A recent investigation announced by the Attorney General’s office and displeasure with the owners of Angel Medical Center overshadowed a Wednesday, Nov. 1 community meeting that gave an update on the hospital.
Gibbins Advisors held its Macon County meeting at the Macon County Public Library to give an update on its independent monitoring of HCA Mission Health Systems.
Despite constructing and opening a new Angel Medical Center in 2022, HCA is the subject of many pointed questions about decreased services and lack of staffing not just in Franklin, but across Western North Carolina.
“We understand you have deep concerns about the performance of Mission Health, under the commitment made,” Ronald Winters, principal for Gibbins Advisors, said at the start of the meeting.
Gibbins Advisors is paid by Dogwood Health Trust to independently monitor HCA Healthcare’s 2019 purchase of Mission Hospital in Asheville and its network of regional hospitals, which includes Angel Medical Center.
The bulk of the presentation was Winters pointing out the 15 commitments HCA made in the 2019 purchase agreement, which is all Gibbins can focus on.
“The commitments don’t include certain other things like quality-of-care metrics, billing or employ metrics of how HCA runs the hospital,” Winters said.
Gibbins is having similar community meetings across the region. Winters said they will be back in Macon in the spring. Winters said they will do site visits in May 2024, then complete its review and submit it to Dogwood.
Kicking off the question-and-answer part of the meeting, Kenn Paul Champney asked about the commitment to participate in Medicare and Medicaid for at least 10 years after purchase (through 2029), believing those programs are in effect indefinitely. Winters said he wasn’t familiar with why that was added to the agreement but said a hospital would likely have to continue participating in Medicare and Medicaid programs.
“The community has lost trust,” Champney said of HCA.
Winters said Dogwood was responsible for enforcing compliance with the 2019 agreement, and if not, the Attorney General may prosecute.
Former Franklin Mayor Bob Scott expressed his frustrations with HCA and what he felt was Gibbins’ lack of direct answers.
“We really haven’t heard anything about these listening sessions,” Scott said. “And what we hear is ‘that’s not in the contract.’”
Scott said they’ve lost both Macon County-based cardiologists, who have moved away and wanted to know how those problems will be remedied.
Winters explained there’s a gap between the commitments and the expected level of service, pointing to a resource guide that lists accrediting and governing bodies that could help. Scott replied that those organizations “don’t listen to Joe Blow from Franklin, North Carolina.”
Franklin Mayor Jack Horton says he gets asked a lot about staffing and what is required for recruiting and retaining staff. Winters responded there was nothing in the contract related to staffing. Horton asked about staffing levels now compared to the 2019 purchase, to which Winters responded that he didn’t know.
Winters said in previous years, HCA was found noncompliant for not giving notice about discontinuing community services, and one time when they weren’t able to offer surgical and endoscopy services in Highlands. Winters said the giving notice issue wasn’t major and the latter was due to a mechanical issue, both of which have since been addressed.
One unidentified commenter said HCA engages in “deceptive and aggressive billing.”
The last speaker was Dr. Michael Messino, the founder of Messino Cancer Centers, who clarified recent news related to Macon County.
Messino Cancer Centers announced in late September they would no longer provide certain oncology services at Mission Hospital in Asheville due to HCA’s alleged failure to adequately staff and provide resources. On Wednesday, Dr. Messino said, “We’re not getting that support,” clarifying it was laboratory, nursing and pharmacy services that HCA failed to provide.
“Medical oncology care is still here in Macon County and will stay here as long as we can survive no matter whatever else is going on,” Messino said. “If you read something or see something and you question it, I want you to call me…services are here and are going to stay here.”
Messino said his organization is “taking aim” at the required commitment to continue specified services for at least 10 years. Addressing Scott’s earlier point, Messino said two Macon County-based cardiologists left “because they were not happy with their situation.”
This meeting comes as HCA is getting blowback from the Asheville-based Mission Hospital staff and the North Carolina Attorney General’s office. According to Asheville-based media, a letter now signed by over 100 Mission Hospital employees decried HCA’s changes, mainly its cuts in staffing.
On Sept. 29, N.C. Attorney General Josh Stein demanded HCA explain their decreased cancer services, saying it might violate its 2019 agreement.
Then on Oct. 27, Stein sent a letter to HCA demanding the organization send documents by Nov. 9 related to oncology services and the lack thereof. Messino Cancer Centers and GenesisCare will no longer provide certain services in Mission Hospital. Messino said Mission failed to adequately staff and provide resources to support chemotherapy patients, according to Stein.
On Oct. 31, the day before the Macon County meeting, Stein’s office sent Dogwood Health Trust a letter alleging a breach of contract by HCA for the closure of various oncology services. After 40 days, Stein can file a lawsuit if the matter is not corrected, the letter states.
Multiple people referenced the various media reports on HCA. Winters said they can’t comment until their full report comes out in 2024.
HCA Media Relations Coordinator Nancy Lindell and Angel Medical Center CEO Clint Kendall were in attendance but didn’t speak. A request for comment sent to Lindell was not returned by press time.
South Moore, assistant general counsel from the N.C. Attorney General’s office, was in attendance but didn’t speak during the presentation. After the presentation and Q&A, multiple attendees spoke individually with Moore.