Updates
Here's a list of updates from the Independent Monitor team.
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2023
MACON COUNTY AND HIGHLANDS-CASHIERS COMMUNITY MEETINGS
Regarding Angel Medical Center and Highlands-Cashiers Hospital
November 1 and 2, 2023, Independent Monitor
Two community meetings with the Independent Monitor for Mission Health System were held across Macon County last week. The first meeting, regarding Angel Medical Center, took place on November 1st at the Macon County Library in Franklin. The second meeting, regarding Highlands-Cashiers Hospital, took place on November 2nd at the Cashiers/Glenville Recreation Center. This was the third and fourth in a series of six community meetings planned to be held by the Independent Monitor in the areas served by Mission Health.
Following a brief presentation providing a “refresher” on HCA’s commitments under the purchase agreement, attendees were invited to share comments and/or questions which were addressed by Independent Monitor representative, Ronald Winters.
Caption: Ronald Winters from the Office of the Independent Monitor presents to members of the
community at the Macon County Library on November 1st.
Photo Credit: WLOS staff

Handouts were provided to participants including a summary of the 15 Commitments, and a Healthcare Reporting Resource Guide to help guide the public toward organizations empowered to address concerns that fall outside the scope of the 15 Commitments.
Community members, including those not able to attend, are encouraged to participate in upcoming meetings, view downloadable meeting materials and transcript (when available), and contact the Independent Monitor team with any additional questions or feedback to share.
BUNCOMBE COMMUNITY MEETING
Regarding Mission Hospital, CarePartners,
and Mission Children's Hospital
October 19, 2023, Independent Monitor
The Independent Monitor team from
GibbinsAdvisors met with approximately 50
members of the local community at The
Scenic Hotel in Asheville, on October 19th.
This was the second in a series of six
community meetings planned to be held by
the Independent Monitor in the areas served
by Mission Health.
Following a brief presentation providing a “refresher” on HCA’s commitments under the purchase agreement, attendees were invited to share comments and/or questions which were each addressed by Independent Monitor representative, Ronald Winters. Handouts were provided to participants including a summary of the 15 Commitments, and a Healthcare Reporting Resource Guide to help guide the public toward organizations empowered to address concerns that fall outside the scope of the 15 Commitments.
Community members including those not able to attend are encouraged to participate in upcoming meetings, view downloadable meeting materials and transcript (when available), and contact the Independent Monitor team with any additional questions or feedback to share.

Photo Credit: Starr Sariego, AVL Watchdog
Caption: Dr. Robert Kline, a former member of Mission Hospital's Board of Directors before the purchase, read the letter Thursday night at a public meeting hosted by the Independent Monitor.

Photo Credit: WLOS News 13
Caption: Independent Monitor representative, Ronald Winters, meets with members of the Buncombe County community.
TRANSYLVANIA COMMUNITY MEETING
Regarding Transylvania Regional Hospital
October 17, 2023, Independent Monitor
The Independent Monitor team from Gibbins Advisors met with members of the local community at Brevard Music Center’s Thomas Concert Hall, on October 17th. This was the first in a series of six community meetings planned to be held by the Independent Monitor in the areas served by Mission Health.
Following a brief presentation providing a “refresher” on HCA’s commitments under the Asset Purchase Agreement, attendees were invited to present comments and/or questions which were each addressed by Independent Monitor representative, Ronald Winters. Opportunity was also offered to the community to participate in breakout sessions to share concerns with the Independent Monitor team regarding HCA’s 15 Commitments or to review the Resource Guide to enable the public to connect with organizations empowered to address concerns outside the scope of the 15 Commitments.
Community members including those not able to attend are encouraged to participate in upcoming meetings, view downloadable meeting materials and transcript (when available), and contact the Independent Monitor team with any additional questions or feedback to share.

Photo credit: Gibbins Advisors, LLC
Caption: Brevard community member engaging Independent Montor representative Ronald Winters
COMMUNITY MEETINGS
October and November 2023, Independent Monitor
Public meetings led by Gibbins Advisors have been scheduled across October and November in several communities in Western North Carolina served by Mission Health System. The first four meetings will be related to (1) Transylvania Regional Hospital (Transylvania County), (2) Mission Hospital, CarePartners and Mission Children’s Hospital (Buncombe County), (3) Angel Medical Center (Macon County), and (4) Highlands-Cashiers Hospital.
Two additional meetings related to Mission Hospital McDowell (McDowell County) and Blue Ridge Regional Hospital (Mitchell County) will be scheduled in early 2024 (details to be released later).
Gibbins Advisors is the Independent Monitor (IM) hired to monitor HCA Healthcare’s compliance with the obligations HCA agreed to when it purchased Mission Health System. In each meeting, the IM team will discuss its role, provide an update on HCA’s 15 commitments, and provide an opportunity for the audience to ask questions.
All events are open to the public based on availability. Registration is strongly encouraged and available at the following link. Questions for the Independent Monitor can be submitted in advance using this same link or can be emailed to IndependentMonitor@gibbinsadvisors.com.
The meetings are open to all members of the public. The community meetings will not be held at the respective hospitals, please note below the meeting locations and details. Doors will open 30 minutes before each event.
Interested parties are encouraged to check the Independent Monitor website for updates: www.independentmonitorMHS.com.
Please see the Events page to register and view meeting dates and location details.

Independent Monitor representative Ronald Winters joined Dogwood Health Trust Board Chair Jack Cecil, Covenant Compliance Committee Chair Martha Tyner, CEO Susan Mims and General Counsel Rachel Ryan to tour Mission’s new Sweeten Creek Mental Health and Wellness Center as it prepares to accept patients.
Mission Behavioral Health Services Chief Operating Officer Melina Arrowood led the tour with HCA North Carolina Division President Greg Lowe on hand. The “Behavioral Health Hospital Project” was a specific undertaking under the Asset Purchase Agreement (Section 7.14(e)(iii) for those following in detail).

TOUR OF SWEETEN CREEK MENTAL HEALTH AND WELLNESS CENTER
September 2023, Independent Monitor
INDEPENDENT MONITOR MEETS WITH THE OFFICE OF THE NC ATTORNEY GENERAL
August 2023, Independent Monitor
TOURS OF HOSPITAL SITES (below)
May 2023, Independent Monitor

At Mission Hospital McDowell, we visited the operating rooms.
At the main Mission Hospital Main Campus, we toured various areas of the hospital, including the Cancer Center, Labor & Delivery Wing, Mother-Baby Unit, Pharmacy, and the Asheville Orthopaedic Associates Center.
At the new Angel Medical Center facility, we toured the new heliport for the MAMA team. Mountain Area Medical Airlift (MAMA) currently provides air medical services to 18 western North Carolina counties, eastern Tennessee, northeast Georgia, and northern South Carolina.
At CarePartners Rehabilitation Hospital, we toured the area of the hospital undergoing renovation and expansion. We saw the “refreshed” areas throughout the older space.
We conduct site visits at least annually and it is always helpful to tour the facilities and meet with local citizens and officials as one component of the information we gather as part of our compliance monitoring process.
To learn more about our process, click here or if you'd like to connect, please contact us.
Together with Dogwood Health Trust, the Independent Monitor team conducted site tours of the key hospital facilities in May 2023. We visited Angel Medical Center, Blue Ridge Regional Hospital, Highlands-Cashiers Hospital, Transylvania Regional Hospital, Mission Hospital McDowell, Mission Hospital’s Main Campus (Biltmore Avenue), Mission Children’s Hospital, and CarePartners Rehabilitation Hospital. During the visits we toured clinical and non-clinical areas of the facilities and sighted major pieces of new capital equipment. We interviewed hospital executives to discuss issues of relevance to HCA's 15 commitments.
We performed a drive-by visit of the construction site of Sweeten Creek Mental Health & Wellness Center. We also performed a drive-by visit of the CarePartners PACE facility to view the newly completed wing.
DOGWOOD HEALTH TRUST ISSUES ITS 2022 ANNUAL REPORT
June 2023, Dogwood Health Trust
HCA ISSUES ANNUAL REPORT AND CAP EX REPORTS to summarize its compliance with certain terms in the Asset Purchase Agreement
April 20, 2023, HCA Healthcare
Revised May 19, 2023
2022
DOGWOOD HEALTH TRUST ISSUES STATEMENT ON HCA COMPLIANCE FOR YEAR 3 REPORTING PERIOD
October 2022, Dogwood Health Trust
DOGWOOD HEALTH TRUST ISSUES STATEMENT ON HCA COMPLIANCE FOR YEAR 2 REPORTING PERIOD
May 2022, Dogwood Health Trust
HCA ISSUES ANNUAL REPORT AND CAP EX REPORTS to summarize its compliance with certain terms in the Asset Purchase Agreement.
April 29, 2022, HCA Healthcare
DOGWOOD HEALTH TRUST ISSUES ITS 2021 ANNUAL REPORT
March 2022, Dogwood Health Trust
2021
MONITORING YEAR 2 OF HCA'S COMPLIANCE WITH ITS 15 COMMITMENTS
May 3, 2021, Op-Ed by Ronald M. Winters
HCA ISSUES ANNUAL REPORT AND CAP EX REPORTS to summarize its compliance with certain terms in the Asset Purchase Agreement.
April 30, 2021, HCA Healthcare
INDEPENDENT MONITOR COMMUNITY WEBINAR TRANSCRIPT
April 7, 2021, Transcript
2020
HCA ISSUES AMENDED & RESTATED CAP EX REPORT to summarize its compliance with certain capital expenditure requirements in the Asset Purchase Agreement.
July 10, 2020, HCA Healthcare
HCA ISSUES ANNUAL REPORT AND CAP EX REPORTS to summarize its compliance with certain terms in the Asset Purchase Agreement.
April 30, 2020, HCA Healthcare
POST-COMMUNITY MEETING INDEPENDENT MONITOR UPDATE
February 24, 2020 - Article by Ronald M. Winters of Gibbins Advisors
MISSION HEALTH'S INDEPENDENT MONITOR HAS OFFICIALLY STARTED. WHAT YOU SHOULD KNOW: OPINION
February 3, 2020, Asheville Citizen Times - Article by Ronald M. Winters of Gibbins Advisors
INDEPENDENT MONITOR FOR HOSPITAL MERGER GOING PUBLIC IN BIG WAY
January 24, 2020, Carolina Public Press - Includes a quote from Ronald M. Winters of Gibbins Advisors
INDEPENDENT MONITOR OF HCA ANNOUNCES PUBLIC MEETINGS IN 6 WNC COUNTIES
January 15, 2020, Blue Ridge Public Radio