Novant tried to buy Mission Health in 2019; knocking on Buncombe’s door again

ASHEVILLE - Novant Health tried to purchase Mission Hospital in 2019, and though it ultimately lost out to HCA Healthcare and an ensuing $1.5 billion, the Winston-Salem based health care system is knocking on Buncombe County’s door again.

This time the company wants to build 67 new acute care beds, a bid process called “certificate of need” or CON in which it is competing with for-profit HCA/Mission and nonprofit AdventHealth.

Previous coverage of the 67-bed hospital 'CON:'

• Mission/HCA, AdventHealth apply for 67 new hospital beds in Buncombe

• Novant Health: 1 of 3 seeking to add hospital services in Buncombe. Here's its pitch.

• 3 hospitals compete for Buncombe expansion: Which does your doctor, mayor support?

• NC Attorney General Stein says state should 'deny Mission' hospital expansion application

Novant wants to open a facility at 200 Technology Drive in South Asheville, and plans to inject $328.7 million into the project. Of the three hospitals that applied, Novant’s slated opening date is the latest: early 2027.

AdventHealth’s CON proposes opening in 2025 and Mission in 2026.

“We’re not new to Western North Carolina,” said Patrick Easterling, senior vice president of Novant Health consumer operations, speaking to the Citizen Times Aug. 3. The company has been seeing patients with hospital partnerships and MRI services in Asheville.

Novant was in Buncombe in 2018, too, Easterling said, attempting to buy Mission.

“We feel like we made a very attractive offer to come to the community,” he said, would not disclose the amount.

That potential deal was emphasized by former Mission Health Chief Financial Officer and current Novant independent contractor Charles Ayscue. His was one of thousands of letters of support garnered by the three competing hospital systems during a monthlong public comment period, which ended Aug. 1.

Related: Will AG Stein, Treasurer Folwell get involved in new HCA lawsuits? Here’s what they said.

Embedded in Ayscue's endorsement of Novant to receive approval for its CON Ayscue noted he’d seen Novant “proposals from 2017 and 2018 to acquire Mission Health.

“These presentations clearly state that Novant Health would match any financial offer proposed by HCA.”

After the for-profit HCA bought the nonprofit Mission, many — including Ayscue — felt as though they were left in the dark about the deal, including community members and elected officials.

Buncombe Board of Commissioners Chair Brownie Newman and Asheville Mayor Esther Manheimer in an April roundtable with Attorney General Josh Stein indicated communication between the hospital board, HCA, and other deal planners wasn’t sufficient.

New Hospital: Buncombe commission to show support for new 67-bed hospital, but not one owned by HCA

In the new bid to grow its North Carolina hospital service footprint westward, Novant is taking a community-centered tack, Easterling said.

He estimated Novant executives have had 12 meetings with community members, local politicians, and business owners since they decided to pursue the CON roughly four months ago. They did those even before submitting the CON June 15.

“We’re a pretty large organization, with 35,000 team members,” Easterling said. “We can talk about how big we are and numbers, but when we do get opportunities to grow and when people reach out to us, it’s very important that there’s a cultural fit between our organization and the community.”

Novant has said no to some growth opportunities, he noted, adding that if the hospital system is to grow, “the community has to invite us in.”

Novant in its original CON presented several letters of support for its 67-bed buildout proposal in Buncombe, many from local physicians.

Related: Mission Health is growing in Western NC. Here are 5 big projects it has in next 2 years

Novant’s proposed hospital would have a number of elements, including:

• 67 acute care beds, including 53 medical-surgical, eight ICU, six labor, delivery, recovery, and postpartum.

• Eight observation beds.

• For surgery services, one operating room in partnership with Surgery Partners, three procedure rooms, one C-section operating room, and one gastrointestinal endoscopy suite.

• For radiology services, mobile MRI, CT, ultrasound, X-ray, and nuclear medicine.

• An emergency department with 35 bays.

Novant also says it is bringing a unique physician partnership model.

“For us, it’s the special ingredient in the special sauce,” Easterling said. “At Novant Health physicians serve in key physician leadership roles alongside administrative leaders. I really challenge other organizations as to whether or not they really empower physicians to have a direct voice in health care.”

That model allows the system to be more patient-focused, he added.

“We’re not bringing physicians with us,” he noted, when asked how Novant planned to staff its proposed facility. “We’re going to work with local physicians and we’re going to ask them to help.”

Lawsuit: Asheville, Buncombe file lawsuit against HCA/Mission Health, which vows to fight back

He insisted Novant won’t “sit in some office” at a distance making decisions and said the system would interact with community members and health care providers to find needs and gaps in service.

Asked how Novant would work to coexist with Mission Health and other providers in the area if it won the CON, Easterling said, “We’ve had no problem in … those situations.”

Novant Health has 687 locations spread mostly throughout North Carolina, South Carolina and Georgia, according to its website.

Its 2021 operating revenue was $7.1 billion with profits totaling approximately $812 million, according to its latest financial report.

The most recently available 990 tax forms show its president and CEO Carl Armato in 2019 made more than $4 million in reportable compensation.

North Carolina Department of Health and Human Services' Division of Health Service Regulation will host a public hearing on the CONs at 9:30 a.m. Aug. 12 at Asheville-Buncombe Technical Community College Asheville Campus, 19 Tech Drive, in the Ferguson Building's Ferguson Auditorium.

Hospital executives from each health system will be in attendance. Novant has not yet decided which of its top brass will appear, according to spokesperson Ashton Miller.

Andrew Jones is Buncombe County government and health care reporter for the Asheville Citizen Times, part of the USA TODAY Network. Reach him at @arjonesreports on Facebook and Twitter, 828-226-6203 or arjones@citizentimes.com. Please help support this type of journalism with a subscription to the Citizen Times.

This article originally appeared on Asheville Citizen Times: Novant was courting Buncombe before it applied for new hospital