The hospital is part of Northern Berkshire Healthcare (NBH), a not-for-profit organization.

Beset by chronically low inpatient censuses in recent years, declining reimbursement from Medicaid and Medicare, and facing rising costs, many rural hospitals, not just NARH, struggled to stay alive.

NARH went through Chapter 11 bankruptcy reorganization in 2011 and built an affiliation with Berkshire Medical Center (BMC) in Pittsfield, MA.

[4] BMC paid a total $3.4 million for the hospital campus and NBH's fixed assets, and $600,000 for the Northern Berkshire Family Practice.

[5] BHS announced a plan to reopen North Adams Regional Hospital in 2024, a decade after the sudden closure in 2014.