ASHEVILLE, N.C. — Following a 20-minute presentation on AdventHealth’s hospital planned in Weaverville, a 30-minute question-and-answer session — featuring a tense verbal exchange between two local hospital officials — was held during a breakfast meeting of the Council of Independent Business Owners on Oct. 3 in UNC Asheville’s Sherrill Center.

Graham Fields, assistant to the president of nonprofit AdventHealth Hendersonville and who gave the address eariler, fielded the queries from the CIBO crowd.

Opening the questioning, an unidentied man asked, “Where are you going to find the workforce, as it’s tight right now?”

Fields replied, “Great question!” He then noted that AdventHealth officials “would look to (local) high schools and A-B Tech,” as well other local colleges and universities for future job prospects.

He added,, “We’re also offering a program called Junior Leaders — and they meet with hospital workers in the concentration they are interested in...”

Further, he said the Junior Leaders’ program is “working on how to develop a ‘flight plan’ that will allow folks” who are interested in hospital work to land” in the concentration in which they aspire to work.

At that point, Greg Lowe, president of for-profit HCA HealthCare’s North Carolina Division based at Mission Hospital in Asheville — as a CIBO member — first voiced a long statement before asking Fields any questions.

Lowe began by telling Fields, “I don’t think you fully provided the overview of where these beds were generated, and I want to make sure that this group is aware of why beds are available in these counties.

“All of Western North Carolina relies on Mission Hospital for their care, for high-end care that is not provided at any other hospital in Western North Carolina. AdventHealth sends us a dozen patients every day that are unable to receive the appropriate level of care in their facility, and so they’re transferred into Mission Hospital on a daily basis.”

Lowe also said he agreed that there is a demand for high-acuity service, such as cardiology, trauma, stroke, neurology, spine, orthopedics, which has created a need for more beds. 

“Every day, Mission Hospital is over-capacity because they have generated the need for additional beds to meet the demand in our community,” Lowe said. He also noted that NCDHHS was giving the hospital an exception every eight weeks to go 10 percent — or 100 beds — above capacity. 

“So my question, Graham, for you and AdventHealth, is, it doesn’t take a hospital to create and provide higher-end acuity services in your facility: You have available beds in your hospital now. Why is AdventHealth not expanding services to meet the demand in Henderson County for your community now, and instead is focused on grandiose plans for a new hospital? Why are you doing it now?”

In response, Fields answered, “I’m not going to get into a debate with you…, I don’t agree with the premise. The premise is, these are the community’s beds. They’re the ones that had the stroke, the heart issue, all those things. 

“Your premise is (that) their Mission’s beds. I say they’re the community’s beds. And so what they’re crying out is: ‘You have to build the scale, the scope, to be able to compete at those higher levels.’ And it starts somewhere. Otherwise they don’t have a choice.’”

Firing back, Lowe asserted, “We never said they were Mission’s beds. There’s a demand for care in the community, and there’s only one hospital (Mission) that has the ability, the depth and breadth of expertise to provide that care. It takes decades to develop trauma, cardiac, comprehensive, stroke, pediatrics. And so they’re not Mission’s beds, they’re the community’s beds. But Mission is the only one that can operate those beds at the level needed for the community demand currently.”

The two hospital officials also engaged in a tense exchange over he Certificate of Need requirement. Proponents say the CON system helps keep healthcare costs down by avoiding wasteful duplication of services and expensive equipment. Opponents say it discourages competition.

To that end, Fields said of the CON requirement, “It’s still a system, as imperfect as it is, that I think is necessary to protect rural areas. I think generally, our position may be different on CON. I think CON is a protection in (Western North Carolina.) I think it’s a necessary safeguard.”

Conversely, Lowe argued that the CON system is holding back Mission in its effort to better serve the area.

Specifically, Lowe told Fields,“We work in states across the country where CON is in place and states that have no CON in place, and we do perfectly fine in either one of them. If CON was to go away, in North Carolina, you would immediately see a new patient tower on Mission Hospital’s campus to accommodate the need that patients have for high-end services. The only thing that’s been holding us back from investing hundreds of millions of dollars of expansion is the CON process.”  

The website Asheville Watchdog that, along with the Daily Planet, covered the meeting, wrote in its Oct. 3 story that “Lowe declined to answer The Watchdog’s questions after the meeting.”

Also, the website reported, “Fields, who has been promoting the hospital at community meetings across the region since AdventHealth first proposed the Weaverville hospital in 2022, told The Watchdog that neither Lowe nor any other Mission official had attended any previous events.”

Regarding Lowe’s comments during CIBO’s Q&A, Fields told the Watchdog immediately afterward the following:

“Spoken like a true market dominant that says: ‘Nobody else can do it but me.’ And, in some ways, he’s (Lowe is) articulating to business people, who, I think, see through it.”