--- title: "Independent Monitor - Dogwood Health Trust" canonicalUrl: "https://dogwoodhealthtrust.org/about/independent-monitor/" excerpt: "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 […]" metaDescription: "Learn how Dogwood and the Independent Monitor oversee HCA compliance. Access reports and see how you can give feedback or raise concerns." datePublished: "2020-01-15T14:23:33-05:00" dateModified: "2026-07-24T10:09:54-04:00" --- - Independent Monitor - Dogwood Health Trust ** # 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. [Learn about HCA’s 15 Commitments in the APA](https://dogwoodhealthtrust.org/wp-content/uploads/2025/07/15-Commitments-Slide-for-web.pdf) 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.  [Contact the Independent Monitor](https://independentmonitormhs.com/) #### HCA Compliance Documents Most Recent Monitoring Year – Calendar Year 2025 – Year 7 [** Notice to the Attorney General’s Office for Calendar Year 2025 - July 22, 2026](https://dogwoodhealthtrust.org/wp-content/uploads/2026/07/2026_07_22_Notice-to-AG_Annual-Report_FINAL2.pdf) [** Affiliated Monitors' Annual Monitoring Report to Dogwood Health Trust for 2025](https://dogwoodhealthtrust.org/wp-content/uploads/2026/07/Independent-Monitor-Report-Cycle-7-CY-2025.pdf) #### Previous Year Archive Calendar Year 2024 – Year 6 [Notice to the Attorney General’s Office for Calendar Year 2024 – July 29, 2025](https://dogwoodhealthtrust.org/wp-content/uploads/2025/07/2025_07_29_Notice-to-AG_Annual-Report_FINAL.pdf) - [Affiliated Monitors’ Annual Monitoring Report to Dogwood Health Trust for 2024](https://dogwoodhealthtrust.org/wp-content/uploads/2025/07/IM-Monitoring-Report-Calendar-Year-2024-final.pdf) - [Compliance Statement for Calendar Year 2024](https://dogwoodhealthtrust.org/wp-content/uploads/2026/02/DHT-Compliance-Statement-Year-6-Calendar-Year-2024.pdf) Calendar Year 2023 – Year 5 - [Notice to the Attorney General’s Office for Calendar Year 2023 – July 29, 2024](https://dogwoodhealthtrust.org/wp-content/uploads/2024/07/DHT-Notice-to-AGO_Annual-Report_Public.pdf) - [Affiliated Monitors’ Annual Monitoring Report to Dogwood Health Trust for 202](https://dogwoodhealthtrust.org/wp-content/uploads/2024/07/IM-Annual-Report-Compliance-Evaluation-2023_FINAL.pdf)3 - [Compliance Statement for Calendar Year 2023](https://dogwoodhealthtrust.org/wp-content/uploads/2025/07/Compliance-Statement-Year-5-Calendar-Year-2023-final.pdf) Calendar Year 2022 – Year 4 - [Notice to the Attorney General’s Office for Calendar Year 2022 – July 27, 2023](https://dogwoodhealthtrust.org/wp-content/uploads/2025/07/2023_07_27_DHT-Notice-to-NCAG-Annual-Report-V3.1-002.pdf) - [Compliance Statement for Calendar Year 2022](https://dogwoodhealthtrust.org/wp-content/uploads/2023/12/DHT-HCACompliance1123-3.pdf) Calendar Year 2021 – Year 3 - [Notice to the Attorney General’s Office for Calendar Year 2021 – July 28, 2022](https://dogwoodhealthtrust.org/wp-content/uploads/2025/07/2022_07_28_DHT-Notice-to-NCAG-Pursuant-to-APA-Section-7.17b-FY-2021-_FINAL.pdf) - [Compliance Statement for Calendar Year 2021](https://dogwoodhealthtrust.org/wp-content/uploads/2022/10/PDF_Dogwood-Statement-on-HCA-Year-3-Compliance_FINAL_103122.pdf) Calendar Year 2020 – Year 2 - [Notice to the Attorney General’s Office for Calendar Year 2020 – July 21, 2021](https://dogwoodhealthtrust.org/wp-content/uploads/2025/07/2021_07_21_Dogwood-Notice-to-NCAG-Pursuant-to-APA-Section-7.17b-FY-2020.FINAL_.pdf) - [Compliance Statement for Calendar Year 2020](https://dogwoodhealthtrust.org/wp-content/uploads/2022/05/Dogwood-Statement-on-HCA-Compliance.docx.pdf) Calendar Year 2019 – Year 1 - [Notice to the Attorney General’s Office for Calendar Year 2019 – Aug. 26, 2020](https://dogwoodhealthtrust.org/wp-content/uploads/2025/07/2020_08_26_DHT-Letter-to-AGs-Office-RE_-2019-Annual-Report.pdf) - [Compliance Statement for Calendar Year 2019](https://dogwoodhealthtrust.org/wp-content/uploads/2024/02/Yr-1-Statement.pdf) ## Frequently Asked Questions ** ** What is the relationship between Dogwood Health Trust and HCA? Dogwood is completely independent from HCA, and HCA has no control or influence over Dogwood, its assets or its community investments. ** ** What is the “Independent Monitor” and what is its role? 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.](https://dogwoodhealthtrust.org/wp-content/uploads/2024/05/DHT-15Commitments0424-1.pdf) ** ** Who works with 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 (NCAG)*** ** ** How does the Independent Monitor do its work? 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](https://independentmonitormhs.com/?page_id=902). ** ** How can community members share their feedback? [Independent Monitor](https://www.independentmonitormhs.com/)  Email:  [[email protected]](/cdn-cgi/l/email-protection) In addition to contacting the Independent Monitor, there are more resources for community members to contact.  [Mission Health’s Office of Patient Experience](https://missionhealth.org/my-mission-experience/) For reporting concerns directly to Mission Health**Phone: 828-213-1210   [NC Division of Health Service Regulation](https://info.ncdhhs.gov/dhsr/ciu/index.html) 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](http://www.jointcommission.org/) The Joint Commission reviews concerns about patient safety. Phone: 800-994-6610    Email: [[email protected]](/cdn-cgi/l/email-protection#4625292b362a272f2832062c292f283225292b2b2f35352f292868293421) [Centers for Medicare and Medicaid Services](https://www.cms.gov/Regulations-and-Guidance/Administrative-Simplification/Enforcements/FileaComplaint) For complaints about HIPPA (patient privacy) Phone: 1-800-MEDICARE ** ** What happens if HCA does not honor the agreement? 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. ** ** Who pays for the Independent Monitor’s work? 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