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Independent Monitor

Beyond community investments in the health and well-being of Western North Carolina, one of Dogwood Health Trust’s roles is to ensure that HCA remains in compliance with the terms it agreed to when it purchased the assets of Mission Health System, also called the Asset Purchase Agreement (APA).

In April 2024, Dogwood engaged the services of Affiliated Monitors, Inc. (AMI) to serve as the current Independent Monitor (IM). AMI helps Dogwood collect community feedback and evaluate HCA’s compliance. They prepare an annual monitoring report that, if necessary, identifies areas of potential non-compliance with the APA. Any areas of potential non-compliance are shared with the Attorney General.

You can access annual compliance statements, notices to the Attorney General and monitoring reports from each calendar year on this page.

From 2019 to 2022, Dogwood published compliance statements because the monitoring reports contained protected information. After 2023, Dogwood requested that the IM produce a monitoring report that could be shared publicly alongside compliance statements. As a result, you’ll find additional documents available for that year and beyond.

Helpful FAQs are also available at the bottom of this page. 

Frequently Asked Questions

Dogwood is completely independent from HCA, and HCA has no control or influence over Dogwood, its assets or its community investments.

Affiliated Monitors, Inc. serves as the Independent Monitor.

The Independent Monitor is a highly qualified firm that helps monitor HCA’s compliance with the promises it made when it acquired the assets of Mission Health System. 

Find out more.

Several organizations work with the Independent Monitor to ensure HCA honors its obligations:

  • Dogwood Health Trust
  • An Asheville Advisory Board that focuses on Mission’s Asheville campus and CarePartners
  • Five local advisory boards that focus on Angel Medical Center, Blue Ridge Regional Hospital, Highlands-Cashiers Hospital, Mission McDowell Hospital, and Transylvania Regional Hospital. 
  • The North Carolina Attorney General (NCAG)

Each year, the Independent Monitor reviews reports from HCA and participates in hospital visits to become familiar with HCA’s operations. The Independent Monitor also engages with local community members throughout the year who want to share concerns or feedback related to compliance issues via their website and through individual, small group or community meetings.

HCA provides an annual report about their compliance for the preceding calendar year at the end of April to the Independent Monitor. From May to July, the Independent Monitor reviews the report and accompanying data to monitor and evaluate HCA’s compliance for that preceding calendar year, producing a Monitoring Report in July for Dogwood. If there are findings of potential noncompliance, Dogwood or the Attorney General will notify HCA in October. This timeline is also available on the IM’s website.

Independent Monitor 

Email:  [email protected]

In addition to contacting the Independent Monitor, there are more resources for community members to contact. 

Mission Health’s Office of Patient Experience

For reporting concerns directly to Mission Health
Phone: 828-213-1210  

NC Division of Health Service Regulation

By Phone: 1-800-624-3004 (within NC) or 919-855-4500 (Hotline Hours: 9:00 a.m. – 12:00 p.m. and 1:00 p.m. – 4:00 p.m. weekdays, except holidays)

By Fax:  919-715-7724

By Mail: Complaint Intake Unit, 2711 Mail Service Center, Raleigh, NC 27699-2711

The Joint Commission

The Joint Commission reviews concerns about patient safety.
Phone: 800-994-6610    Email: [email protected]

Centers for Medicare and Medicaid Services

For complaints about HIPPA (patient privacy)

Phone: 1-800-MEDICARE

If the Independent Monitor, the applicable advisory board and HCA cannot come to an agreement about a change in HCA’s obligations, then Dogwood Health Trust will attempt to resolve any dispute. If the dispute cannot be resolved, Dogwood Health Trust may choose to pursue the matter through the courts.

Dogwood Health Trust pays for the Independent Monitor’s services.