News

Mission monitor says HCA failed to comply with purchase agreement

By Lightning Reports, Published: July 30, 2024

Dogwood Health Trust told the North Carolina Attorney General’s Office on Monday that it plans to notify HCA of potential noncompliance with provisions of the Asset Purchase Agreement.

The letter is based on findings from the Independent Monitor’s review as outlined in Affiliated Monitors’ report to Dogwood Health Trust. Both the letter and compliance report are available on Dogwood’s website.

“This past year, we heard requests from both the Attorney General and the communities we serve for more education and transparency regarding Dogwood’s compliance oversight of HCA,” Dr. Susan Mims, CEO of Dogwood Health Trust, said in a news release. “We listened, which is why we are sharing this letter and report. Our hope is that sharing this letter and report will help educate the public on our compliance oversight work for the 2023 reporting year and help Affiliated Monitors engage the public for the upcoming 2024 reporting year.”

The APA requires HCA each year to provide an annual report for the preceding year at the end of April. The report goes to Dogwood Health Trust, the Independent Monitor, the AGO and the Mission Hospital Advisory Board. From May to July, the Independent Monitor reviews the report and accompanying data to monitor and evaluate HCA’s compliance for the preceding year and sends its findings to Dogwood. Ninety days after receiving the annual report from HCA, Dogwood must provide notice to the attorney general's office as to whether they intend to notify HCA of any potential noncompliance.

After carefully reviewing HCA’s 2023 report and with advice from the Independent Monitor, Dogwood intends to notify HCA of three instances of potential noncompliance: the provision of Emergency and Trauma Services and Oncology Services at Mission Health; failure to remain “enrolled and in good standing” in Medicare and Medicaid; and issues with uninsured and charity care policies. Following the process set forth in the APA, in its role as seller representative, Dogwood has notified the AGO and intends to officially notify HCA of potential noncompliance. 

“We hope that our report will inform the communities, provide a greater understanding of the monitoring process and serve as a starting point for further productive discussions to improve the quality of healthcare in Western North Carolina,” said Gerald Coyne of Affiliated Monitors Inc. 

Thirty days after receipt of Dogwood’s letter, the Attorney General has to inform Dogwood if it disagrees with its findings. By October 27, 180 days after receipt of HCA’s Annual Report, Dogwood or the AGO is required to provide notice to HCA of any potential noncompliance. Following delivery of notice to HCA, Dogwood will engage HCA in discussions to address the identified compliance issues. 

In early 2025, Dogwood will share a summary of how issues of noncompliance were addressed and/or resolved.