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Mission Health’s sale clears final AG hurdle; deal completion pending
Sunday, 03 February 2019 21:28

From Staff Reports

After negotiating changes to a deal to — in his words — protect the public, state Attorney General Josh Stein said Jan. 16 that he will allow HCA Healthcare’s proposed purchase of Asheville-based Mission Health’s assets without a legal challenge.

Stein’s approval paves “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,” Carolina Public Press reported on Jan. 17.

The Asheville Citizen Times stated in a  Jan. 16 story that “a review by the state Department of Justice, which Stein heads, is the biggest regulatory hurdle the sale must clear to take effect. His announcement could mean the nearly $1.5 billion deal will take place soon.”

However, CPP stated, “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.”

CPP added, “Ultimate approval of the hospital companies’ deal, with stipulations, was in keeping with comments that Laura Brewer, a spokesperson for the state Department of Justice, made to Carolina Public Press in a November email.”

Suggesting that outright rejection of the deal was never likely, Brewer wrote, “Ordinarily, when our office has objections, the parties involved accommodate those objections and revise the transaction accordingly.

In his Jan. 16 announcement of his decision, Stein stressed the importance of continued access to health care for residents of the areas currently served by Mission.

“Access to health care is truly a life-or-death issue,” Stein said.

Further, the attorney general asserted, “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 health care 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.”

CPP reported, “With the sale’s value potentially exceeding $1.5 billion by some estimates, the resulting Dogwood Health Trust would immediately rival the largest grant-making foundations in North Carolina.”

Mission Health currently operates hospitals in Asheville, Marion, Spruce Pine, Brevard and Franklin in addition to numerous smaller health care provider facilities across Western North Carolina.

HCA owns more than 150 hospitals in the United States and some in the United Kingdom. If the purchase is successful, Mission Health’s facilities would be the company’s only hospitals in North Carolina.

Following are a series of stipulations to which Mission Health and HCA Healthcare have consented, according to state Attorney General Josh Stein, in his letter approving the transaction, as as reported by CPP:

• 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.

• HCA will be limited in its ability to cite economic conditions as a pretext for seeking exceptions to compliance.

• Both the new Dogwood Health Trust and the Regional Foundation will have the right to bid on the assets of any local hospitals that are sold or closed.

• HCA will build a new facility in Franklin to replace the existing Angel Hospital. Mission Health has already received a certificate of need for this project.

• HCA will build a new 120-bed behavioral health hospital in Asheville.

• HCA will continue most of Mission Health’s community service programs, with at least a $14.28 million expenditure.

• HCA will continue Mission Health’s financial support of emergency medical services in Madison, Mitchell and Yancey counties.

Stein’s letter also made specific provisions for the Dogwood Health Trust’s board, limiting terms of representatives from Buncombe County and ensuring that by 2021 the number of members from any one county will be no more than four.

The letter additionally required efforts to have a level of diversity on the board reflecting the diversity of Western North Carolina’s population. Stein’s letter observed that the initial board had no persons of color but has now been changed to have 27 percent membership by persons of color.

In addition, the letter provided for a number of means of enforcement of its requirements and for fairness in concluding the transaction.


 



 


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