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What happens to a rural community after its hospital closes?
Nashoba Valley residents face longer drives to appointments and emergency services.
By Shira Schoenberg Globe Staff,Updated August 10, 2026, 3:00 a.m.
The former Nashoba Valley Medical Center building in Ayer sat vacant in July.Shira Schoenberg/Globe Staff
What happens when a community loses its hospital?
In the working-class communities of the Nashoba Valley, a mix of rural and suburban towns in North Central Massachusetts, the closure of Nashoba Valley Medical Center two years ago made it harder to access health care. Residents are driving farther for appointments. First responders are stretched, leaving communities underresourced when a fire or emergency arises. Those most affected are the most vulnerable, including older adults and people without cars.
But this story is also one of collaboration among local health care providers and community groups that are finding ways to fill the gaps.
When Steward Health Care closed Nashoba Valley Medical Center outside of Ayer on Aug. 31, 2024, residents clamored to save it, pushing for its purchase by another hospital operator or for the state to take it over by eminent domain and transfer it to another operator. Some nearby homes still have signs reading “No hospital 2024, No Healey 2026,” expressing the frustration many felt that Governor Maura Healey let it close. But ask many in the region today what should happen to the vacant building, and the response tends to be a shrug. Health care providers and community-based organizations have largely moved on to seeking other ways to fill the health care gaps.
“It’s owned by Apollo,” said Chelsey Patriss, executive director of the Health Equity Partnership of North Central Massachusetts, referring to the New York-based investment firm that acquired the property during Steward’s bankruptcy. “We don’t get to decide what happens with it.”
The loss of the hospital was felt in myriad ways by residents of small towns like Ayer, Pepperell, Shirley, and Groton. It was Ayer’s biggest employer, with around 500 employees, according to Ayer Town Manager Robert Pontbriand, and its closure left the town with between $250,000 and $300,000 less in annual property tax revenue because a vacant hospital is worth less than an operational one. Patriss said residents lost further trust in the health system, with the hospital closure coming less than a year after UMass Memorial Health HealthAlliance-Clinton Hospital in Leominster eliminated its maternity unit.
The biggest concrete impact is on emergency services. Ambulances now have to travel to UMass hospital in Leominster or Emerson Hospital in Concord, each about 15 miles from Nashoba Valley Medical Center. A report by the Nashoba Valley Health Planning Working Group found that as of February 2025, the median emergency medical services transport time in the region had increased from 12 minutes to 17 minutes.
But that metric understates the actual impact in the most affected communities. Ayer Fire Chief Timothy Johnston said the typical time ambulances took between leaving for a call and returning to the station in Ayer went from between 20 and 40 minutes when Nashoba Valley was open to one to two hours after the closure. Johnston said the department had four people working 24/7 before the closure, but as calls took longer, the department relied more on on-call firefighters and mutual aid. Since the closure, the department has received about $1 million in state aid, which it used to buy a paramedic vehicle and hire two more firefighters to work each day shift.
Another lingering impact is the loss of primary care and specialty doctors. While Bookmark Medical, formerly Revere Medical, acquired Steward’s physicians, Patriss said some doctors retired or took jobs elsewhere.
Jenna Montgomery, public health educator for Nashoba Associated Boards of Health, a regional health department that works on behalf of 15 towns’ boards of health, said her father, who lives in Townsend, had a Steward primary care doctor in Townsend. It took him six months to find a new doctor in Sudbury, nearly an hour away.
Montgomery said the boards of health, working with consumer health care advocacy group Health Care for All, held focus groups with residents after the hospital closure and found people were delaying or skipping care. Montgomery said a common refrain was, “I’m not going to doctors’ appointments because I couldn’t be bothered to deal with the logistics to figure it out.”
Providers are working to address these shortages. A big improvement should come when UMass Memorial Health opens a satellite emergency facility in Groton in February 2027 with 16 treatment rooms, imaging, and a helipad and private ambulance to transport people to area hospitals. “A big piece of what we’re doing is to support local EMS crews so they don’t have to make long travel times to other area hospitals,” UMass Medical Center President Justin Precourt said. 
UMass Memorial Health is building a new satellite emergency facility in Groton.Shira Schoenberg/Globe Staff
Emerson Health President and CEO Christine Schuster said Emerson is rotating more specialists through its Littleton office and adding five new clinicians plus mammography services to a Groton primary care office.
One ongoing problem is transportation. The region has minimal public transit, and most people have cars — but not everyone. Patriss said senior centers that provide rides to older adults have had to turn down requests or eliminate rides to social events or grocery stores to accommodate the need for medical transportation.
A lingering reminder of the hospital loss still sits in Ayer: the hospital’s vacant shell. Although parts of the campus were sold and remain in use as a nursing home and doctors’ offices, the main building is empty. Both UMass Memorial and Emerson Health considered buying the hospital but couldn’t make it work financially.
At the other hospital Steward closed during its bankruptcy, Carney Hospital in Dorchester, developers are advancing a proposal to build housing and a medical building.
The Ayer site is zoned for medical services, and Pontbriand, the town manager, said he hopes the site can be used to serve the region’s growing, aging population. Nashoba Valley Medical Center had a geriatric psychiatric ward, which hasn’t been replaced. It provided medical care to the region’s three prisons. A report by the Nashoba Valley Health Planning Working Group identified an ongoing lack of mental health and addiction services.
The challenge will be finding an operator that can make money there given the cost of removing or renovating the hospital building. “In Boston, there are many more people you might be able to bring to the table to finance a big project like that. It’s hard the farther you get from Boston,” said Amie Shei, president and CEO of the Health Foundation of Central Massachusetts.
Shei said the region’s residents are accustomed to traveling far distances and struggling to access health care. Even before the hospital closure, a Community Health Needs Assessment by the Nashoba Associated Boards of Health found, based on 2022 data, that there are far fewer primary care physicians and mental health providers per capita in the region than in Massachusetts overall. The closure of Nashoba Valley Medical Center made those problems worse. Two years later, finding solutions to help the most vulnerable residents remains a work in process.
Correction: The description of Apollo and how it obtained the property has been corrected.
