by John Osborn ·
Friday, May 22, 2026
For nearly two years, the story of healthcare in the Nashoba Valley has been defined by what the region lost. A new regional health study says the problem is bigger—and older—than that.
The 2025 Community Health Needs Assessment, prepared by the Nashoba Associated Boards of Health, identifies 14 urgent health problems across 15 towns in Middlesex and Worcester counties. Youth mental health tops the list. Isolation and loneliness among older adults rank second. Stress on emergency rooms and trauma services ranks fifth. The district’s most pressing needs, the report concludes, are not all consequences of the August 2024 closure of Nashoba Valley Medical Center. Many of those needs were already here.
The 172-page report matters for a practical reason: It will drive public health spending in the region for years. NABH intends to use it to guide programs, projects, and partnerships targeting the most urgent needs. Towns can use disaggregated data in the study’s appendix to make their own decisions about strategy and funding. A Community Health Improvement Plan now being written will translate the report’s ranked priorities into specific programs, timelines, and measurable goals.
The region’s most urgent need, a panel of 14 community leaders concluded, is youth mental health. Focus group participants described waiting up to six months to see a therapist who accepts their insurance, a delay that community members said was already costing lives.
“You can’t ask somebody who’s struggling to wait six months to get help,” one told researchers. “I think it’s going to impact a lot of lives, and we’re going to see a real shift in statistics for suicide.”
The crisis is not a product of the hospital closure. “Youth mental health, since COVID, has become more and more relevant,” said Jo Morrisey, the lead consultant from Crescendo Consulting Group, who has conducted community health assessments nationally for years. “The changes to the way that we educate our children, the way in which our children are now communicating with each other, or not, because of devices, has become a very real, tangible experience for populations all across the country.”
The roots are layered. A working group studying the mental health crisis in the district has identified the absence of “third spaces” as a factor: neutral gathering places outside home and school where young people can connect and belong. Morrisey added another: young people who want to express their individuality without being stigmatized. “That lack of feeling of being accepted for who you are,” she said, “is impacting their mental health as well.”
Since the assessment was conducted, wait times have improved somewhat but not evenly, Michelle DellaValle, director of pupil services for the Harvard Public Schools, told the Press. The gains have gone largely to students with private insurance. Families covered by MassHealth are still waiting significantly longer and finding fewer providers willing to accept their coverage.
Isolation and loneliness among older adults ranked second in urgency, followed by long-term care and aging in place. In a region where 12 of the 15 towns meet the definition of rural, the two problems reinforce each other. Seniors on fixed incomes are financially stranded in towns where property taxes have outpaced their means, while a lack of public transportation cuts them off from the social connection that sustains health.
“I see a direct correlation between leaving the house and better mental health,” one community member told researchers.
Nearly 22% of adults across the district report lacking adequate social and emotional support, a rate above state and national averages. In the hardest-hit towns, nearly half of seniors 65 and older live alone. Debbie Thompson, director of the Harvard Council on Aging, said the critical turning point arrives when a senior loses the ability to drive. “The minute they can’t drive anymore,” she said, “it becomes a real problem for them.”
The provider shortage data is stark. In Shirley, there is one primary care physician for every 7,017 residents; in Stow, one for every 7,109. The Massachusetts average is one for every 535.
Mental health providers are even scarcer: Ayer has one mental health provider for every 8,491 residents. More than one in seven adults across the district, 14.3%, reported experiencing poor mental health for 14 or more days in the month when the survey was conducted. Nearly 7 in 10 respondents to the NABH survey said they are less mentally healthy than before the pandemic.
The closure of Nashoba Nursing Service and Hospice made the situation worse. The agency had sent nurses to patients’ homes across the district on regular schedules, managing wounds, monitoring medications, and catching problems before they became emergencies. When it closed in August 2023, a full year before the hospital shut down, those visits stopped and nothing replaced them. The calls that home nursing had been preventing began going to 911 instead. “They closed Nashoba Nursing Services and that was a huge number of services, and no company came in and picked up all those visits,” one key informant, quoted anonymously, told researchers. “So now you have EMS who is truly holding the bag.”
Without the Nashoba emergency room, ambulances must travel the extra distance to Concord, Clinton, or Leominster, in some cases doubling or tripling drive times. The problem compounds at the destination. Ambulance teams wait with patients on stretchers, “holding the wall” in EMS shorthand, until hospital beds become available, keeping trucks out of service for extended periods. For stroke patients, those delays carry measurable consequences. State regulators, in approving the new Groton emergency facility last July, cited research finding that every 10-minute delay in treatment for a severe stroke costs the patient up to eight weeks of healthy life.
Running beneath nearly every finding is economic pressure. Cost-burdened households ranked seventh as an urgent need. Focus group participants described being forced to choose day-to-day between housing, medication, and food.
“People who held down good, working class, livable wage jobs are now really struggling because changes in healthcare, changes in benefits, just the cost of living, has risen so much in the last four to five years,” one community member said.
Jenna Montgomery, NABH’s public health educator and the project’s local coordinator, said those pressures are among the findings she worries will not get the attention they deserve. “Cost-burdened households and a worsening, overstressed healthcare system, that feels very big, like national level big in some ways,” she said. NABH’s role in addressing those pressures, she suggested, may be less direct intervention than advocacy: “convening groups that can share what kinds of struggles people see at the local level, raising those stories to the legislative level.”
NABH commissioned the assessment in 2024, selecting Crescendo Consulting Group, a national public health consultancy with experience conducting health assessments from Alaska to Florida, to lead the research. Morrisey designed the methodology, oversaw the fieldwork, and wrote the report. Montgomery served as the local convener, drawing on her knowledge of the 15-town district to help Crescendo identify the right communities and participants for interviews and focus groups.
Fieldwork ran from July through October 2025. Crescendo conducted 1,349 community surveys, 31 one-on-one stakeholder interviews, and 12 focus groups. On Nov. 20, the 14-member panel ranked 14 health priorities using the Hanlon Method, a public health scoring tool that weighs each need by its magnitude, severity, and the feasibility of an effective response. The prioritized list appears at right. Not all 14 priorities are health problems in the conventional sense; some are the social and economic conditions that produce them. The full list runs from youth mental health and elder isolation at the top to affordable childcare, insurance complexity, political polarization, and stagnant population growth.
NABH and Crescendo acknowledge that the survey “was not a random sample” and that findings “should not be interpreted as representative of the full population.” The 1,349 respondents skewed heavily older, white, educated, and female. Morrisey said the profile roughly mirrors the district itself, and that Crescendo supplemented survey responses with regional health data from other agencies plus qualitative findings from its focus groups and interviews with stakeholders, which were designed to reach populations the survey was least likely to capture.
The five months since the assessment’s release have brought concrete movement on several fronts.
The most tangible response to the emergency services crisis is now under construction. UMass Memorial Health broke ground in September 2025 on a Satellite Emergency Facility at 490 Main Street in Groton, a full-service emergency department with a helipad, CT and ultrasound imaging, and around-the-clock adult and pediatric emergency care. The state approved the project the previous July, after finding that the nearest comprehensive emergency services from the Groton area are in Concord, Leominster, and Lowell, with travel times of 27 to 30 minutes. UMass Memorial sited the facility in collaboration with the region’s fire and EMS chiefs. It is expected to open in late 2026 or early 2027 and is projected to perform nearly 5,000 CT scans in its first year.
UMass Memorial hospitals in Clinton and Leominster could not absorb the volume from towns formerly served by Nashoba Valley Medical Center, and EMS services could not absorb the longer transport times, said UMass Memorial Health President and CEO Dr. Eric Dickson at the groundbreaking. “So, we had to do something,” he said.
State grant dollars have also helped regional EMS departments adapt. In December 2025, Gov. Maura Healey announced $5 million in grants to 13 Nashoba Valley EMS providers. An earlier round of $2 million had already gone to Ayer, Devens, Groton, Harvard, Shirley, Townsend, and others for new ambulances and equipment.
The broader health response is being organized through the Nashoba Health Equity Partnership, a coalition formed in December 2025 to address the health needs of towns in the NABH service area. The Health Foundation of Central Massachusetts provided the money, a three-year grant of $250,000. CHNA 9, a regional health equity network covering 27 north-central Massachusetts cities and towns, channeled it and set the framework. NABH acts as the local backbone, running the partnership’s day-to-day work within the district. Four working groups, each focused on one cluster of priorities from the assessment, do the actual work: healthcare access; youth mental health; social isolation and digital equity; and aging in place and holistic community planning.
Telehealth hubs are now operating at five libraries, including Harvard, and at councils on aging across the district, funded through an AARP Livable Communities grant. Each hub provides a blood pressure cuff, a scale, privacy screening, and instructional materials on common telehealth platforms. Laptops and tablets from the state’s Mass Broadband Institute are expected to be distributed to regional organizations for loan in the coming months.
Montgomery said youth mental health is the area where the partnership is most likely to show early results. “Youth mental health is something that is within our purview to tackle sooner rather than later and will have a big impact,” she said. Chronic disease prevention is another area, she said, where targeted interventions can show measurable progress within the partnership’s three-year window. The aging population, she added, will take longer.
The Community Health Improvement Plan being written by NABH and Crescendo will provide a road map for the work of the partnership, or it won’t. It does not yet exist. What the partnership builds, and whether it matches the scale of what the assessment found, is the question the coming year will answer.
This is the first of a two-part series. Next week: Harvard has the best primary care ratio in the district, a newly upgraded ambulance service, and the third-worst mental health provider ratio in the region. Part 2 looks at how the regional crisis plays out in a town that is better positioned than most, but still not insulated from it.
About the survey and its methodology
The 1,349 community survey respondents skewed heavily older with 45% aged 65 or above, as well as highly educated, white (94%), and female (74%). NABH and Crescendo acknowledge that the survey “was not a random sample” and that findings “should not be interpreted as representative of the full population.” Crescendo’s lead consultant, Jo Morrisey, said the demographic profile of respondents roughly mirrors the district itself, and that Crescendo compared survey findings against other health data and what it learned from focus groups and stakeholder interviews.
The report does not address how institutional populations, including a federal medical prison at Devens and a state correctional facility in Shirley, may affect the census-derived figures attributed to those communities. Morrisey said the distortion is real but limited: It applies to census-derived demographic counts only. Health outcome data and provider ratios in the report are drawn from the National Provider Identifying system, which excludes both the incarcerated population and internal prison medical staff. Shirley’s extreme primary care ratio reflects an actual shortage, not a census artifact. “When the hospital closed, all of their related practices were either gobbled up or closed themselves,” Morrisey said. “That has had an impact on the provider ratios.”