Written by Andrew R. Jones, Asheville Watchdog.
Dogwood Health Trust’s recent announcement that it would open a request for proposals for independent monitoring of HCA Healthcare’s purchase of Mission Health follows “changing needs” after Attorney General Josh Stein sued the hospital corporation last month.
The current monitor, Gibbins Advisors, will continue working for Dogwood “until we have a new independent monitor in place,” Dogwood CEO Susan Mims told Asheville Watchdog on Wednesday.
“As the environment has shifted over these five years so has the work of the IM,” Mims said, referring to the independent monitor. “In response to listening to our communities and through collaboration with the Attorney General’s Office, Dogwood has asked the IM to add responsibilities beyond what is in the current scope of work.”
Dogwood’s announcement was first reported by WLOS-TV on Tuesday. The trust is responsible for overseeing HCA Healthcare’s compliance with terms of the $1.5 billion Mission Health sale in 2019 as required by the attorney general.
As stated on its website, Dogwood is completely independent from HCA and HCA has no control over Dogwood or its assets. Most of Dogwood’s work centers on investing in health and wellness research and project funding.
Proposals are due by Feb. 6 and the new contract will start April 1, according to Dogwood’s request for proposals.
“Dogwood told us they would start a Request for Proposal process a few weeks ago but we saw the documentation yesterday for the first time,” Gibbins co-founder and managing director Ronald Winters said Wednesday. “We are reviewing the material now. As indicated on the RFP, proposals are due by February 6th. Of course, we are continuing our Independent Monitors duties now and Dogwood has encouraged us to submit a proposal as part of the RFP process.”
HCA will submit an annual report on compliance to Dogwood and the independent monitor by the end of April.
For much of 2023, Stein, a Democratic candidate for governor, investigated HCA and Mission. He filed a lawsuit on Dec. 14, alleging that HCA has violated at least two of fifteen agreements it made when it purchased Mission, specifically not keeping oncology and emergency care services at Mission Hospital in Asheville at the levels it committed to at the time of the sale.
HCA has yet to file a response to the lawsuit.
The attorney general’s office did not immediately respond to requests for comment on the request for proposals.
Dogwood asked Gibbins to undertake ”additional responsibilities” in 2023 including community engagement and education and engagement with the Attorney General’s Office, Mims said.
These extra activities “exceed those required under the Asset Purchase Agreement (APA),” Mims said.
She would not say how much Dogwood pays Gibbins annually.
“In response to the changing needs of our community and engagement with the Attorney General’s Office, it made sense to revise the scope of work to better accommodate our current and future work,” she said.
Gibbins’ role currently is to “help determine on an ongoing basis if HCA adheres to its commitments which include, but are not limited to: keeping major Mission Health facilities open, continuing to provide certain key services, continuing policies for uninsured and charity care, and making significant capital investment in promised projects and programs,” according to the website Gibbins dedicated to sale oversight.
Along with solicitation for proposals, Dogwood published a seven-page “statement of work” defining exactly what the independent monitor will be expected to do and when. Many of these are similar to duties Gibbins has performed since the Mission sale, including reporting to the attorney general’s office, documenting HCA’s compliance with the sale agreements and engaging with and educating the public.
This includes “During the first year of the IM’s engagement (spring of 2024), hosting, promoting, and organizing 6 in-person information sessions in Buncombe, Highland/Cashiers, Macon, McDowell and Mitchell and Transylvania.”
Gibbins hosted similar events late in four counties, including Buncombe, in 2023 and is set to host two more in early 2024.
For the next five years, the independent monitor, Dogwood, and the attorney general’s office will collaborate on compliance monitoring following a cycle outlined on Gibbins’ website and in the “standard of work.”
“The IM’s role as advisor to Dogwood is critically important to our oversight of HCA’s commitments under the APA,” Mims said in Dogwood’s news release Tuesday. “Dogwood relies on the IM’s ability to evaluate all aspects of compliance with HCA’s commitments including actively engaging with and listening to the community in order to lift up any issues of potential non-compliance.”
Asheville Watchdog is a nonprofit news team producing stories that matter to Asheville and Buncombe County. Andrew R. Jones is a Watchdog investigative reporter. Email [email protected]. To show your support for this vital public service please visit avlwatchdog.org/donate.