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Independent Monitor

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. 

To learn more about HCA’s obligations under the purchase agreement, click here

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

If you would like to share comments regarding HCA, please click here to connect to the Independent Monitor comments portal.  

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

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.

Gibbins Advisors conducted town hall community meetings in the first quarter of 2020 in each of the hospital regions to provide information on its role and to gather feedback on concerns or issues related to compliance matters under its scope.

Community members can continue to share comments about HCA through the Independent Monitor’s online portal at

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.

Read our latest statement about HCA’s compliance.