ASHEVILLE, N.C. (828newsNOW) —
Will any agency hold HCA Healthcare and Mission Health accountable?
That was the crux of the question-and-answer session Wednesday night as community members expressed frustration, skepticism and anger during a meeting with Affiliated Monitors Inc. representatives.
Community meetings are part of the independent monitor’s efforts to determine whether HCA Healthcare is complying with its Mission Health System purchase agreement.
Since the hospital system’s sale in 2019, there have been accusations of services being cut and declines in health care, numerous lawsuits and most recently a finding of immediate jeopardy that threatened Mission Hospital’s Medicare provider agreements.
“This whole process has been very concerning to me,” Dr. Mark Hoch said. “My concern is we keep having all these things going on and regulatory agencies keep dropping the ball. The problems keep happening.”
Ric LaCivita said the community deserved answers, something they haven’t gotten yet.
“We expect as monitors that you have a bone in the dog’s mouth and find us some answers,” he said.
How independent monitors work
During Wednesday night’s meeting at Asheville-Buncombe Technical Community College, Affiliated Monitors representatives Gerald Coyne, Denise Moran and Jeff Brickman provided an overview of how independent monitoring works and discussed ways the community could get involved.
Dogwood Health Trust was created in 2019 when Mission was sold to HCA Healthcare. One of the roles of Dogwood Health Trust is to ensure that HCA complies with the purchase agreement. To help do that, it has hired an independent monitor.
Affiliated Monitors, which has been involved in more than 1,000 monitorships across the country, will be reviewing documents provided by HCA, visiting hospital sites, interviewing staff and getting community feedback.
Brickman said there are 15 commitments in the Asset Purchase Agreement.
“Probably about 10 of them have been fulfilled,” Brickman said. “We’re going to be monitoring the commitments that are left. At the end of our assessment, we will offer an opinion.”
The Buncombe County meeting
Several of those who attended Wednesday night’s meeting offered the monitors suggestions and asked questions of them.
One person wanted to know if site visits to the hospitals would be announced, cautioning that if they were, people who might speak negatively about the hospital system might not be there to answer questions.
The monitors said they wanted to know if the hospital attempts to keep people from answering questions.
They also said there is an email address people may use to submit information and a hotline will be set up soon.
“If you have a complaint and you don’t share it, we can’t respond to it. We can’t act on it,” Brickman said.
“Your voice does matter,” Moran said. “We want to hear from you. Keep reporting. That includes the good things and the bad things.”
Another person wanted to know how monitors would verify the information they received was valid.
Coyne said monitors will test some of the transactions in the documents.
“It’s similar to an audit,” he said. “Sometimes it means asking for additional data. Sometimes it means asking to speak to people who can explain the data.”
What if HCA does not submit the requested documents, one person wanted to know.
Coyne said that if that happened, it would be noted in the report.
People also expressed concern about people who wouldn’t speak to the monitors out of fear of retribution.
“One of the things that’s very important is the idea of community engagement,” Brickman said. “It’s a critical piece.”
Monitors said they would speak to people away from the job site. People could also email them information or use the hotline.
“Our reports do not identify specific people,” Coyne said. “We are very mindful of it. We don’t publicize names. We don’t list the people we have spoken to.”
Some in the audience questioned the monitors’ autonomy.
“Have any of you had prior experience with HCA?” one audience member asked.
“We’ve never monitored HCA. Nobody on the team has ever been affiliated with HCA,” Coyne said.
The report
Some expressed concern that HCA might not cooperate and monitors might submit an incomplete report.
“We will not rubber stamp,” Moran said.
Another person asked if monitors had the power to subpoena the documents or force HCA to comply with the purchase agreement.
Monitors do not have subpoena power, nor can they force HCA to comply, they said.
The representatives explained that Affiliated Monitors Inc. is not the entity that would take action against HCA. They compile a report of their findings and submit it to Dogwood Health Trust, who would then report the findings to an enforcement agency.
“We don’t assume a company is or isn’t in compliance. Our goal is to present a balanced report that people can rely on,” Brickman said.
Dogwood Health Trust President and Chief Executive Officer Susan Mims said the report from Affiliated Monitors would be sent to the North Carolina Attorney General’s Office.
“We care deeply about this community where we live, work and serve,” Mims said.
Mission Health spokesperson Nancy Lindell said they look forward to working with the new independent monitor
“We are confident that we have been and will remain in compliance with the Asset Purchase Agreement. We welcome direct feedback to our Quality and Care Experience teams about patient care who diligently work to address any concerns during or after a visit,” Lindell said.
Contact information
North Carolina Department of Health and Human Services Division of Service Regulation: 800-624-3004 (in NC) or 919-855-4500
North Carolina Attorney General’s Office: 919-716-6000
Centers for Medicare and Medicaid Services: 888-317-0751
Affiliated Monitors Inc.: mission@affiliatedmonitors.com
Mission Health System Quality Office: 828-213-1210
Mission Hospital McDowell Patient Advocate Office: 828-659-5713
Blue Ridge Regional Hospital Patient Advocate Office: 828-766-1815
Mission Hospital Asheville Patient Advocate Office: 828-213-0004
Transylvania Regional Hospital Patient Advocate Office: 828-862-6383
Highlands-Cashiers Hospital Patient Advocate Office: 828-526-1243
Angel Medical Center Patient Advocate Office: 828-349-6647
Mission Quality Team Office: 828-213-1210
Upcoming meetings:
Transylvania County Meeting (Transylvania Regional Hospital)
5:30–7 p.m. Monday, June 17, at Transylvania County Library, 212 Gaston St. Brevard
Highlands/Cashiers Meeting (Highlands-Cashiers Hospital)
5:30–7 p.m. Tuesday, June 18, location to be determined
Macon County Meeting (Angel Medical Center)
5:30–7 p.m. Thursday, June 20, at Robert C. Carpenter Room, Macon County Community Facilities Building, 1288 Georgia Road, Franklin