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Independent Monitor

Dogwood Health Trust is completely independent from HCA, and HCA has no control over Dogwood or its assets. In addition to investing in the health and wellness of our region, 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. We have engaged the services of an Independent Monitor, Gibbins Advisors, to help us collect and evaluate comments about HCA’s compliance. 

Learn more about HCA’s obligations under the purchase agreement.

You can review HCA’s most recent annual report on the Independent Monitor website. 

You can share comments regarding HCA on the Independent Monitor comments portal.  

To learn more about the Independent Monitor’s role, please see below.

HCA Compliance Statements

Read our latest statement about HCA’s compliance.

Dogwood Health Trust’s request for submissions of proposals to provide Independent Monitor Services is now closed.

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. Among those promises are: 

  • Keeping Angel Medical Center, Blue Ridge Regional Hospital, Highlands-Cashiers Hospital, McDowell Hospital and Transylvania Community Hospital operating for 10 years, and continuing all existing services for five years
  • Completing the new tower on Mission’s Asheville campus (complete)
  • Building a 120-bed inpatient behavioral health hospital in Asheville
  • Constructing a new facility for Angel Medical Center
  • Implementing an agreed-upon policy of uninsured and charity care at all hospitals
  • Investing $232 million in general capital expenditure within five years
  • Spending $750,000 per year for 10 years in Community Contributions
  • Providing $25 million over 5 years in an innovation/investment fund to invest in businesses located in western North Carolina that provide innovations in the delivery of health care
  • Continuing the graduate medical education program
  • Continuing long-term acute care services at the St. Joseph campus of Mission Hospital for two years 
  • Continuing Mission’s community activities, services and programs for at least 12 months (complete)

Gibbins Advisors, a healthcare consulting firm headquartered in Nashville, TN, serves as the Independent Monitor.  

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

The Independent Monitor visits all hospitals to become familiar with their operations and reviews regular reports from HCA. HCA also shares these reports will all of the organizations listed above. In addition, the Independent Monitor offers an avenue for WNC residents to share any concerns or feedback related to compliance issues.


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

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

 

Mission Health’s Office of Patient Experience

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

NC Division of Health Service Regulation

Complaint Intake is available to receive complaints regarding the care and services provided to patients/residents/consumers by health care facilities/agencies/homes licensed by the Division of Health Service Regulation.

Phone: (in-state) 1-800-624-3004; (out-of-state) 919-855-4500

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 currently pays for the Independent Monitor’s services.

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Health & Wellness | Goal 4

Increase Access to Behavioral Health and Substance Use Prevention and Treatment

Support programs and networks that reduce deaths, treat addiction, and prevent first use

Objective 4.1: Reduce opioid overdose mortality throughout the region

Objective 4.2: Reduce untreated behavioral health and substance use disorder in disproportionately affected communities

Objective 4.3: Prevent and reduce behavioral health issues and substance use (tobacco, alcohol, illicit and prescription drugs) in youth

Health & Wellness | Goal 3

Address Health Disparities

Help reduce disparities based on race, location, education and income factors

Objective 3.1: Improve health outcomes for women and infants in rural and low-income communities and communities of color

Objective 3.2: Reduce the prevalence of common chronic health diseases in disproportionately affected communities

Objective 3.3: Increase effectiveness of health care through delivery of culturally aligned services

Health & Wellness | Goal 2

Increase Access to Whole-Person Health Care

Invest in integrated heath care with seamless connections to supportive services

Objective 2.1: Increase the number of people with affordable health insurance coverage

Objective 2.2: Increase the available workforce for primary and allied health care services

Objective 2.3: Increase access to comprehensive and integrated care

Objective 2.4: Increase access to community-based services in low-income, elderly and rural communities

Health & Wellness | Goal 1

Support and Build Healthy Communities

Support communities that promote healthy living and resiliency and help mitigate the impact of trauma, isolation and stress on individuals and families, especially those experiencing poverty

Objective 1.1: Decrease adverse experiences (ACEs and traumatic violence) and improve individual and family resiliency

Objective 1.2: Increase access to community environments that promote healthy living and social connectedness across the age continuum

Economic Opportunity | Goal 4

Foster Entrepreneurship

Support a well-funded, sustainable, competitive entrepreneur and small business ecosystem throughout the region

Objective 4.1: Increase the number of Person of Color (POC)-led small businesses throughout the region

Objective 4.2: Increase the number of rural small businesses throughout the region

Economic Opportunity | Goal 3

Build Economic Ecosystems

Help build a regional economic ecosystem that supports increased creation/retention of jobs and business ownership

Objective 3.1: Improve access to higher-paying jobs throughout the region, targeting the lowest income populations

Objective 3.2: Increase and retain quality jobs

Objective 3.3: Stimulate economic growth, catalyzing businesses and revenue

Economic Opportunity | Goal 2

Promote Work Readiness

Help build a skilled workforce with the knowledge and technical abilities to excel in a wide range of industry employment opportunities that provide a competitive, sustainable wage

Objective 2.1: Close the educational attainment gap in WNC, staying on pace with regional and county-specific projections (myFutureNC 2030).

Economic Opportunity | Goal 1

Develop a Comprehensive Data Resource

Source, analyze and share a comprehensive, county-by-county data set that paints a full picture of work readiness, economic development and entrepreneurial needs and opportunities specific to Western North Carolina

Education | Goal 3

Support Higher Education Career Readiness

Work in tandem with Economic Opportunity Strategic Priority to invest in career readiness at the community college and university levels

Objective 4.1: Close the educational attainment gap in WNC, staying on pace with regional and county-specific projections (myFutureNC 2030).

Education | Goal 2

Improve K-12 Education

Support K-12 learning experiences with the resources and sustainability to provide an excellent academic and social-emotional education, so that all students graduate ready for college or career

Objective 2.1: Address teacher workforce challenges

Objective 2.2: Equip families of students to support academic growth and social-emotional health

Objective 2.3: Increase capacity of partners to provide supports and services, particularly for children facing challenges related to poverty, systemic racism, being differently abled or English language learners

Education | Goal 1

Improve Early Childhood Education Ecosystem

Invest in an improved early childhood education ecosystem with the resources and sustainability to provide developmentally appropriate, affordable and accessible education and care to support ages birth to five, so that all children in WNC enter kindergarten ready to learn

Objective: Address early childhood educator workforce challenges

Education | Goal 4

Develop a Comprehensive Landscape Study

Source, analyze and share a comprehensive set of publicly available data that provides a regularly updated, county-by-county picture of access, workforce and student outcomes in early childhood education and K-12 education specific to Western North Carolina

Housing | Goal 5

Use Impact Investments to Create Affordable and Workforce Housing

Loans, guarantees, and other financial tools to leverage funding opportunities

Housing | Goal 4

Create and Preserve Housing Units for Persons Below 50% of the Median Income

Increase affordable housing for lowest-income individuals and families

Objective 4.1: Create rental units for households below 50% of the median income

Objective 4.2: Help families pay no more than 30% of their income on housing

Objective 4.3: Create and preserve communities in a way that is representative of the WNC natural landscape

Housing | Goal 3

Create and Preserve Senior Housing

Support age-appropriate resources in affordable and workforce units, rental and owned

Objective 3.1: Create needed rental and homeownership opportunities for seniors

Objective 3.2: Incorporate supportive services in rental housing developments

Objective 3.3: Increase use of universal design in development

Housing | Goal 2

Create and Preserve Supportive Housing Rental Units

Invest in housing with sustainable supports for physical and mental health and wellbeing

Objective 2.1: Create new supportive housing

Objective 2.2: Preserve existing supportive housing

Objective 2.3: Leverage state and federal funds

Single story home in the midst of being build with 3 volunteers helping.

Housing | Goal 1

Support Healthy and Safe Revitalization Opportunities

Support healthy and safe revitalizations that work against displacement and gentrification, preserve home ownership and create generational wealth.

Objective 1.1: Revitalize Neighborhoods

Objective 1.2: Repurpose existing structures to minimize environmental impact

Objective 1.3: Support home ownership