Week of January 12–18, 2019


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Saturday, January 12, 2019

WEBSITE:  citizen-times.com
AUTHORS:  Carmen Ramos-Kennedy & Risa Larsen
SUBJECT:  For Dogwood Board, Loyalty To Mission is a Liability-Not an Asset 

SUMMARY:  Here’s the task: Help good people see that they may be the wrong people to do good work. That’s the conundrum facing critics of current makeup of Dogwood Health Trust board, which is strongly dominated by Mission Health board members. More to the point, it’s the conundrum facing state Attorney General Josh Stein. Fortunately, because the Mission people who have set up Dogwood are good people, they may come to understand. But it’s tricky, because they’re deeply invested, and they’re no doubt feeling personally – and unfairly – maligned. From their point of view, they are obviously the best people to administer the roughly $1.5 billion that will flow to Dogwood when Mission is sold to HCA. They have years, in some cases decades, of experience overseeing Mission, and they regard Dogwood as its “successor. What’s understandably hard for them to see is that, in this instance, loyalty to Mission can be a liability rather than an asset. Mission is a business that provides a service; Dogwood will disperse money to combat problems like poverty, inadequate education, social isolation and barriers to inclusion and equity. The knowledge and skills required are very, very different.

ADDITIONAL PUBLICATION:
Sunday 1/13/19 The Asheville Citizen-Times

 

Saturday, January 12, 2019

WEBSITE:  mountainx.com
REPORTER: Virginia Daffron
SUBJECT:  Wellness Briefs: Grants boost nonprofits, January health events

SUMMARY:  MAHEC President Daniel Frayne told leaders that the time is right to pursue this initiative, citing as positive factors the strength of the region’s health care system, the opportunities presented by the Dogwood Health Trust — the foundation that would be created as the result of the sale of Mission Health to HCA Healthcare, if the transaction is approved by N.C. Attorney General Josh Stein — and the success of health programs across the region. Mayfield said many nonprofits that receive funding from the city operate on small budgets; those groups could benefit from MAHEC’s leadership and organizational capacity, she said.

 

Saturday, January 12, 2019

WEBSITE:  citizen-times.com
AUTHOR: Victoria Loe Hicks
SUBJECT:  Wary of hearing ‘Mission knows best”? Tell Josh Stein now

SUMMARY:  Mission knows best. That’s the stock answer of Mission’s corporate spokeswoman, Rowena Buffett Timms, and others on the Mission team. Asked any question about the proposed sale to HCA – which will put your family’s health care in the hands of a for-profit corporation that answers to Wall Street – that’s their response: Mission knows best. Often delivered with a patronizing smile and an implied pat on the head. Don’t worry, it’s too complicated for you to understand. Just let the grownups handle it. It will be fine, because Mission knows best. “ …  no outcome would or could ever fully satisfy everyone, particularly those with only a limited understanding of the transaction" (Buffett Timms to the Citizen Times, Nov. 26, 2018). Don’t worry that the sales agreement creates a “local advisory board” for each hospital, whose one and only reason for existing is to cut services or sell or close the hospital – in other words, to override HCA’s so-called “guarantee” of continued services. And don’t worry that Mission and HCA will determine the membership of those boards. “Healthcare is an ever-changing industry … At times, certain services may need to be … discontinued in order to continue providing the highest quality of care close to home for patients” (Buffett Timms to North Carolina Health News, Nov. 29, 2018).

ADDITIONAL PUBLICATION:
Sunday 1/13/19 The Asheville Citizen-Times

 

Sunday, January 13, 2019

WEBSITE: mitchellnews.com
SUBJECT:  SEARCH Meets Jan. 15 in Burnsville

SUMMARY:  SEARCH will inaugurate the new year with a public meeting at 7 p.m. Tuesday, Jan. 15, at the First Baptist Church in Burnsville. While there will be brief reports from the Outreach and Outcomes Committees, the focus of the meeting will be the developing activities around the sale of Mission Health to HCA, including recent resolutions by the towns of Bakersville and Spruce Pine sent to N.C. Attorney General Josh Stein. Sustaining essential services in this rural area is the core mission of SEARCH, and defining what those services should be, became even more critical when a list of only three services for Blue Ridge Regional Hospital was deemed necessary in the Asset Purchase Agreement, which Mission and HCA sent to the Attorney General for approval. SEARCH will review the APA recommendation for Blue Ridge as opposed to for the other hospitals in the Mission Health System and will seek input from attendees on a more complete and accurate list. An Asheville group called Western North Carolina Healthcare Equity was formed this fall, primarily in response to perceived inequities in the establishment of the Dogwood Health Trust. Members of SEARCH have been involved tangentially and will report on the group’s plans and progress.

 

Sunday, January 13, 2019

WEBSITE: mcdowellnews.com
SUBJECT:  Noted neurologist to speak in Marion about Parkinson’s disease

SUMMARY:  The local support group for those living with Parkinson’s disease will feature a noted neurologist from Georgetown University Medical Center at its next meeting. The McDowell County Parkinson’s support group is open to people with Parkinson’s disease and their caregivers. The group meets the third Thursday of each month at 5:30 p.m. in the Mission Hospital McDowell’s community building. The next meeting is Thursday. Dr. Yasar Torres-Yaghi, a physician who specializes in movement disorders and an assistant professor of neurology at Georgetown University Medical Center in Washington, D.C., will come to speak about a new process for treating Parkinson’s disease, said Marlene Spitz with the local group.

 

Sunday, January 13, 2019

WEBSITE: histalk2.com
SUBJECT:  Top News

SUMMARY: The average acquired health system had annual revenue of $409 million in 2018, according to a new Kaufman Hall report on mega-mergers. Seven billion-plus dollar transactions must have skewed the average upward, however. Only 20 percent of those sellers were financially distressed, and 75 percent of the buyers were non-profit health systems anxious to grow. Kaufman Hall lists several reasons that health systems are expanding, all of them involving improving their own business rather than patient care. It notes that the line between for-profit and not-for-profit health systems is blurring, such as HCA’s acquisition of North Carolina-based Mission Health that also involves funding a local non-profit health trust. The country’s largest health system, HCA, operates 178 hospitals with annual revenue of $43 billion. It is focusing on markets where the population is increasing and unemployment is low. Kaufman Hall recommends that health systems expand in markets with high growth or strong demographics, seek strong operational or clinical partners, and increase consumer engagement.

 

Monday, January 14, 2019

WEBSITE: wlos.com
REPORTER: Jennifer Emert
SUBJECT: Final approval still pending, but financials for sale of Mission Health considered fair

SUMMARY: There is another step forward in the purchase of Mission Health System by HCA Healthcare, Inc. The company the attorney general’s office contracted with to consider the financial impact of the deal, Stout, has issued its opinion. In a four-page letter to the Attorney General’s Office, Stout says that based on the financial statements from both Mission Health Systems and HCA, it’s their opinion that as of their dated letter, "the consideration to be received by the company, pursuant to the transaction, is fair, from a financial point of view.” Attorney General Josh Stein has been reviewing the purchase deal since the summer of 2018. According to the AG’s office, the process is still moving forward.

 

Monday, January 14, 2019

WEBSITE: ashvegas.com
REPORTER: Jason Sandford
SUBJECT: Opinion: Stop the sale of Mission Health

SUMMARY: Here’s an opinion piece submitted by John L. Shirey, an adult inpatient clinical social worker at Mission Health who says that Jan. 12 was his last day on the job. “Please know that I have not been fired, I am not under duress, and I am leaving after a five-week notice that I completed on good terms,” he writes. In the opinion piece below, Shirey is referencing the pending sale of Mission Health to HCA Healthcare, a for-profit healthcare company based in Tennessee.  I’m sure you’ve heard: Mission is going for-profit, there will be a foundation, they’re going to pay taxes, it will be good for the community, and the foundation will be the largest in Western North Carolina. I’m sure you have even wondered, how will this effect me? Or maybe, why should I care? Well I can give you one of the many inside perspectives. I have kept silent till now, worried about my job, turning a blind eye to what is happening inside an institution that I believed in, an institution I loved. I completed my graduate degree with a nine-month internship at Mission. I loved the compassionate nature of all the professionals that I worked with, the care for the homeless, the care for the down trodden, the community good, the organization that made you feel like they cared about you, and give you a mission that is worthwhile.

 

Monday, January 14, 2019

WEBSITE: transylvaniatimes.com
AUTHOR: Michele Pilon, President TRH
SUBJECT: Build Resilience in 2019 With Easy Health Shifts

SUMMARY: Most everyone I know, myself included, creates a few New Year’s resolutions each year. Many have to do with taking better care of ourselves, with the end goal of improving our health. Unfortunately, after just a few months elapse, the resolutions are often long forgotten. The simple truth is that drastic changes are less likely to become long-term behaviors; instead, making just minor tweaks is far more realistic. Those tweaks can support our health, renew our spirits and build long-term resilience. Even slight changes in diet, exercise and stress busting help us as we juggle family, work, school, our health and what sometimes seems like an endless list of duties. I recently asked the Transylvania Regional Hospital leadership group to share ideas about the practices they employ to enhance their own health and wellbeing. Not surprisingly, they came up with long list of great tips on everything from incorporating movement into the workday to techniques that promote work-life balance, proving that it can be done.

 

Tuesday, January 15, 2019

WEBSITE: wlos.com
SUBJECT: Attorney General’s Purchase Opinion

SUMMARY: Monday, North Carolina Attorney General Josh Stein released a letter dated Nov. 16, 2018, from Stout Consulting, which had been hired by the AG to review the Mission Hospital sale price. In the letter, Stout said the $1.468 billion sale price “is fair, from a financial point of view.” Stein was not available for comment, but in December he said his office had been inundated with communications from concerned residents and reviewing the sale was his top priority. The AG must approve such a sale from a nonprofit to a for-profit company. In December, Stein said he was still collecting information and the consultant (Stout) was still working on the review.

 

Wednesday, January 16, 2019

WEBSITE: healthexec.com
REPORTER: Amy Baxter
SUBJECT: 2018 M&A market brought out new competitors, strategies

SUMMARY: In 2018, the hot M&A market showed no signs of slowing down, with 90 deals announced during the year, according to a recent report from Kaufman Hall. The healthcare industry’s new market is still shaping up as transactions over the last several years have reshaped the landscape, but several trends have emerged…As health systems look for ways to grow, not-for-profits and for-profits are overlapping more often. HCA’s bid to acquire Mission Health in 2018 is one example of a new blurred line between the for-profit and not-for-profits worlds.

 

Wednesday, January 16, 2019

WEBSITE: citizen-times.com
REPORTER: Mark Barrett
SUBJECT: As NC evaluates Mission-HCA deal, community critics call Dogwood Health Trust secretive

SUMMARY: The organization that will spend millions of dollars annually to improve the health of Western North Carolina residents if a sale of Mission Health wins approval faces concerns about transparency and diversity as a state review of the deal may be nearing a conclusion.  Dogwood Health Trust is set to receive an estimated $1.5 billion from the sale to Nashville, Tennessee-based health care titan HCA Healthcare. That money would be used to make grants to attack societal problems that affect health. A North Carolina Department of Justice spokeswoman says a decision on whether the department will challenge the proposed sale in court should come soon. Some community leaders who were nominated last year to serve on the Dogwood board of directors say they have heard nothing from Dogwood since, and people who have challenged aspects of the sale say Mission and Dogwood have been slow to share information about the sale and Dogwood’s operations. 

 

Wednesday, January 16, 2019

WEBSITE: Mountainx.com
SUBJECT: Attorney General Josh Stein to make announcement on Mission Health Sale

SUMMARY: Attorney General Josh Stein will make a major announcement related to the Mission/HCA transaction today. 

Who: Attorney General Josh Stein                                    

What: Announcement regarding his review of the Mission/HCA transaction 

Where: Murphy-Oakley Recreation Center, 749 Fairview Rd., Asheville, North Carolina 

When: Wednesday, Jan. 16, 3:30 p.m.

 

Wednesday, January 16, 2019

WEBSITE: wlos.com
REPORTER: Kristy Kepley-Steward
SUBJECT: Happening Today: NC Attorney General to make ‘major’ announcement about Mission/HCA sale

SUMMARY: Just announced, North Carolina Attorney General Josh Stein will be in Asheville Wednesday morning to make a “major announcement” concerning the Mission Health-HCA Healthcare deal. In a press release Wednesday, Stein announced the press conference for 3:30 p.m. Wednesday afternoon. On Monday, Jan. 14, 2019, North Carolina Attorney General Josh Stein released a letter dated Nov. 16, 2018, from Stout Consulting, which had been hired by the AG to review the Mission Hospital sale price. In the letter, Stout said the $1.468 billion sale price “is fair, from a financial point of view.”

 

Wednesday, January 16, 2019

WEBSITE: foxcarolina.com
REPORTER: Dal Kalsi
SUBJECT: NC attorney general to speak in Asheville Wednesday on Mission Health-HCA Merger

SUMMARY: North Carolina’s attorney general is expected to speak Wednesday in Asheville on the acquisition of Mission Health by HCA. Mission announced in August 2018 that the hospital system had entered into an agreement for Nashville-based HCA Healthcare to acquire the hospital system. The agreement was sent to North Carolina Attorney General Josh Stein for review. According to the news release, Stein was tasked to “evaluate any effect the transaction could have on market competition, whether HCA Healthcare is paying a fair price for the acquisition and how proceeds resulting from the sale will continue to benefit western North Carolina.” Mission said the deal would allow its hospital system to continue to be managed locally but also give the hospital system access to HCA’s “significant capabilities in operations, capital access, clinical trials, research, predictive modeling, analytics,” mental health treatment options, and advanced geriatric care.

ADDITIONAL PUBLICATIONS:
Wednesday 1/16/19 whkp.com
Thursday 1/17/19 healthleadersmedia.com

 

Wednesday, January 16, 2019

WEBSITE: citizen-times.com
REPORTER: Mark Barrett
SUBJECT: Mission-HCA deal gets key regulatory OK from state Attorney General Stein

SUMMARY: State Attorney General Josh Stein said Wednesday he will allow HCA Healthcare's purchase of Mission Health to go through without a legal challenge after negotiating changes to the deal designed to protect the public. A review by the state Department of Justice, which Stein heads, is expected to be the biggest regulatory hurdle the sale must clear to take effect. Stein had said Dec. 4 that he wanted to ensure the nearly $1.5 billion purchase price is fair, that provisions to keep specific services operating at Mission hospitals once HCA takes over are strong enough and that the foundation to get sale proceeds is representative of Western North Carolina. In announcing his decision, Stein said Dogwood Health Trust, the nonprofit foundation that will get money from a sale, has agreed to make its board more representative of WNC. Critics have said the foundation's board of directors has too few people from outside of Buncombe County and little minority representation. Stein said under changes he negotiated, the Dogwood board must by January 2020 have no more than five members from any one county, and by January 2021 it must have no more than four members from any one county.

ADDITIONAL PUBLICATION: Thursday 1/17/19 The Asheville Citizen-Times

 

Wednesday, January 16, 2019

WEBSITE: highlandsinfo.com
AUTHOR: Patrick Taylor, Mayor of Highlands
SUBJECT: Decision about trees on Main Street to be decided tonight at town board meeting

SUMMARY: Tonight the board will hear from the committee and consider three possible plans. First, the board could approve the plan for planting four trees. Second, they may consider the plan calling for seven trees, or they may decide to put no additional trees on Main Street. In any case, I see this issue being decided tonight. At that special meeting in August the board also discussed the sale of the hospital by Mission to HCA. The board passed a resolution of concerns that I forwarded to the North Carolina Attorney General. It has been a contentious issue, but one that needed careful review. I suspect the Attorney General will approve the sale and conversion very soon. I hope he will have improved certain parts of the agreement that helps assure continued healthcare access for folks in Highlands and Cashiers.

ADDITIONAL PUBLICATION: Thursday 1/17/19 The Highlander

 

Wednesday, January 16, 2019

WEBSITE: highlandsinfo.com
AUTHOR: Jackie Medland
SUBJECT: Community participants wanted for new Highlands-Cashiers Hospital Patient and Family Advisory Council

SUMMARY: January finds many of us thinking about the old habits we need to shed and what we might do differently as we usher in the New Year. Lots of us think about health resolutions, but I am going to ask you to think about a different kind of New Year’s resolution for 2019 – one that centers on being a force for positive change. An important part of providing the best care to this community is gaining feedback from our patients – and acting upon it. A perfect example of this was our recent series of focus groups in which over 30 community members gave their valuable time and thoughts about how we can make our facilities and services even more age-friendly. I appreciate your involvement, and we intend to use your feedback to create a strategic plan for our future – one that will align closely with what you define as our community’s needs.

ADDITIONAL PUBLICATION: Thursday 1/17/19 The Highlander

 

Wednesday, January 16, 2019

WEBSITE: modernhealthcare.com
REPORTER: Shelby Livingston
SUBJECT: HCA-Mission Health deal OK’d by N.C. attorney general

SUMMARY: North Carolina's attorney general approved hospital giant HCA Healthcare's $1.5 billion acquisition of Asheville, N.C.-based Mission Health on Wednesday, after nabbing commitments from HCA meant to protect the state's healthcare industry.  "Access to healthcare is truly a life or death issue," North Carolina Attorney General Josh Stein said in an announcement. "We kept that fact in mind as we conducted our review of this transaction. After extensive negotiations, I am satisfied that this new agreement protects healthcare in western North Carolina, ensures that the full value of Mission's assets will continue to be used for public purposes, and requires that the Dogwood Health Trust will be independent and representative."
Stein said Nashville, Tenn.-based HCA also agreed to enforcement measures that allow the attorney general's office to pursue legal action if the hospital system breaks its commitments, which include providing services at local hospitals for at least 10 years, building new N.C. facilities, and supporting community service programs that Mission supports.

 

Wednesday, January 16, 2019

WEBSITE: foxcarolina.com
REPORTER: Dal Kalsi
SUBJECT: NC attorney general does not object to Mission Health-HCA Healthcare merger

SUMMARY: North Carolina’s attorney general said Wednesday he does not object to the acquisition of Mission Health by HCA. Mission announced in August 2018 that the hospital system had entered into an agreement for Nashville-based HCA Healthcare to acquire the hospital system. The agreement was sent to North Carolina Attorney General Josh Stein for review. According to the news release, Stein was tasked to “evaluate any effect the transaction could have on market competition, whether HCA Healthcare is paying a fair price for the acquisition and how proceeds resulting from the sale will continue to benefit western North Carolina.” Mission said the deal would allow its hospital system to continue to be managed locally but also give the hospital system access to HCA’s “significant capabilities in operations, capital access, clinical trials, research, predictive modeling, analytics,” mental health treatment options, and advanced geriatric care.

 

Wednesday, January 16, 2019

WEBSITE: beckershospitalreview.com
REPORTER: Ayla Ellison
SUBJECT: HCA’S $1.5B Acquisition of Mission moves forward

SUMMARY: North Carolina Attorney General Josh Stein said Jan. 16 he will allow HCA Healthcare's acquisition of Mission Health to go through without a legal challenge, according to the Asheville Citizen Times. The announcement came after a consultant hired by Mr. Stein to review Nashville, Tenn.-based HCA's purchase of Asheville, N.C.-based Mission deemed the $1.5 billion sale price "fair," according to WLOS. Stout Consulting reviewed financial statements from Mission and HCA and determined the sale price "is fair, from a financial point of view," according to WLOS, which cited a letter Stout Consulting sent to the attorney general. A spokesperson for Mission told WLOS the board was pleased with the consultant's conclusion. "The board would never have approved any deal that was not fair or that wasn’t in the best interests of our community," the spokesperson told WLOS. "We are pleased that this has been confirmed, and Mission remains optimistic that the transaction with HCA Healthcare will close at the end of the month." In announcing his decision Jan. 16, Mr. Stein said Dogwood Health Trust, the nonprofit foundation that will get money from a sale, has agreed to changes to its board. Under the changes Mr. Stein negotiated, the board must be "fully and fairly representative of Western North Carolina across all dimensions, including ethnic, gender and geographic dimensions," according to the Asheville Citizen Times, which cited a summary released by the attorney general.

 

Wednesday, January 16, 2019

WEBSITE: wlos.com
REPORTER: Kristy Kepley-Steward
SUBJECT: NC Attorney General ‘does not object’ to Mission/HA deal

SUMMARY: UPDATE: North Carolina Attorney General Josh Stein says he does not object to HCA Healthcare's acquisition of the Mission Health System's assets. "As a result of extensive negotiations with the Attorney General's Office, HCA has strengthened its commitments to provide health care service, the Dogwood Health Trust has agreed to make its board more representative of the communities it will serve and the parties have agreed to enforcement measures that will ensure compliance with this agreement," Stein said in a news release Wednesday. "These commitments will be included in a revised asset purchase agreement and letter agreement." The announcement was made during a news conference in Asheville on Wednesday afternoon. Nashville-based HCA's plans to acquire Mission were announced in March 2018. HCA has 177 hospitals across the country and hopes to add Mission’s six-hospital system to that list.

 

Wednesday, January 16, 2019

WEBSITE: bpr.org
REPORTER: Matt Bush
SUBJECT: North Carolina Attorney General Gives Blessing To Mission/HCA Sale, But With Changes

SUMMARY: North Carolina attorney general Josh Stein will give his blessing to the proposed sale of Mission Health to HCA.  That means Western North Carolina's major health system will go from a non-profit to a for-profit in the coming months.  But before he gave his approval, Stein announced several changes to the proposed sale contract between the two sides after hearing from concerned community members and groups.  Stein made the announcement Wednesday afternoon in Asheville. The changes to the proposed sale contract - called the asset purchase agreement - include extending the timeframe that HCA must keep services at Mission’s current rural hospitals from five to 10 years.  Those hospitals include McDowell Hospital, Angel Medical Center, Blue Ridge Regional Hospital, Highlands-Cashiers Hospital, and Transylvania Community Hospital.   Stein adds HCA would not be able to close any of those facilities in that 10-year time period without the approval of a local advisory board, as well as an independent monitor. 

 

Thursday, January 17, 2019

WEBSITE: mountaineer.com
SUBJECT: N.C. Attorney General signs off on Mission/HCA deal

SUMMARY: Attorney General Josh Stein has no objections to HCA’s acquisition of Mission Health System’s assets. As a result of extensive negotiations with the Attorney General’s Office, HCA has strengthened its commitments to provide healthcare services, the Dogwood Health Trust has agreed to make its board more representative of the communities it will serve, and the parties have agreed to enforcement measures that will ensure compliance with this agreement. These commitments will be included in a revised asset purchase agreement and letter agreement. “Access to healthcare is truly a life or death issue,” said Stein. “We kept that fact in mind as we conducted our review of this transaction. After extensive negotiations, I am satisfied that this new agreement protects healthcare in western North Carolina, ensures that the full value of Mission’s assets will continue to be used for public purposes, and requires that the Dogwood Health Trust will be independent and representative.” HCA has agreed to enforcement measures that gives the Attorney General's office the ability to take legal action should HCA fail to comply with the commitments it has made.”

 

Thursday, January 17, 2019

WEBSITE: wlos.com
REPORTER: Rex Hodge
SUBJECT: The impact the Mission-HCA deal could have on smaller mountain hospitals

SUMMARY: HCA’s plans to acquire the Mission Health system took another step forward Wednesday, when state Attorney General Josh Stein made a major announcement in Asheville. Mission, whose main hospital is in Asheville, has facilities in other western counties, including two in Macon County. And people there were listening to the announcement carefully. Stein said his office does not object to the $1.5 billion deal, which has some revisions that especially pertain to Mission's rural hospitals like Angel and Cashiers-Highlands. Residents on the streets of Highlands are following the HCA-Mission deal closely. “I think it could be a good thing for the area,” Kelly Barbato said. Highlands Mayor Patrick Taylor said the conversion process has been contentious at times but also healthy, with the town board wanting assurances Mission's rural hospitals would stay open beyond five years.

 

Thursday, January 17, 2019

WEBSITE: wlos.com
REPORTER: Kimberly King
SUBJECT: Mission trust to expand from rural counties in next few years

SUMMARY: Improving the well-being and health of Western North Carolina is the opening line of Dogwood Health Trust’s website. The 11-member board will oversee tens of millions of dollars expected to be handed out each year with the goal of making societal changes from potential investments in new housing to healthier meals for low-income families. The funds will come from Mission's sale to HCA. Experts said societal issues from housing to food lead to poor health from childhood on. But there is controversy around the current list of board members, which include many affluent executives from the region who have served on Mission boards before. The cry from regional health care advocacy groups is for more diversity and even representation from the grass-roots world, people who work on the front lines of impoverished families facing health care and access challenges.

 

Thursday, January 17, 2019

WEBSITE: blueridgenow.com
SUBJECT: NC attorney general doesn’t object to Mission acquisition by HCA

SUMMARY: Attorney General Josh Stein said Wednesday he does not object to HCA’s acquisition of Mission Health System’s assets. As a result of extensive negotiations with the Attorney General’s Office, HCA has strengthened its commitments to provide health care services, the Dogwood Health Trust has agreed to make its board more representative of the communities it will serve, and the parties have agreed to enforcement measures that will ensure compliance with this agreement, Stein said in a news release. These commitments will be included in a revised asset purchase agreement and letter agreement. “Access to health care is truly a life or death issue,” Stein said. “We kept that fact in mind as we conducted our review of this transaction.

 

Thursday, January 17, 2019

WEBSITE: wwnc.iheart.com
REPORTER: Mark Starling
SUBJECT: Attorney General Okay with Mission Health Purchase

SUMMARY: The purchase of Mission Health by HCA Healthcare appears to be a go from North Carolina's Attorney General.  Josh Stein said yesterday that he has no problems with the proposed acquisition after reviewing details of the negotiations.  A consulting firm hired by Stein advised him in November that the nearly one-point-five-billion-dollar sale price was fair.  The closing date is expected to be at the end of this month.  

 

Thursday, January 17, 2019

WEBSITE: biltmorebeacon.com
AUTHOR: John Burns, urologic oncologist at Mission Urology
SUBJECT: What Goes in Must Come Out: How a Toxic Bladder Can Lead to Cancer over time

SUMMARY: Many of the things that we put in our bodies get metabolized, filtered through the kidneys and end up dwelling in the bladder. Over time, the bladder becomes exposed to many of the toxic elements that we expose ourselves to, which can sometimes lead to cancer. So, let’s break the seal on bladder cancer. Bladder cancer is the fourth most common cancer in men and the fifth most common cancer overall. In the United States in 2018, about 81,000 new cases of bladder cancer and 17,000 deaths from bladder cancer are expected. Bladder cancer typically presents with patients who have either visible or microscopic blood in the urine, called hematuria. Bladder cancer is found in roughly one-third of patients with visible hematuria, and up to 10.5 percent of patients with microscopic hematuria. It can present in patients who have pain with urination in the absence of an infection. If you are experiencing any of these symptoms or are ever told that you have blood in your urine, tell your doctor.

 

Thursday, January 17, 2019

WEBSITE: citizen-times.com
REPORTER: Mark Barrett
SUBJECT: Mission’s sale to HCA: Top promises given to WNC

SUMMARY: State Attorney General Josh Stein announced Wednesday he will not challenge the pending sale of Mission Health to HCA Healthcare, but that's only after winning a raft of changes to the sale agreement Mission and HCA signed in August.  Here is a summary of changes negotiated by Stein and his Department of Justice in talks with Mission, HCA and Dogwood Health Trust, the foundation that will receive the nearly $1.5 billion in proceeds from the sale…HCA will be required to continue services at rural hospitals for 10 years instead of five. New provisions are much more specific as to what kinds of services it must provide. A loophole the department says could have allowed government actions or an economic downtown to end services earlier than promised has been narrowed.

 

Thursday, January 17, 2019

WEBSITE: hendersonvillelightning.com
REPORTER: Bill Moss
SUBJECT: Stein blesses Mission sale after negotiating rural coverage

SUMMARY: After negotiating changes to ensure sustained hospital facilities in rural counties and greater geographic representation of a new health care trust, North Carolina Attorney General Josh Stein announced Wednesday that he would not object to HCA’s acquisition of Mission Health System’s assets. As a result of extensive negotiations with the Attorney General’s Office, HCA has strengthened its commitments to provide healthcare services, the Dogwood Health Trust has agreed to make its board more representative of the communities it will serve, and the parties have agreed to enforcement measures that will ensure compliance with this agreement, Stein's office said. These commitments will be included in a revised asset purchase agreement and letter agreement. More information about these commitments is available here.

 

Thursday, January 17, 2019

WEBSITE: businessnc.com
REPORTER: David Mildenberg
SUBJECT: Stein OKs HCA purchase of Mission Health

SUMMARY: The second big story involved N.C. Attorney General Josh Stein’s decision yesterday not to oppose HCA Healthcare’s $1.5 billion purchase of Mission Health, the Asheville-based system that dominates western North Carolina health care. Stein pressed HCA for more promises in return for accepting the transaction, which he called a fair price. Those pledges include enabling the AG to take legal action if HCA breaks its commitments, including a promise to provide services at Mission’s local hospitals for at least 10 years. The Federal Trade Commission still must approve the deal, which Mission expects will close on Jan. 31. Mission has a 49.5% market share across its 11-county region. It marks the biggest incursion by a for-profit hospital system in state history. Proceeds from the sale will create a foundation with more than $1 billion in assets, to be used to promote better health.

 

Thursday, January 17, 2019

WEBSITE: healthcaredive.com
REPORTER: Rebecca Pifer
SUBJECT: HCA’s $1.5B buy of Mission gets North Carolina AG nod

SUMMARY: North Carolina Attorney General Josh Stein will allow HCA Healthcare's $1.5 billion acquisition of Asheville, North Carolina-based hospital chain Mission Health to move forward without legal challenge. The approval comes after HCA pledged to double the period it will provide comprehensive services in rural hospitals from five to 10 years, keep all of Mission's facilities open until 2029 and follow through with expansion plans, among other commitments. The news advances HCA's foray into North Carolina. The for-profit health system currently doesn't operate any facilities in the state.

 

Thursday, January 17, 2019

WEBSITE: mountainx.com
REPORTER: David Floyd
SUBJECT: Annual prayer breakfast to feature Green of the Little Rock Nine

SUMMARY: Ernest G. Green was the first member of the Little Rock Nine to graduate from high school, receiving his diploma after a tumultuous year of intimidation from fellow students and members of his community. Green and eight other African-American students integrated Little Rock Central High School in Little Rock, Ark., in 1957, three years after the Supreme Court’s Brown v Board of Education decision declared school segregation unconstitutional…Mission Health will hold the Spirit of Dr. Martin Luther King Jr. Award Ceremony at the Mission Health A-B Tech Conference Center. Doors will open at 11:30 a.m. with the ceremony starting at noon. The awards are given annually to members of the Mission Health team who have been nominated by peers or leaders “for their ability to overcome barriers that separate human beings and who see diversity as an opportunity rather than an obstacle to impact change.”

 

Thursday, January 17, 2019

WEBSITE: nashvillepost.com
AUTHOR: Geert De Lombaerde
SUBJECT: HCA raising $1B in debt

SUMMARY:  HCA Healthcare plans to sell $1 billion in senior debt, in part to help finance its planned $1.5 billion acquisition of Mission Health, which received North Carolina regulatory approval this week. The terms of the notes to be sold have not yet been finalized by Nashville-Based HCA and an 18-member consortium of investment banks led by UBS, Barclays and BofA Merrill Lynch. HCA’s regulatory filing says the offering’s proceeds will go toward “general corporate purposes which may include acquisitions,” but– in upgrading the hospital giant’s senior secured debt­–analysts at Moody’s Investors Service say the money will go toward buying Mission. That acquisition will take HCA into North Carolina for the first time.

 

Thursday, January 17, 2019

WEBSITE: wlos.com
SUBJECT: 2 Mission employees receive diversity awards

SUMMARY:  HCA Healthcare plans to sell $1 billion in senior debt, in part to help finance its planned $1.5 billion acquisition of Mission Health, which received North Carolina regulatory approval this week. The terms of the notes to be sold have not yet been finalized by Nashville-Based HCA and an 18-member consortium of investment banks led by UBS, Barclays and BofA Merrill Lynch. HCA’s regulatory filing says the offering’s proceeds will go toward “general corporate purposes which may include acquisitions,” but– in upgrading the hospital giant’s senior secured debt­–analysts at Moody’s Investors Service say the money will go toward buying Mission. That acquisition will take HCA into North Carolina for the first time.

 

Thursday, January 17, 2019

WEBSITE: carolinapublicpress.org
SUBJECT: Attorney general places stipulation on major NC hospital deal

SUMMARY:  HCA’s acquisition of Asheville-based Mission Health’s assets received approval from state Attorney General Josh Stein on Wednesday, paving the way for the largest health care provider in Western North Carolina to move from nonprofit to for-profit ownership while setting up a massive nonprofit foundation with the sale’s proceeds. However, Stein listed a series of stipulations to which the parties have consented in his letter approving the transaction. Some of these address concerns that residents of Western North Carolina have voiced since negotiations between HCA and Mission Health became public knowledge…HCA extends its promise to acquire and maintain several smaller Mission Health properties in Franklin, Spruce Pine, Highlands, Marion and Brevard from five years to 10 years, with greater specificity for continued services at these hospitals. An independent monitor will review compliance and, along with an advisory board, must sign off on any exceptions to these continued services at the local hospitals.

ADDITIONAL PUBLICATIONS:
Friday 1.18.19 The Hendersonville Times-News
Wednesday 1.23.19 The Avery Journal

 

Friday, January 18, 2019

WEBSITE: thefranklinpress.com
REPORTER: Lee Buchanan
SUBJECT: Attorney General clears way for Mission sale

SUMMARY:  N.C. Attorney General Josh Stein said Wednesday that he will allow the sale of Mission Health to HCA Healthcare to proceed after negotiating a “fair deal for the people of Western North Carolina.” In the new sales agreement, HCA agreed to extend its commitment to keep rural hospitals open for 10 years, instead of the original five years, and reaffirmed plans to build a facility to replace Angel Medical Center. “They cannot close any of those hospitals within that 10 years without the approval of a local community board,” Stein said Wednesday at a press conference in Asheville. That 10-year commitment extends to Angel Medical Center, Highlands-Cashiers Hospital in Highlands, Mission Hospital McDowell in Marion, Blue Ridge Regional Hospital in Spruce Pine and Transylvania Regional Hospital in Brevard. In Franklin, “the replacement hospital will not contain fewer beds or provide fewer services than what is already described in its existing certificate of need,” according to a statement from the attorney general’s office. “HCA is required to use commercially reasonable efforts to obtain all necessary permits and must complete this project within five years of obtaining all such necessary permits.”

 

Friday, January 18, 2019

PUBLICATION: The Asheville Citizen-Times
REPORTER: Mark Barrett
SUBJECT: NC adds public protections to Mission deal

SUMMARY:  Concerns the foundation due nearly $1.5 billion HCA Healthcare will pay for Mission Health lacks diversity and transparency and is too close to Mission’s leaders drove many of the changes won by state Attorney General Josh Stein. Stein announced Wednesday that he had negotiated an agreement with Dogwood Health Trust and secured changes to a sale agreement signed in August to ensure the foundation will reflect Western North Carolina. They will cause major changes in the board’s membership. New provisions will require Dogwood hold at least three public meetings in 2019 and one thereafter, plus report on its activities annually to the public. Stein said Wednesday he will allow the purchase to go through without legal challenge after negotiating those and other requirements. Mission said Stein’s decision means Tennessee-based HCA will take ownership of the system Feb. 1. Added safeguards include establishing rules for the composition of Dogwood’s board of directors. The foundation will use money from Mission’s sale to attack societal problems that affect health.

 

Friday, January 18, 2019

PUBLICATION: The Franklin Press
SUBJECT: New HCA-Mission deal much better for Macon, WNC

SUMMARY:  N.C. Attorney General Josh Stein delivered the news Wednesday in Asheville: The proposed sale of Mission Health to HCA Healthcare can go forward. To win the state’s approval, HCA agreed to make several important changes to the terms of the transaction. Perhaps most important, HCA extended its pledge to keep Mission’s existing hospitals open for 10 years, up from five years in the original agreement. Current services will also be continued for 10 years. After that 10-year period, hospitals now in the Mission system cannot be sold or closed without the approval of a local community board. An independent monitor to be appointed later will be charged with holding HCA to its commitments. HCA also confirmed plans to build a hospital to replace the aging Angel Medical Center and said that the facility must be built within five years of receiving all necessary permits. Dogwood Health Trust agreed to improve the diversity of its board of directors and include at least one member from each county covered by Mission hospitals. These changes have produced meaningful and positive changes to a transaction that has been cause for concern for months.

ADDITIONAL PUBLICATIONS:
Thursday 1.24.19 The Highlander
Thursday 1.24.19 The Franklin Press

 

Friday, January 18, 2019

PUBLICATION: The Mountaineer
SUBJECT: N.C. Attorney General signs off on Mission/HCA deal

SUMMARY:  Attorney General Josh Stein has no objections to HCA’s acquisition of Mission Health System’s assets. As a result of extensive negotiations with the Attorney General’s Office, HCA has strengthened its commitments to provide healthcare services, the Dogwood Health Trust has agreed to make its board more representative of the communities it will serve, and the parties have agreed to enforcement measures that will ensure compliance with this agreement. These commitments will be included in a revised asset purchase agreement and letter agreement. “Access to healthcare is truly a life or death issue,” said Stein. “We kept that fact in mind as we conducted our review of this transaction. After extensive negotiations, I am satisfied that this new agreement protects healthcare in western North Carolina, ensures that the full value of Mission’s assets will continue to be used for public purposes, and requires that the Dogwood Health Trust will be independent and representative.” HCA has agreed to enforcement measures that gives the Attorney General’s office the ability to take legal action should HCA fail to comply with the commitments it has made.” Under statute, the Attorney General has the right to review any transaction in which a nonprofit corporation sells substantially all of its assets. The Attorney General’s office has been reviewing the sale of Mission Health System since May 2018.

 

Friday, January 18, 2019

WEBSITE: fiercehealthcare.com
REPORTER: Tina Reed
SUBJECT: North carolina’s attorney general OK’s HCA acquisition of Mission Health

SUMMARY:  HCA's planned acquisition of Asheville, North Carolina-based Mission Health System cleared a major hurdle this week after North Carolina Attorney General Josh Stein announced that he has no objections to the deal. Stein pointed to HCA's commitments to provide healthcare services and to make its board more representative of the communities it will serve. Both parties also agreed to enforcement measures that will allow the AG's office to take legal action should HCA, which is based in Nashville, fail to comply with its commitments. “After extensive negotiations, I am satisfied that this new agreement protects healthcare in western North Carolina [and] ensures that the full value of Mission’s assets will continue to be used for public purposes," Stein said in a statement. 

 

Friday, January 18, 2019

WEBSITE: nashvillebusinessjournal.com
REPORTER: Joel Stinnett
SUBJECT: HCA offers $1 billion in notes, hints at expansion

SUMMARY:  HCA Healthcare Inc. has a new offering that could help the health care giant grow even larger. HCA announced Thursday it will offer $1 billion of senior secured notes with the intent to use the proceeds for “general corporate purposes, which may include acquisitions,” according to a news release. Terms of the notes, including their interest rate, have yet to be set. The notes are set to mature in 2029. While it’s unclear what acquisitions HCA could be considering, any purchase would be the first major move by new CEO Sam Hazen, who took over for Milton Johnson on Jan. 1. HCA (NYSE: HCA) is already the biggest hospital operator in the nation, with 179 hospitals and 123 freestanding surgery centers in 20 states. It's also Nashville’s largest publicly traded company, with $43.6 billion of revenue in 2017, according to Nashville Business Journal research.

 

Friday, January 18, 2019

WEBSITE: beckershospitalreview.com
REPORTER: Kelly Gooch
SUBJECT: HCA reportedly selling $1B in debt to aid Mission Health acquisition

SUMMARY:  Nashville, Tenn.-based HCA Healthcare is raising $1 billion in senior debt to help finance its planned $1.5 billion acquisition of Asheville, N.C.-based Mission Health, according to a NashvillePost.com report. HCA, one of the nation's largest for-profit hospital operators, said in a filing with the U.S. Securities and Exchange Commission that it plans to use the net proceeds of this offering "for general corporate purposes, which may include acquisitions." On Jan. 17, Moody's Investors Service upgraded ratings on HCA's senior secured credit facilities and senior secured notes to "Baa3" and assigned a "Ba2" rating to the company's new $1 billion of unsecured notes. The ratings agency said HCA will use proceeds from the new unsecured notes to fund the Mission Health acquisition.

 

Friday, January 18, 2019

WEBSITE: mountainx.com
REPORTER: Daniel Walton
SUBJECT: Attorney General approves ‘rearticulated’ Mission-HCA deal

SUMMARY:  One of the largest sales of nonprofit assets to a for-profit company in North Carolina history, the $1.5 billion acquisition of Mission Health’s by Nashville-based HCA Healthcare, is set to take place by the end of the month after getting the go-ahead from state Attorney General Josh Stein. During a surprise Jan. 16 press conference at the Murphy-Oakley Recreation Center in East Asheville, the state’s top lawyer said he will not object to the deal — before adding the important caveat, “as it is being rearticulated.” Stein announced that his office had developed a new asset purchase agreement after months of “extensive negotiations” between Mission, HCA and the Dogwood Health Trust, the nonprofit foundation that will administer the proceeds of the sale. He explained that the changes would strengthen HCA’s community commitments, make the DHT board more representative of its service area and ensure greater accountability for both organizations. “I would like to say a special word to the people of Western North Carolina in expression of my appreciation,” Stein said. “It was through the public forums that my office attended, delegations of your folks who came and met with me and folks in my office, hundreds of letters, dozens if not hundreds of phone calls — it was through your input that you helped to shape our objectives and priorities for what constituted a fair deal.”

ADDITIONAL PUBLICATION: Wednesday 1.23.19 The Mountain Xpress

 

Friday, January 18, 2019

WEBSITE: citizen-times.com
SUBJECT: Stein has done his best for WNC. Now Mission’s leaders must follow through

SUMMARY:  The state has negotiated important safeguards into the sale of Mission Health. Now it’s up to those who will lead both the new Mission Heath and the foundation that will handle proceeds from the sale to HCA Healthcare to ensure these guidelines are followed and WNC is well-served by the deal. The sale cleared its final hurdle Wednesday, when NC Attorney General Josh Stein signed off on the $1.5 billion deal. Stein did, however, gain important concessions, especially on the future of the rural hospitals Mission owns and the Dogwood Health Trust's board membership and operations. The changes double to 10 years the period HCA will be required to provide certain services at the rural hospitals, create an outside “independent monitor” to help ensure HCA lives up to terms of the deal, require geographical diversity on the Dogwood board and make the board’s operations more open to the public. Risa Larsen, a leader of a group of Mitchell and Yancey county residents who had criticized the deal, said she was pleasantly surprised at how many new protections came out of the negotiations. Mission operates, in addition to its flagship institution in Asheville, hospitals in Brevard, Franklin, Highlands, Marion and Spruce Pine, plus CarePartners. There already have been some reductions in services in those areas, and people there feared the sale could lead to loss of their hospitals.

 

Friday, January 18, 2019

WEBSITE: mountainx.com
SUBJECT: Mission Health presents Spirit of Martin Luther King Jr. Awards

SUMMARY:  Mission Health held the 2019 Spirit of Martin Luther King, Jr. Awards Thursday at the Mission Health A-B Tech Conference Center. These awards are given to celebrate diversity and inclusion in healthcare and honored the nominees and recipients. The 2019 winners were Tracey Harper for Workplace Excellence and Lori Wagner, MD, for Community Impact. Harper is a Guest Services Specialist at Mission Hospital and Dr. Wagner is an Endocrinologist at Mission Children’s Hospital. The Spirit of Dr. Martin Luther King, Jr. Awards are given annually to Mission Health team members who have been nominated by their peers or leaders for their ability to overcome barriers that separate human beings and who see diversity as an opportunity rather than an obstacle to impact change. The award celebrates diversity in healthcare and the people who carry on the spirit, leadership and vision of Dr. Martin Luther King, Jr., and influence unity, equality, equity and justice in both the workplace and their communities.

 

Friday, January 18, 2019

WEBSITE: beckerasc.com
SUBJECT: HCA announces $1B public offering that could be used for acquisitions-4 insights

SUMMARY:  Nashville, Tenn.-based HCA Healthcare is offering $1 billion in aggregate principal senior notes, subject to market conditions, the company announced.

What you should know:

1. HCA stated the proceeds of the offering will be used for, "general corporate purposes, which may include acquisition."

2. Several financial institutions are acting as joint book-running managers for the offering.

3. The Nashville Business Journal said while HCA hasn't specified what the funding will be used for — if the funds go towards an acquisition — it would be new CEO Sam Hazen's first major move since taking over from former CEO Milton Johnson Jan. 1.

4. HCA was tied to KKR's purchase of Nashville-based Envision Healthcare in 2018, but the deal never came to fruition. HCA sought to acquire Envision's ASC unit AmSurg.

 

Friday, January 18, 2019

WEBSITE: healthcarepackaging.com
REPORTER: Jim Butschli
SUBJECT: Syringe, IV Bag, Compounding/Filling Systems Fulfill ‘Mission’: Part 1

SUMMARY:  In 2018, for the sixth time in the past seven years, Asheville, NC-based Mission Health was named one of the U.S.’s Top 15 Health Systems by IBM Watson Health. Mission Health, which operates six hospitals, including Mission Hospital, was also recognized last year as one of the nation’s best hospitals by U.S. News & World Report, one of only 29 hospitals in the country to receive that status. This level of excellence is achieved in part by employing advanced technology, which includes two RIVA™ automated IV compounding systems from ARxIUM that sterile-fill liquids and lyophilized products into IV syringes and bags for administration to Mission Health patients. Mission Health employs the RIVA systems in an 864 sq-ft cleanroom suite within its 10,000 sq-ft central distribution pharmacy located at Mission’s Materials Management Distribution Center. Built in 2010, the suite meets USP <797> guidelines for the sterile preparation and compounding by pharmacies of medications administered through injection.