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Residents of Mitchell and Yancey County express their concerns to the Independent Monitor



When members of SEARCH attended the Burnsville session of the Independent Monitor’s meeting to hear public comments about how things are going with our local hospital, Blue Ridge Regional Hospital (BRRH), as well as Mission Hospital in Asheville and other Mission facilities in the region, we expected to hear concerns about access to the charity care policy, concerns about whether services will continue to be available here, concerns about safe staffing levels and negative feedback from medical personnel. What we did not expect to hear was that in some cases patient’s rooms and bathrooms are not being cleaned, patients aren’t being bathed, patients are leaving the hospital with insufficient guidance about their care, and that patients have actually given up treatment because they are so tired of fighting with the billing offices about their bills.  To be clear, most of these issues were with the Mission Hospital in Asheville  The BRRH Emergency Department in particular was praised by several speakers as being excellent. About 100 people attended the meeting at the Burnsville Town Center on February 13, in which Ron Winters, co-founder of Gibbins Advisors explained what the role of the Independent Monitor (IM) is, and then patiently listened to the stories from the crowd.  BRRH itself was represented by its new Chief Executive Officer and Chief Nursing Officer, Dr. Tonia Hale, two members of its Board of Trustees, Alex Glover and Darla Harding, and a handful of other employees. So what is the role of the Independent Monitor?  The best description we have found is on the Dogwood Health Trust’s website. One important part of understanding the roles played by the various parties is described in those materials.  The IM is initially working with ANC Healthcare, Inc. (the company that is winding down the former Mission Health System). As ANC works through its wind-down activities, Dogwood Health Trust will eventually assume ANC’s role with regard to the Independent Monitor. Mr. Winters indicated that he speaks with HCA at least every other week. The Burnsville meeting was the last of seven regional meetings that have occurred.  Mr. Winters indicated that each of these meetings was taped, and that they will be creating a transcript of the meetings to be provided to his client.  The attendees asked if the public, too, could receive a copy of the transcript and he indicated he would have to receive permission from his client before doing so. Based on the agreement signed between HCA and Mission Health System, there will be an annual report of compliance created by Dogwood Health Trust which will be posted on their website.  SEARCH will let the public know as soon as it, and hopefully the meeting transcript, is available. If you missed the meeting, here are three ways that you can report a concern or issue:

One of the questions raised by the attendees was how  the agreement between HCA and Mission Health System would be enforced.  The agreement, known as the Amended and Restated Asset Purchase Agreement, does have guidance about legal enforcement, which was summarized by the Attorney General’s announcement with these words:


  • HCA agreed that the promises listed in this document can be enforced not only by Mission or Dogwood, but also by the Attorney General.

  • North Carolina law will apply to HCA’s key promises in the event of a legal dispute.

  • If there is legal conflict over HCA’s key promises, the case will go to North Carolina Business Court instead of arbitration.

Anthony Chiang, the Chief Executive Officer of the Dogwood Health Trust, has had experience in pursuing a legal conflict with the buyer of a hospital system over failure to uphold their charity care policy.  In October 2019, the Empire Health Foundation in Washington state, Chiang’s previous employer, announced a $72 million settlement of its lawsuit against Community Health Systems, Inc.


Read the Empire Health Foundation Settlement Press Release

During the Burnsville meeting, Victoria Hicks of SEARCH said that in some cases the issues being discussed could be reported to the North Carolina Division of Health Service Regulation by calling 1-800-624-3004.  Their website also says complaints can be mailed or faxed.  Here is the link to that information. It was encouraging that Mr. Winters said that if the IM receives a concern that is not within the scope of the IM’s role, it will be re-directed it to the appropriate organization. During the meeting some of the comments were about issues that the speakers felt should have been resolved before the sale of the hospital.  SEARCH’s position is that we, along with other groups across western North Carolina and many elected officials, did everything we could to study the agreement, request improvements, and in almost all cases all the improvements were incorporated into the final agreement.  Now is the time for us all to work with our local hospital, its Advisory Board, the Independent Monitor and the Attorney General’s office to report issues and provide supporting information about those issues.  It is crucial for both Mitchell and Yancey County to continue to have BRRH hospital here. Both of our local newspapers provided coverage of the event, and there has been a lot of coverage of the other 6 meetings in our region. Another post is coming soon with links to those articles. At the next SEARCH meeting on March 10 an agenda item will be how to respond to concerns expressed at the IM meetings. Please join us in working together to promote safe, quality, affordable and LOCAL healthcare for our communities.


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