Asheville independent hospital monitor to increase oversight; monitor oversees HCA

ASHEVILLE - More oversight authority is going to the independent monitor created to ensure that the for-profit buyer of the nonprofit Mission Hospital does its job to maintain the region's health care system ― something critics say it is failing to do.

The growth in scope of how the independent monitor will oversee the company HCA was announced after community members and others urged the monitor to help fix what they said was a widespread deterioration of care. It also follows a Dec. 14 lawsuit filed by North Carolina Attorney General and gubernatorial candidate Josh Stein against HCA for what Stein said was a failure to provide the level of emergency and cancer care the Tennessee-based corporation agreed to when it purchased the Mission Health system in 2019.

The independent monitor is hired by Dogwood Health Trust, a nonprofit that received the proceeds of the $1.5 billion hospital purchase. It is responsible for overseeing HCA’s compliance with commitments and delivers grants to Western North Carolina organizations meant to improve regional health.

"Through the expanded scope of work, the IM will increase its engagement with and listening to the community beyond what is outlined in the Asset Purchase Agreement," Dogwood CEO Dr. Susan Mims said in a Jan. 4 statement to the Citizen Times.

"This change in the scope of work will allow the IM to evaluate any issues of potential non-compliance and work with the AG’s office to help people share their concerns that are not addressed in the APA, such as quality of care, with the appropriate bodies with oversight for those issues."

Reached Jan. 4, HCA spokesperson Nancy Lindell said, "we look forward to working with whomever is selected."

The current company serving as monitor, Gibbins Advisors of Tennessee, has responded to many concerns by noting they are limited by their contract with Dogwood and by the Asset Purchase Agreement that sets out what HCA must do.

Attendees of an Oct. 20 public meeting said HCA's emphasis on profits had "gutted" the once well-respected Mission system, cutting staff and causing many to quit out of frustration. Ronald Winters, co-founder and managing director of the Tennessee-based Gibbins, told attendees his company's current oversight powers do not include billing, number of employees or "quality care metrics."

The Citizen Times reached out to Gibbins asking if it will apply for the expanded position.

After the 2019 sale, the monitor was tasked with checking that HCA met 15 commitments. Those included keeping facilities open and maintaining specified services, such as oncology, for 10 years as well as investing $25 million in an innovation fund.

Some commitments have already been met, such as building a 120-bed behavioral health hospital in Asheville, replacing the Angel Medical Center in Franklin and putting $232 million into general capital needs and improvements.

Dr. Robert Kline, who read a letter at the Oct. 20 meeting signed by dozens of doctors saying HCA had "gutted the heart and soul of our community healthcare system," said he hoped the expanded monitoring would help to improve services.

"The monitor had a very, I think, narrow circumscribed set of duties, and what was overlooked obviously were the qualitative concerns: the shortfall in manpower and the provision of adequate supplies and equipment ― not to simply say you’re providing orthopedics, neurosurgery, etc., when you're extensively gutting the services, mainly by cutting staffing," Klein said Jan. 4.

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Joel Burgess has lived in WNC for more than 20 years, covering politics, government and other news. He's written award-winning stories on topics ranging from gerrymandering to police use of force. Got a tip? Contact Burgess at jburgess@citizentimes.com, 828-713-1095 or on Twitter @AVLreporter. Please help support this type of journalism with a subscription to the Citizen Times.

This article originally appeared on Asheville Citizen Times: Asheville independent hospital monitor to add oversight; oversees HCA