FAQ

What is the “Independent Monitor” and what is its role?

Gibbins Advisors, a healthcare consulting firm headquartered in Nashville, TN, serves as the Independent Monitor.  As Independent Monitor, we help 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 (the “Local Hospitals”) operating for at least 10 years, and continuing thereafter subject to the occurrence of certain safety or quality issues or other specified contingencies.

  • Continuing specified services at each of these Local Hospitals for 10 years, subject during the 6th through 10th years to the ability of such facility to maintain certain levels of quality and safety.

  • Keeping the Memorial Campus of Mission Hospital, Community CarePartners facilities and Mission Children’s Hospital Reuter Outpatient Center, each located in Asheville, operating and providing specified services in those facilities for at least 10 years and continuing thereafter subject to the occurrence of certain safety or quality issues or other specified contingencies.

  • 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)


We advise ANC (and ultimately Dogwood Health Trust) and six advisory boards on HCA’s compliance, and share responsibility with local advisory boards to evaluate requests to modify HCA’s commitments to local hospitals in certain limited circumstances.

Please see IM scope / HCA’s commitments for more information.


Who works with the Independent Monitor?

Several organizations work with the Independent Monitor to ensure HCA honors its obligations:

  • ANC Healthcare, Inc. (the entity that sold Mission Health System). As ANC works through its wind-down activities, Dogwood Health Trust will eventually assume ANC’s role with regard to the Independent Monitor. 

  • 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 “Local Hospitals”). 

  • An Advisory Board that focuses on Mission’s Asheville campus, CarePartners, and other facilities and services not included as one of the Local Hospitals

  • The North Carolina Attorney General

As Independent Monitor, we are completely independent from HCA and Mission Health System. We are not receiving compensation from HCA and our firm Gibbins Advisors does not do any business with HCA.   

For more information on the roles and responsibilities of each party, please see Advisory Board Structure.


How does the Independent Monitor do its work?

In doing our work, we will review HCA’s annual reports and evaluate HCA’s compliance with its ongoing commitments under the purchase agreement by various forms of monitoring including site visits, discussions with HCA managers and receiving comments and input from the public.

You can review the commitments that fall under our scope on our IM scope / HCA’s Commitments webpage.

If you’d like to submit a question or comment, you can Contact Us using the online form or emailing us at independentmonitor@gibbinsadvisors.com.

How can community members share their feedback?

We are conducting town hall community meetings in the first quarter of 2020 in each of the hospital regions to provide information on our role and to gather feedback from the community.


Please see our Event schedule for more information.

In addition, you can Contact Us using the online form or emailing us at independentmonitor@gibbinsadvisors.com.


What happens if HCA doesn’t 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 ANC Healthcare (the legacy entity that sold Mission Health System) will attempt to resolve any dispute.  If the dispute cannot be resolved, ANC or the Attorney General may choose to pursue the matter through the courts. Dogwood Health Trust will eventually assume ANC’s role in this regard.

Who pays for the Independent Monitor?

ANC Healthcare (the entity that sold Mission Health System) currently pays the Independent Monitor’s services. Dogwood Health Trust will eventually assume ANC’s role in this regard.

As Independent Monitor, we are completely independent from HCA and Mission Health System. We are not receiving compensation from HCA and our firm, Gibbins Advisors, does not do any business with HCA.   

 

©2020 by Gibbins Advisors.