in a single decade. About one-third of caregivers are supporting both adults and children.
Administering at-home care can often mean giving injections, managing medicines and dealing with medical equipment, but only 22% of caregivers receive training, the study found.
“Dartmouth Health at Home is a direct response to the need that we live with every day,” Joanne Conroy, chief executive officer and president of Dartmouth Health, said Tuesday. “It reflects our long-held belief that patient-centered care means treating people where they want to be treated, and that caregiver support isn’t a luxury, but instead foundational to good outcomes.”
Aging is another component of home care. New Hampshire is the second-oldest state in the country, with over a quarter of its residents over the age of 59. The state’s nursing homes are expected to face bed shortages in the coming decades. In Merrimack County alone, a deficit of 503 assisted living facility beds is anticipated by the year 2035 as a result of the “silver tsunami,” according to a study done for the county by consultant Steve Norton.
“The whole idea is to improve patients’ health outcomes and show that aging at home can provide economic benefits as well, for patients, health systems, and insurers,” said Dartmouth College President Sian Beilock on Tuesday. “This is a bet on where healthcare is headed nationally, that we have to help people age successfully in their homes, and that this is especially important in rural areas, and that the work we’re doing here can be a model not just in rural areas but in urban areas across the country.”
Dartmouth Health At Home is intended to set the scene for the future of healthcare, the initiative’s founders all agree. The team aims to have the different services be fully operational by March of the new year, with patient enrollment beginning as early as January.
“This gift really does mean that we can create the models, test the models, and implement the models to be scaled nationally,” said Jennifer Hunt, dean of Dartmouth’s medical school. “It’s very important for me, from the education side, that this also allows us to train the next generation of students who will be in the rural setting and will be caring for the elderly in ways that we can’t even imagine today.”
As it begins creating the caregiver institute and laying the framework for at-home primary and palliative care services, the health system is still navigating financial challenges.
Earlier this year, it reported a $63.5 million deficit from October 2025 through March 2026. Then, two weeks ago, Dartmouth Health laid off 124 employees while eliminating 303 positions at both Dartmouth Hitchcock Medical Center and Dartmouth Hitchcock Clinics Southern Region.
These cuts were designed to “improve long-term sustainability,” according to the health system. The personnel cuts largely impacted the tele-ICU and tele-ED and collaborations with other health providers. Dartmouth Health also decided to switch to outside providers for employee training.
This is not the first time the health system has had layoffs in recent years. Last year, it announced a hiring pause. Back in 2023, facing a financial deficit, Dartmouth Health laid off 75 employees and got rid of 100 open roles.
