Attorney General Jeff Jackson agrees with the findings of an independent monitor that HCA may be in violation of its purchase agreement of Mission Health, the dominant hospital system in Western North Carolina.
This marks the most recent step in a process designed to hold HCA — the largest hospital corporation in the nation — accountable here in North Carolina.
For-profit HCA purchased the formerly nonprofit Mission Health for $1.5 billion in 2019. In allowing the acquisition, the attorney general’s office placed key stipulations on the purchase, to which HCA agreed. That $1.5 billion resulted in the formation of Dogwood Health Trust, which is tasked with monitoring whether HCA abides by those stipulations. It contracts with an independent monitor, currently Affiliated Monitors, to do so.
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For the second year running, Dogwood has found potential violations of the terms of the purchase agreement. The central issue is the degradation of emergency and oncology services as a result of staffing shortages.
It’s no surprise Jackson agrees with this finding, since that diminished care is the topic of a lawsuit from his very office. It was filed during Gov. Josh Stein’s tenure as attorney general, but Jackson stands behind it.
“I know HCA was hopeful that a new attorney general would drop our office’s lawsuit,” Jackson said in a statement earlier this year. “I am the attorney general, and that’s not going to happen.
“HCA broke the promises it made to provide emergency and cancer care services to the people of Western North Carolina. We’ll keep fighting for this case as long as it takes to restore the health care HCA promised to provide and western North Carolinians deserve.”
As long as Jackson’s lawsuit accusing Mission Health of failing to maintain emergency and cancer care services is active, HCA will continue to be found in potential noncompliance. Dogwood Health Trust doesn’t feel it can deliver an opinion on ongoing litigation — that’s the job of the North Carolina Business Court.
The next expected milestone in the case is the deadline for expert discovery on Sept. 15.
Those who oppose HCA’s handling of Mission Health welcomed Jackson’s decision.
One such entity is Reclaim Healthcare, a coalition of physicians, nurses, elected officials, business leaders, clergy and advocates whose goal is to replace HCA Healthcare as owner of Mission Health with a nonprofit hospital system, as Mission Health was prior to HCA’s acquisition.
“Reclaim is glad that the attorney general agrees with the assessment from not only Dogwood Health Trust, but also the independent monitor, that HCA is not in compliance with the purchase agreement,” Aaron Sarver, spokesperson for the coalition, told Carolina Public Press.
“We appreciate (Jackson’s) continued advocacy for our community members in Western North Carolina.”
Now, Dogwood Health Trust and HCA will sit down and discuss how they can remedy these issues in a process called specific performance.
“The only remedy under the asset purchase agreement is what we refer to as specific performance,” Dogwood Health Trust’s attorney Rachel Ryan said. “It’s about working with HCA to get them back into compliance. There’s no monetary penalties or anything like that.”
If Dogwood and HCA are unable to come to a resolution through dialogue, then Dogwood has the right to move toward resolution through the courts, adding to the web of litigation surrounding the beleaguered hospital system.
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