The team at Gibbins Advisors wants to hear every complaint raised about Mission Health — but they can only call noncompliance on concerns directly tied to the 15 core commitments HCA Healthcare agreed to uphold when the hospital conglomerate purchased the Mission system in 2019, the consultants stressed throughout an April 7 webinar.
Gibbins Advisors is the independent monitor hired by nonprofit Dogwood Health Trust to ensure HCA makes good on commitments outlined in the Mission Health system sale contract. Among the conditions outlined in the transaction agreement, HCA promised to continue emergency, surgical and acute medical services at Asheville’s Mission Hospital and its five regional facilities for at least 10 years.
The Gibbins team, which operates independently from Mission Health and HCA, is carefully watching for any sign of violation, explained Ronald Winters, one of the firm’s principal consultants. In their first year as independent monitor, the consultants did not find any evidence of noncompliance with the terms of the contract.
The annual review process for year two is about to jump into overdrive. HCA is expected to release its second annual and capital expenditure reports at the end of April, at which point the Gibbins team will begin analyzing the document, along with any additional supporting evidence. Engagement sessions with key stakeholders — including physicians, local government officials, community organizations, hospital advisory boards and the Dogwood Health Trust — will occur in May and June. A final compliance evaluation report will be sent to DHT by the end of August.
COVID-19 has hampered the independent monitor’s in-person engagement with community members, Winters noted. More than 600 people attended seven in-person informational sessions last winter, just weeks before the pandemic stay-at-home orders went into place. Strict visitation policies at area hospitals meant the Gibbins team could not visit Mission facilities for on-site updates during the past year, he added, but he plans to visit several of the facilities this spring.
Gibbins staff spent the second half of the two-hour webinar answering questions submitted by community members. Comments ranged from physician retention and facility cleanliness to transparency around HCA’s Charity Care policy.
Many of the community concerns expressed likely fall under the authority of regulatory and government bodies that assess the quality of care in hospital settings, said Tom Urban, a former hospital CEO and member of the Gibbins team. However, the independent monitor is looking for both direct and indirect violations of HCA’s commitments, Winters said, noting there’s a chance concerns around staffing could ultimately impact the services a hospital is able to provide.
Last year, the firm received 263 reports from community members; each comment was logged, anonymized and shared with HCA and hospital leadership. The team is also following the Facebook group Mission Maladies, said Clare Moylan, another principal advisor.