House Oversight Official Calls For Probe of HCA Over Fraud, Staffing Allegations

September 17, 2022Read more

The chairman of the U.S. House Ways and Means Committee’s oversight subcommittee is calling for an investigation into Nashville, Tenn.-based HCA Healthcare over reports of alleged fraud and staffing issues at its facilities.

“Recent reports of systematic, unnecessary inpatient admissions intended to raise more-profitable reimbursement rates, in addition to severe understaffing issues,

“Recent reports of systematic, unnecessary inpatient admissions intended to raise more-profitable reimbursement rates, in addition to severe understaffing issues, raise disturbing questions about HCA’s corporate policies and practices,” Rep. Bill Pascrell, Democrat of New Jersey, wrote in a letter Sept. 13 to Health and Human Services HHS Secretary Xavier Becerra.

Pascrell asked Becerra to investigate whether HCA, a 182-hospital system that owns and operates Asheville’s Mission Hospital, five other hospitals in western North Carolina, and many other healthcare facilities in the area, is improperly admitting patients to hospitals when patients do not require inpatient care.

Pascrell cited a report by the Service Employees International Union that HCA may have billed Medicare as much as $1.8 billion in unnecessary admissions from 2008 to 2019.

“I am especially alarmed by these findings given HCA’s history of health care fraud settlements with both federal and state authorities,” Pascrell wrote. “This includes a settlement for $1.7 billion in the early 2000s that resolved multiple criminal counts and civil fraud allegations — at the time the largest health care fraud in U.S. history — as well as other health fraud settlements involving HCA in subsequent years.”

Pascrell asked HHS to investigate HCA’s joint venture with EmCare, which provides emergency physician staffing in many of HCA’s hospitals.

“There have also been allegations that HCA sets corporate admission targets and routinely threatens retaliation against staff if those targets are not met,” Pascrell wrote. “HCA’s long-standing joint venture with EmCare, a subsidiary of private-equity-owned Envision Healthcare, may play an essential role in the setting and/or implementation of these admission targets.”

Pascrell also wrote to HCA Healthcare CEO Sam Hazen, requesting details about incentives for physicians related to patient admissions, a description of data collected related to physician performance, and a description of the company’s internal review processes.

“We are reviewing Congressman Pascrell’s letter and will respond to his requests for information,” HCA said in a statement to Becker’s Hospital Review. “The issues raised in the letter appear to be similar to ones we addressed previously and publicly. HCA Healthcare operates more than 180 hospitals in a variety of communities throughout the country. Our hospitals are staffed by physicians, clinicians and nurses who work tirelessly to ensure our patients receive medically necessary care in the appropriate clinical setting.” — Peter H. Lewis

North Carolina Is Ranked Dead Last for Workers

September 14, 2022Read more

Third Year in a Row

For the third year in a row, North Carolina ranks as the worst state in the nation for protecting and supporting working families, and in particular meeting the needs of working women, according to an annual study by Oxfam, the international anti-poverty organization.

The study,

The study, called the Best and Worst States to Work in America 2022, tracks 26 policies across all 50 states plus the District of Columbia and Puerto Rico. It puts North Carolina at 52, or the worst place to work. The state, the study found, has a minimum wage stuck at the federal level of $7.25 an hour — unchanged since 2009; has no mandate for paid leave; no accommodations for pregnancy; and no sexual harassment protections.

The study examines policies that “can determine whether workers are safe at work, can afford food for a family, or whether they have a voice in the workplace.” Oregon was ranked number 1 for its worker-friendly policies.

For women, the study focused on the federal minimum tipped wage of just $2.13 an hour, unchanged in over three decades, because women are 69 percent of all tipped wage earners. Of those, 36 percent are mothers, half of whom are single mothers, according to the report.

The report said that “to have a sub-minimum tipped wage traps many women, especially single moms, in cyclical poverty.” It noted that according to the National Women’s Law Center, poverty rates are nearly 30 percent higher in states that maintain a sub-minimum tipped wage compared to those which have ended the policy altogether.

Asheville-based Just Economics, which studies wages and cost of living in western North Carolina, reported the living wage rate for Asheville metro area is $17.70 per hour (with or without health insurance). It noted that in Buncombe County, “the disparity between wages and housing costs is a major factor in the local economy and our living wage rate continues to be tied to the cost of housing.”

RentCafe, which calculates housing costs, puts the average rent in Asheville at $1,640 and average home price at $459,418, both out of reach for any minimum wage earner. It calculates that the “cost of living in Asheville, NC is 8 percent higher than the state average and 4 percent higher than the national average.”

According to Living Cost, a global crowd-sourced database that calculates costs of living worldwide, Asheville is the second-most expensive city in North Carolina after Chapel Hill, and in the top 3 percent of the most expensive cities in the world. — Barbara Durr

NC Elections Workers Threatened, Harassed

August 25, 2022Read more

With just over two months to go before the 2022 elections, North Carolina election officials are reporting what has become commonplace in their jobs: harassment, intimidation and even death threats.

“We have had emails or correspondence that wish us a painful death, “ Karen Brinson Bell, the executive director of the State Board of Elections,

With just over two months to go before the 2022 elections, North Carolina election officials are reporting what has become commonplace in their jobs: harassment, intimidation and even death threats.

“We have had emails or correspondence that wish us a painful death, “ Karen Brinson Bell, the executive director of the State Board of Elections, said recently on the podcast Tying It Together. “We’ve had racist phone calls.”

In the last year, 43 of North Carolina’s 100 county elections directors have retired or left.

“It’s not what you signed up for,” Brinson Bell said. “Every day, we are still dealing with the 2020 election. It’s making it very difficult to prepare for this year’s election.”

Elections offices are being flooded with public records requests, many aiming to prove fraud or conspiracy theories in the 2020 election, Brinson Bell said in the podcast. In the six months leading up to that election, the State Board of Elections received 48 records requests. In 2021, that number jumped to 229, and Brinson Bell expects as many as 500 this year.

“It’s taking our attention and our energy,” she said.

Tensions have risen in Buncombe County, said elections Director Corrine Duncan. But “we’ve been lucky,” she told Asheville Watchdog. “We haven’t had any instances of harassment.”

Buncombe needs hundreds of temporary poll workers this year. Duncan said she fears some long-time poll workers may not return because of the contentious environment. She said she is even having difficulty filling her four open permanent posts.

The elections office is coordinating with local law enforcement to ensure safety at polling places. “We are taking reasonable precautions,” Duncan said. “We’ve always taken it seriously” because “we are talking about the right to vote.”

One change that could improve the next election is stricter rules for election observers, who are appointed by political parties. Proposed by the state elections board, the rules would prohibit the kinds of bad behavior that was documented in a statewide poll of North Carolina elections officials after the May primaries.

Observers questioned poll workers carrying out their duties, repeatedly entered and exited the polling place, attempted to interfere with voters submitting their ballots, asked to photograph voters forms with confidential information, followed poll workers to their cars, and filmed them after polls closed, the election officials reported

The rules on disruptive conduct must be approved by the board’s Rules Review Commission. – Barbara Durr

Update: Cawthorn Files Overdue Campaign Report

August 16, 2022Read more

Cawthorn celebrated his birthday with longtime friend Blake Harp, whose consulting firm is owed $183,991.35 from the campaign // Credit: Cawthorn’s Instagram account

Congressman Madison Cawthorn on Monday filed his overdue final campaign financial report as required by federal election law, although — to borrow the cliche — a day late and a dollar short.

Congressman Madison Cawthorn on Monday filed his overdue final campaign financial report as required by federal election law, although — to borrow the cliche — a day late and a dollar short. Make that 32 days late and some $304,566.02 short.

Earlier this month, the 27-year-old Republican had been scolded by the Federal Elections Commission for failing to file the report, which details the campaign’s income and outgo. In Cawthorn’s case, there is considerably more of the latter, leaving him in a deep financial hole and under continuing scrutiny by the FEC for possible violations of the law.

The report covered the second quarter of the year, from April 27 through June 30. This was a critical period for Cawthorn because it covered the run-up to the May 17 Republican Party primary election — which he lost — and the weeks after when the financial damage could be tallied.

In addition to anodyne campaign costs, much of the spending repeated a pattern from prior reports: staff lunches at the Hendersonville Chick-fil-A, Papa’s & Beer and Moe’s BBQ, as well as cigars at the Casablanca Tobacconist.

Cawthorn, who became a right-wing wunderkind during his term, raised $4,095,533 — a record for any Western North Carolina candidate and among the highest in the Congress. But he spent $4,199,759, leaving him in a hole some $104,225 deep.

The report showed that much of the money he spent wasn’t actually his to spend. It was money from donors who intended for it to be used in a general election campaign in the presumption that he’d win the GOP nomination. He didn’t, losing to state Sen. Chuck Edwards. So he had to repay all those folks, some $265,071.

The report shows that Cawthorn chipped in $207,858 of his own money to partially cover those refunds, as the law requires. He also raised $87,168 from new donors. This is a pittance in comparison to prior quarters, but it came during a time when Cawthorn was in the news for some controversial behavior (suffice it to say this entailed sex, drugs and explicit videos).

Notably, although the re-election campaign was in a tail-spin in the closing weeks, Cawthorn still paid some buddies for working on his campaign, all of whom were also collecting federal paychecks as members of Cawthorn’s congressional staff. For example, he paid his district director, Harold Weathermann, $5,008. He paid $5,600 to his cousin and traveling companion, Stephen L. Smith, who also worked in the congressional office as a scheduler and ADA consultant.

But it appears one longtime friend, Blake Harp, the congressman’s chief of staff, is among those being stiffed by the campaign. Outside his job with Congress, Harp moonlights as managing partner of a Texas consulting firm called EMP Strategies, which profited handsomely from campaign spending in the earlier reports. But the final report lists EMP Strategies as a creditor in the amount of $183,991.35. Cawthorn also is in debt $33,844 to another Texas consulting firm, Harris Media specializing in helping arch-conservative politicians, recently among them Rand Paul, Ted Cruz and Benjamin Netanyahu.

Unlike with over-paying donors, Cawthorn can settle that debt for fractions of the total, or even walk away from it altogether without federal penalty.

Harp apparently wasn’t too upset about holding that debt. He joined Cawthorn on August 1, the congressman’s birthday, as they donned commando gear and staged a mock raid to assassinate a mannequin while it was sleeping – as shown in photos posted on Cawthorn’s Instagram account. – Tom Fiedler

Mission Memo

August 5, 2022Read more

From Mountain Maladies Facebook page

AdventHealth H’ville Named a “Best Hospital in America”

July 6, 2022Read more

AdventHealth Hendersonville is designated one of the “Best Hospitals in America” in a new ranking from Money (formerly Money magazine) and The Leapfrog Group. No other hospital in western North Carolina made the list.

Out of more than 6,000 hospitals nationwide, only 148 hospitals were given the “best hospital” designation,

Out of more than 6,000 hospitals nationwide, only 148 hospitals were given the “best hospital” designation, based on criteria including quality, safe care, a reputation for excellent patient experiences, adequate staffing, and an ethical approach to treatment.

Five other hospitals in North Carolina earned the “best” designation, including Rex Hospital in Raleigh, WakeMed Cary Hospital in Cary, Watauga Medical Center in Boone, Wake Forest Baptist Health Wilkes Medical Center in North Wilkesboro, and Wake Forest Baptist Health Davie Medical Center in Bermuda Run.

To qualify for the list, eligible hospitals were required to carry an “A” letter grade on the Leapfrog Hospital Safety Grade assessment for Fall 2021. Mission Hospital in Asheville received an “A” grade in that rating, but Pardee UNC Health Care in Hendersonville received a “B.” AdventHealth Hendersonville, Pardee, and Mission all received “A” grades in the Spring 2022 scoring.

Hospitals were also required to meet a qualitative assessment of excellence. They were disqualified if they exceeded national mortality rates for heart attacks, heart failure, pneumonia, chronic obstructive pulmonary disease or coronary bypass surgery.

Leapfrog applied additional criteria related to safe medication ordering practices (to prevent medication errors), intensive care unit staffing, the response to “never events” (medical errors that are so serious they should never happen to patients, like operating on the wrong body part, leaving instruments inside the body after surgery, or a transfusion of the wrong type of blood), and performance related to certain high-risk surgeries including heart surgeries, bariatric surgery, hip replacements and lung cancer surgeries. — Peter Lewis

New Nursing School To Open in Asheville

June 14, 2022Read more

Photo credit: Galen College of Nursing

Asheville is getting a new nursing school. HCA-owned Galen College of Nursing said this week it plans to open a new campus in Biltmore Park on Sept. 29, expanding the number of nurses being trained in western North Carolina during a nationwide nursing shortage.

Photo credit: Galen College of Nursing

HCA — the Nashville-based corporation that owns Mission Hospital in Asheville and five other hospitals in western North Carolina — said the new nursing school, located 30 Town Square Boulevard in Biltmore Park, will be a “state of the art” 16,900-square foot facility for classroom and patient simulation training.

Admissions for the fall quarter are now open, HCA said. HCA did not say what the expected enrollment or faculty size of the new campus is expected to be, but it said the addition of the Asheville-area campus will increase total enrollment across its 13 campuses to about 10,000 students this fall, for an average of about 750 per campus.

At present the Mission Health system has nearly 450 unfilled positions open for registered nurses (RNs), roughly equivalent to the total number of nurses graduated each year from all western North Carolina nursing schools combined. Mission Health recently awarded grants to three local nursing schools to add an instructor; in general, each instructor can train 10 students.

HCA-Galen’s Asheville campus will initially offer three degree options, including a two-year Associate Degree in Nursing (ADN), a three-year Bachelor of Science in Nursing (BSN), and a Licensed Practical Nurse to Associate Degree in Nursing Bridge Option (LPN to ADN Bridge). Galen also offers online programs. Admissions appointments can be scheduled by calling (877) 223-7040 or going online to galencollege.edu.

Based on tuition and fees at other Galen campuses, the new Asheville school is likely to be more expensive than other area nursing schools, with tuition and fees of as much as $20,000 a year, not counting living expenses and books.

A two-year associate degree at A-B Tech in Asheville costs about $4,000 a year, not counting living expenses, according to the A-B Tech website. Costs at Western Carolina University’s nursing school in Biltmore Park are approximately $5,000 a year, not counting living expenses, according to WCU’s website.

The opening of an HCA-owned nursing school in Asheville is not expected to reduce opportunities for graduates of other local nursing school programs, given the soaring demand for nurses and related healthcare jobs locally and nationwide. — Peter Lewis

City of Brevard Sues HCA, Citing ‘Skyrocketing’ Costs

June 3, 2022Read more

[This story appeared first in Brevard Newsbeat, and is republished here with permission.]

By DAN DeWITT, Brevard Newsbeat

BREVARD — The city of Brevard filed a federal class-action antitrust lawsuit Friday that says HCA Healthcare Inc.’s monopoly in Western North Carolina has caused skyrocketing medical costs and “dramatically worsened facility conditions and patient service.”

The arguments in the suit mirror those in a class-action claim filed last August in Buncombe County Superior Court on behalf of six local residents.

[This story appeared first in Brevard Newsbeat, and is republished here with permission.]

By DAN DeWITT, Brevard Newsbeat

The arguments in the suit mirror those in a class-action claim filed last August in Buncombe County Superior Court on behalf of six local residents. But the city’s lawsuit, the document says, focuses on the burdens HCA’s “unlawful restraint of trade and monopolization” has placed on self-insured entities such as Brevard. The suit was filed in US District Court in Asheville rather than Superior Court, said City Attorney Mack McKeller, because it relies on federal antitrust laws.

Mission Health, which owns Mission Hospital in Asheville as well as smaller facilities throughout Western North Carolina, acquired Transylvania Regional Hospital in 2012.

Mission Health was purchased for $1.5 billion in 2019 by HCA, which the suit calls “the world’s largest for-profit hospital chain.”

The Mission system dominates the market for inpatient care throughout the region, the lawsuit says, and holds a 79 percent market share in Transylvania County.

The claim, like the one filed in August, provides a window on the prices charged throughout the system and at its Asheville flagship, Mission Hospital — prices HCA has failed to disclose in violation of a 2021 federal rule requiring healthcare pricing transparency, the suit said.

“Were HCA to comply and reveal to consumers and regulators the true prices that it charges, the public would know that HCA’s prices in the relevant markets are by far the highest in North Carolina,” the complaint says.

Citing a private database, it says “Mission Hospital-Asheville (has) charged commercial insurers 305% above the Medicare price” for inpatient services compared to a statewide average of 211 percent more than Medicare.

One of several examples listed in the suit was the cost of a shoulder arthroscopy: “The Mission-Asheville price for this procedure was $2,419 — nearly three times the statewide average of $897.”

Though the 2021 suit also documents the resulting higher prices of private medical insurance in the region, the city’s action addresses direct costs to self-insured entities, which can include cities, counties and some large private companies, McKeller said.

Though Brevard has paid “significantly more” for employee medical care in recent years, he said, it has not established the amount of these increases that can be attributed to HCA’s practices.

Once the city’s burden is tallied, however, the suit seeks a three-fold reimbursement of this amount, as well as an end to the conditions that allow HCA to charge “artificially inflated supracompetitive prices.”

“If HCA has increased the amount we have to pay because of monopolistic practices, the damages will be tripled as a way of punishing it for being a monopoly,” McKeller said.

One of the two law firms representing the city is Berger Montague, which has offices in several major cities and “is one of the nation’s most experienced and successful complex litigation firms,” a city press release said.

The claim also requests a reimbursement of legal fees, but McKeller said that even if the city loses the suit “we are not liable to the attorneys to pay them anything.”

The City Council agreed to go forward with the suit in a closed session about two months ago, McKeller said.

Nancy Lindell, Mission Health’s media relations director, said in an email the company had not been served with the suit and would “respond appropriately through the legal process.” But she did push back on the suit’s contention that it had neglected care at Transylvania Regional, where the company has invested more than $14 million in equipment and “infrastructure projects,” she wrote.

HCA has also recently added five primary care doctors locally and “renovated the primary care practices,” she wrote.

Mayor Maureen Copelof, who is the city’s designated liaison with HCA and, in the past, a harsh critic of its management of Transylvania Regional, said in the press release that the city has a responsibility to ensure quality healthcare for its residents.

“Over the past few years, our community has repeatedly expressed concerns over the degradation of health services, the difficulty in obtaining services, and the high cost of these services,” she said in the release. “Our attempts to address these concerns directly with HCA have been rebuffed.”

In a recent interview she praised HCA Chief Executive Officer Sam Hazan for traveling to Brevard to meet with her and former members of the hospital board. She also said the meeting had left her cautiously optimistic the company will be more responsive to residents’ concerns.

On Friday, she said the suit shouldn’t derail that progress.

“There’s really two separate sides to this,” she said. The issues raised in the lawsuit are “completely different from the disconnect that exists between the community and HCA on delivering health services.”

[This story was updated to include a response from HCA Healthcare’s North Carolina division.]

Dan DeWitt is publisher of Brevard Newsbeat, which provides in-depth local reporting about Transylvania County, politics, environment, and land use. DeWitt is a longtime reporter and local columnist, Tampa Bay Times, formerly the St. Petersburg Times. Email: brevardnewsbeat@gmail.com.

All ‘A’s for local hospitals

May 10, 2022Read more

Mission Hospital employees Erin Young (left ) and Lindsey Regner celebrate LeapFrog “A” safety grade // Mission photo

HCA-owned Mission Hospital in Asheville, Pardee UNC Health Care in Hendersonville, and AdventHealth Hendersonville all earned “A” grades in the Spring 2022 national hospital safety ratings by the nonprofit LeapFrog Group. Grades are updated twice annually, in the fall and spring, and for AdventHealth it was the 12th straight “A” grade.

Pardee’s score improved from a “B” in Fall 2021. Mission repeated its “A” score from Fall 2021, after getting a “B” in Spring 2021.

Mission Hospital McDowell in Marion also earned an “A” grade in the Spring 2022 ratings, but Haywood Regional Medical Center in Clyde, Rutherford Regional Medical Center in Rutherfordton, and Harris Regional Hospital in Sylva all collected “B” grades.

The Leapfrog Group assigns an “A,” “B,” “C,” “D,” or “F” grade to all general hospitals across the country. The grade uses more than 30 measures of safety data including rates of preventable errors, injuries and infections, while also accounting for whether hospitals have systems in place to protect patients from harm.

Nationwide, 33 percent of nearly 3,000 general hospitals achieved “A” ratings. North Carolina ranked first among all states for the percentage of A-rated hospitals, with 59.8 percent of all general hospitals earning the top grade. — Peter H. Lewis

Cawthorn Pulls a Fast One In Buncombe County Plea Deal

April 18, 2022Read more

Rep. Madison Cawthorn (R-NC11)

Congressman Madison Cawthorn was able to dodge a serious speeding charge in Buncombe County by making a pre-trial plea deal with District Attorney Todd Williams just days before the State of Georgia alerted Williams’s office that Cawthorn’s license had been suspended as the result of a 2019 conviction for speeding and driving with an expired tag,

Meanwhile, Cawthorn was a no-show in Polk County court on Monday to face the second of three charges he’s collected in recent months for speeding and other alleged driving violations.

Last month Cawthorn, through a lawyer, pleaded guilty to a reduced speeding charge in Buncombe County after striking a plea deal with Williams and paying a fine. Cawthorn had been ticketed for driving 89 miles per hour in a 65 m.p.h. zone near Swannanoa in October. In return for the guilty plea, Williams agreed to reduce the charge to traveling just 74 miles per hour, a lesser infraction that allowed Cawthorn to keep his license without going to trial as scheduled on March 4.

But had he been aware of Cawthorn’s conviction in the December 2019 case in Clayton County, Georgia, Williams told Asheville Watchdog, he would not have agreed to offer the 26-year-old congressman the plea deal. The more serious charge could have resulted in Cawthorn facing up to 20 days in jail and fines up to $200.

Although the Georgia speeding citation occurred in December 2019, it wasn’t settled until August 2021 when the conviction was entered and Cawthorn’s license was revoked. But, according to Williams, the State of Georgia didn’t report the revocation to North Carolina until February, after the pre-trial deal had already been reached with Williams’ office.

Williams said that when he learned of the Georgia revocation he inquired about reopening the case. But, he said, because Cawthorn had already paid the fine, the case was closed. Williams said the plea deal took advantage of what he called a “legal fiction” in North Carolina law where the driver can blame a faulty speedometer and receive leniency.

In the Polk County case, Cawthorn was ticketed in January for driving 87 miles per hour in a 70 m.p.h. zone, and ordered to face the charge in court April 18. But his lawyer, Gabrielle Valentine, appeared on Cawthorn’s behalf and successfully asked that the case be postponed until June 2.

Valentine offered no reason for the requested delay and commented later that it was “routine.” Cawthorn’s press secretary, Luke Ball, did not respond to Asheville Watchdog’s request for an explanation of the delay and whether Cawthorn planned to contest the charge.

The postponement means the case will not be heard until after the May 17 primary election, where the incumbent Cawthorn faces seven challengers in the Republican race to represent western North Carolina in Congress.

Cawthorn still faces a third court date for a charge on March 3 near Shelby in Cleveland County. That alleged violation occurred shortly after North Carolina had been notified that Cawthorn’s license had been revoked for speeding in Georgia. The state trooper stopped the congressman for swerving across the highway centerline, but charged him only with driving with the revoked license. That case is scheduled to be heard May 6, just days before the May 17 GOP primary.

The Cleveland County charge is a misdemeanor criminal offense that could result in a jail sentence of up to 20 days, as well as a fine of up to $200. — Tom Fiedler

NC Justice Department Scolds HCA-Mission For High Prices, Declining Quality of Care

April 1, 2022Read more

Greg Lowe

The North Carolina Department of Justice notified the Mission Health System last week that it was “extremely concerned” about ongoing citizen complaints over high prices, lack of transparency, anti-competitive behavior, chronic under-staffing, and declining quality of care at HCA-managed medical facilities in western North Carolina.

In a letter to Greg Lowe,

In a letter to Greg Lowe, president of HCA Healthcare’s North Carolina division, Assistant Attorney General Llogan R. Walters wrote that his office was still receiving “troubling allegations regarding patients not receiving proper care, core functions being reduced and not replaced, and subpar conditions regarding basic sanitation and cleanliness” at Mission Hospital and other HCA facilities. The letter was provided to Asheville Watchdog this week by Attorney General Joshua H. Stein’s office.

Lowe responded to Walters in a letter dated March 30, writing that “MHS remains invested in having an ongoing dialogue with the North Carolina Department of Justice regarding any concerns it has related to MHS.”

Also this week, Stein, acting on behalf of the State of North Carolina, filed a legal brief in Buncombe County Superior Court urging the court to reject Mission Health’s request to dismiss a class-action lawsuit brought against it by local residents. Dismissal of the lawsuit would prevent an outside investigation into HCA-Mission’s business practices.

The lawsuit alleges anti-competitive behavior by Mission Health that results in higher prices for all healthcare consumers in western North Carolina, where HCA and Mission have an effective monopoly.

The plaintiffs in the class-action suit include Katherine Button, Faith Cook, and Will Overfelt of Asheville, Richard Nash of Candler, William Davis of Clyde, and Jonathan Powell of Morganton. The complaint was prepared by the law firms Wallace & Graham of Salisbury, N.C., and Fairmark Partners of Washington, D.C.

The “friend of the court” brief filed by Stein on Wednesday follows a similar amicus brief filed in support of the plaintiffs by Dale Folwell, North Carolina’s state treasurer, in December 2021. Stein, a Democrat who allowed the sale of nonprofit Mission Health to HCA Healthcare in 2019, and Folwell, a Republican, are widely regarded as potential rivals for future elected office.

“For many services, Mission Health charges insurers prices far higher than the state-wide average price for the same service,” Walters’ letter said. “Unsurprisingly, these costs are passed onto consumers.”

Walters continued, “Complaints note that, at the same time Mission Health charges high prices, Mission Health is enjoying significant profits while the quality of care at Mission Health facilities declines.”

Walters’ letter indicated it was in response to a letter Lowe wrote to the attorney general’s office in July 2021, in which Lowe argued that Mission Health’s chronic understaffing was the result of a “challenging labor market” and the ongoing COVID-19 pandemic.

“However,” Walters wrote, “health care systems across the state face these same issues without resulting in the same high number of complaints to this office.”

Lowe’s March 30 letter to the assistant attorney general promised “a more fulsome response on certain topics will follow,” but noted that “the amount a patient pays for the care she receives is impacted by a variety of factors” including insurance coverage, out of pocket costs, “and other factors not set by the prices negotiated between MHS and the insurer.”

Lowe noted that “MHS is compliant with all federal regulations regarding price transparency,” and that commercial insurance contracts contain terms negotiated at length between “highly sophisticated parties.”

As for chronic under-staffing, cleanliness, and long wait times at Mission hospitals, Lowe wrote that Mission Health “is taking a number of concerted steps to address staffing challenges.”

“Further, MHS has received high marks on recent surveys and inspections related to patient safety and quality,” Lowe wrote. — Peter H. Lewis

Cawthorn’s 52-Point Plan For 2022 GOP House Majority

March 19, 2022Read more

Rep. Madison Cawthorn of western NC // YouTube screenshot

Once again bucking the Republican leadership, U.S. Rep. Madison Cawthorn (R-western North Carolina) has introduced a resolution in the House of Representatives to outline his legislative “freedom agenda” if he is re-elected in November and if Republicans regain control of Congress.

Cawthorn’s resolution — which so far has failed to attract any co-sponsors, and reportedly earned a rebuke from House GOP leaders — enumerates the 26-year-old congressman’s more than 50 priorities including ending Social Security entitlements, abolishing the federal income tax, abolishing the Department of Education, allowing concealed carry of weapons in every state, outlawing abortion, completing the southern border wall, censuring Anthony Fauci, resuming work on the Keystone pipeline, ending Obamacare, enacting a Parental Bill of Rights, promoting “patriotic civil engagement,” and downsizing the Environmental Protection Agency along with the Departments of Agriculture, Commerce, Energy, Health and Human Services, Housing and Urban Development, the Interior, Labor, and Transportation.

Cawthorn’s House Resolution 937, titled “Recognizing the duty of the Federal Government to preserve liberty by operating within the enumerated powers in the Constitution of the United States and its founding principles,” follows his equally successful House Resolution 732, “Expressing the sense of the House of Representatives that . . . nothing in the Constitution or Declaration of Independence is meant to be construed as racist or harmful.”

Below are Cawthorn’s 52 “duties of the Federal Government,” slightly edited for brevity. — Peter Lewis

Reduce government spending by one-third by 2031.
Enact a balanced budget amendment.
Turnaround the mismanagement of Social Security … by incentivizing people to work and get off entitlement programs.
Abolish the income tax.
Expand Opportunity Zones.
Demand instant COVID compensation from Communist China.
Incentivizing domestic manufacturing and agriculture production.
Abolish the Department of Education.
Establish English as the official language of the United States.
Downsize the Departments of Agriculture, Commerce, Energy, Health and Human Services, Housing and Urban Development, the Interior, Labor, and Transportation, and the Environmental Protection Agency.
Cut all outrageous Federal waste and spending and reallocate funds to nonprofits fighting the opioid epidemic, promoting veterans’ entrepreneurship, and promoting patriotic civil engagement.
Recognize the past abuse that Directors of three letter agencies have committed.
Impose term limits on Members of Congress (six terms for House, two terms for Senate).
Impose term limits on Federal career employees.
Ensure … that there is only one subject matter per one bill.
Protect employer-sponsored insurance from single-payer, government-run health care schemes.
Protect patients with preexisting conditions.
Require price transparency.
Provide generous subsidies, offset by cuts to government waste, for individuals to shop for their own health insurance and choose their own doctors.
Preserve health care freedom and choice and expand health savings accounts.
End monopolies in health care and among hospitals by unleashing individual choice and free market competition.
Guarantee health care choice for America’s veterans.
Expand the use and availability of telemedicine.
Federal funding [for education] should follow the student to whichever education institution the student attends [including private religious schools].
Prevent taxpayer dollars from funding anti-American critical race theory.
Document decades of failed progressive governance in our Nation’s urban centers.
Prevent Federal funding for cities that have defunded their police and law enforcement.
Recognize that life begins at conception.
Enact a parental bill of rights.
Make “political affiliation” protected from workplace discrimination.
Protect Americans from violence by recognizing that every American who can legally own a firearm has the ability to carry and conceal firearms in every State without a permit.
Abolish the National Firearms Act of 1934.
Expedite permits for modular nuclear reactors.
Incorporate underused hydropower into our energy grid.
Invest in development of breakthrough technologies using an “all of the above energy” strategy.
Immediately resume work on the Keystone pipeline.
Immediately withdraw from the Paris Climate Agreement.
Demand that China dismantle concentration camps, grant free speech rights to religious and political minorities, and offer a formal apology for the Tiananmen Square massacre.
Impose tariffs on Chinese goods.
Reform the National Environmental Policy Act.
Protect the United States’ access to critical minerals.
Complete President Trump’s border wall.
Prohibit federal funding to sanctuary cities.
Fight human trafficking.
Formally recognize Taiwan independence.
Use money generated from downsizing government to repair bridges, update highway system, and deliver rural broadband access.
Break up big tech monopolies.
Deregulate cryptocurrencies and incentivize blockchain innovation.
Rebuild America’s military.
Immediately return war making powers to Congress.
Invest in cyber, artificial intelligence, hypersonic weapons, and the Space Force.
Prioritize getting our veterans back to work through fellowship programs.

Ex-Trump Lawyer Powell Is Selling Her Asheville Home

March 17, 2022Read more

Sidney Powell’s house in Biltmore Forest

Sidney Powell, an attorney and former federal prosecutor best known for her promotion of conspiracy theories and attempts to overturn the 2020 presidential election, is selling her home in Biltmore Forest.

Real estate listings show that Powell’s 3,400-square-foot ranch house at 9 Forest Road,

Sidney Powell’s house in Biltmore Forest

Real estate listings show that Powell’s 3,400-square-foot ranch house at 9 Forest Road, which her company Fawkes Partners purchased in 2007 for $750,000, is currently under contract. The asking price is $1.55 million.

Powell joined the legal team of then-President Donald Trump in 2020 by falsely alleging that the election was stolen from Trump by a vast global conspiracy involving China, Venezuela, and secret algorithms inside machines made by Denver-based Dominion Voting Systems. She vowed to “release the Kraken” to overturn the results.

“President Trump won by a landslide,” she falsely claimed. “We are going to prove it, and we are going to reclaim the United States of America for the people who vote for freedom.”

She was later permanently banned from Twitter for promoting the bizarre claims of QAnon, a political group that believes a cabal of Satanic, cannibalistic pedophiles operating a global child sex-trafficking ring conspired against Trump during his term in office.

After the election Powell raised more than $14 million by promising that her nonprofit organization, Defend the Republic, would restore Trump to the presidency, according to The Washington Post. In August 2021 she paid $1.2 million in cash to buy a house in Alexandria, Va., Politico reported.

Powell did not immediately respond to a question from Asheville Watchdog about her plans to keep an Asheville residence. — Peter Lewis

Sidney Powell // Photo by sidneypowell.com

Sports News: Tourists Change Leagues, Sort Of

March 16, 2022Read more

Score it an error: Major League Baseball this week restored the historic names for each of the minor leagues, after meddling with the names last season. After playing last season in the High-A East League, the hometown Asheville Tourists will open the 2022 season in the South Atlantic League.

Final Standings,

Final Standings, 2021

Also last season, the Tourists changed their parent club affiliation to the Houston Astros, a decision that MLB failed to rectify this season.

The Tourists home opener is April 12 versus the Greenville Drive. — Peter Lewis

Mission Named One of Healthgrades’s “America’s 50 Best Hospitals”

February 9, 2022Read more

Mission Hospital in Asheville is one of the top 50 “Best Hospitals” in the United States for clinical excellence, as measured by the consumer ratings group Healthgrades, Mission Hospital announced today.

Healthgrades analyzed the clinical performance of nearly 4,500 hospitals nationwide across more than 31 of the most common procedures and conditions,

Healthgrades analyzed the clinical performance of nearly 4,500 hospitals nationwide across more than 31 of the most common procedures and conditions, and Mission Hospital was the only hospital in North Carolina to get the “50 Best” award, Mission said.

It is the seventh straight year Healthgrades has awarded Mission the “America’s 50 Best Hospitals Award.”

“Healthgrades does not take into consideration perception or popularity in analyzing and rating hospitals,” the Mission news release said. Healthgrades ratings are based on the Medicare Provider Analysis and Review data for 2018 through 2020 and represent three-year estimates for Medicare patients only. Patient reviews and pricing are not included in the evaluations.

Healthgrades is published by Red Ventures, a media and marketing company based in Indian Land, South Carolina, that also publishes Lonely Planet travel guides, Chowhound, and TV Guide, and owns GameSpot, Giant Bomb, and The Points Guy.

“We are so proud of the team at Mission Hospital and grateful to Healthgrades for recognizing their hard work and exceptional care,” said Chad Patrick, CEO of Mission Hospital. — Peter Lewis

He’s Out! Asheville native Joe West Retires From MLB

February 5, 2022Read more

Joe West, the all-time leader in Major League Baseball games umpired, announced his retirement this week after calling a record 5,460 regular-season games. Born in Asheville 69 years ago, and known as “Country Joe,” West called his last game Oct. 6, 2021, behind home plate in the National League wild-card game between the Los Angeles Dodgers and St.

Dogwood Makes It Official: Susan Mims is New CEO

January 31, 2022Read more

Dogwood Health Trust named Dr. Susan Mims chief executive officer of the $2 billion Asheville-based foundation, removing the “interim” title she has held since December 2020.

Created with the net proceeds from the 2019 sale of nonprofit Mission Health, Dogwood had been without a titular CEO since the abrupt and as yet unexplained departure of Antony Chiang in September 2020.

Dogwood Health Trust named Dr. Susan Mims chief executive officer of the $2 billion Asheville-based foundation, removing the “interim” title she has held since December 2020.

In announcing the decision, Dogwood said the search evaluated “more than 400 potential prospects,” eventually narrowing the field to 16 candidates, and then to four finalists, before concluding that that the best leader was already in the job.

“Over the past year, Dr. Mims has been an excellent leader for Dogwood and has demonstrated her commitment to dramatically improve the health and well being of all people and communities of Western North Carolina,” Casey Cooper, co-chair of Dogwood’s CEO search committee, said in a statement.

Before joining Dogwood, Dr. Mims, a physician, was chairperson of the Department of Community and Public Health at UNC Health Sciences at MAHEC, the Asheville-based Mountain Area Health Education Center. Before that she was a vice president at Mission Health, and former CEO of Mission Children’s Hospital. — Peter Lewis

Dogwood Executive Departs; CEO Search Continues

January 4, 2022Read more

William Buster // Dogwood Health Trust

William Buster, senior vice president at the Dogwood Health Trust in Asheville, has been named chief executive officer of the $1.3 billion New Hanover Community Endowment Inc. in Wilmington, NC.

Just as the Dogwood Health Trust arose from the $1.5 billion sale of Asheville’s nonprofit Mission Health System to HCA Healthcare,

William Buster // Dogwood Health Trust

William Buster, senior vice president at the Dogwood Health Trust in Asheville, has been named chief executive officer of the $1.3 billion New Hanover Community Endowment Inc. in Wilmington, NC.

Just as the Dogwood Health Trust arose from the $1.5 billion sale of Asheville’s nonprofit Mission Health System to HCA Healthcare, the New Hanover Community Endowment was formed from the sale of the previously county-owned New Hanover Regional Medical Center to Novant Health. Dogwood Health and the New Hanover Community Endowment each instantly became two of the largest healthcare endowments, per capita, in the United States.

Buster joined the Dogwood Trust’s Impact Team, responsible for grant-making and program-related investment activity, in November 2020. His departure after 14 months comes as Dogwood continues its search for a permanent CEO. Susan Mims, a physician and former member of the senior leadership team at Mission Hospital, has held the title of Interim CEO since the abrupt and as-yet unexplained departure of Antony Chiang as CEO after less than a year at Dogwood.

Dogwood announced its search for a new permanent CEO in October, with plans to announce the new leader “in early 2022.” Buster will assume his new job at the New Hanover Endowment in March. — Peter Lewis

Mission Hospital Gets an “A” In Latest Safety Grading

November 10, 2021Read more

Mission Hospital in Asheville received an “A” grade in the latest national rating of hospitals for its performance in preventing medical errors and harms to patients, in what its chief medical officer called “a tribute and credit to all the people on this team who have been working so hard through all the challenges we’ve faced during the pandemic.”

And for the eighth straight time, AdventHealth Hendersonville also received an “A” grade from the Leapfrog Group, an independent, nonprofit organization that measures patient safety and assigns a letter grade to hospitals based on how well they prevent medical errors, accidents, injuries, and infections that kill or harm patients.

But Pardee Memorial Hospital in Hendersonville slipped to a “B” rating in the Leapfrog Fall 2021 ratings, which were announced today. Pardee had scored “A” the previous three gradings.

Also receiving “B” grades in the Fall 2021 period, released Nov. 10, were Haywood Regional Medical Center in Clyde, Mission Hospital McDowell in Marion, Rutherford Regional Medical Center in Rutherfordton, and Harris Regional Hospital in Sylva.

Nationwide, 32 percent of all hospitals reviewed by Leapfrog received “A” grades, and 26 percent got “B” grades. And among all states, North Carolina ranked No. 2 nationally for the highest percentage of “A” hospitals.

Mission Health, owned by HCA Healthcare of Nashville, is by far the biggest hospital in Western North Carolina and the region’s only Level II trauma center. It was downgraded to a “B” in the Spring 2021 Leapfrog safety ratings before rebounding in the current period. Grades are updated twice yearly.

“Compassionate care and safety are our highest priorities at Mission Hospital and I am incredibly proud of our team and their commitment to the patients we are privileged to care for,” Chad Patrick, CEO, Mission Hospital, said in a prepared statement. “The entire team’s dedication to the highest level of care for our patients — especially during the challenges of a pandemic — is proven with this safety grade A from Leapfrog.”

The Leapfrog Hospital Safety Grades surveyed 2,901 hospitals nationwide and assigned them point scores on more than 30 categories, including infections, surgical problems, safety problems, practices to prevent errors, and medical staff.

Jay Kirby, chief executive of Pardee, asked to comment on his hospital’s downgrade, told The Watchdog: “Our focus is, and always will be, to provide exceptional care to our patients. A rating score from Leapfrog in no way diminishes our commitment to safety across our organization. Nor does it take away from the very hard work and determination exhibited by our team throughout this past year and the six-month review period for this particular rating. “

“I am very proud of the work we’ve accomplished, the lives we have saved, and the deaths prevented as a result of our efforts,” Kirby said.

Dr. William Hathaway, Mission’s chief medical officer, told Asheville Watchdog that the hospital’s success in the latest scoring came in part from improved information management. In particular, he cited Patient Safety Indicator 90, a composite measure that tracks patient safety (or “avoidance of harm”) during the delivery of health care.

Mission Hospital received an “above average” positive score for having “enough qualified nurses” to care for patients. The hospital has been criticized repeatedly by National Nurses United, the labor union representing registered nurses at Mission, for what the union calls unsafe levels of staffing.

Mission was scored “below average” for “communication with doctors,” “communication with nurses,” and “responsiveness of hospital staff.” — Peter Lewis

Stein joins effort to halt hospital merger … in New Jersey

November 9, 2021Read more

NC Attorney General Josh Stein

Nov. 9 — North Carolina Attorney General Joshua H. Stein, who approved the 2019 sale of nonprofit Mission Health System to for-profit HCA Healthcare, giving HCA a virtual monopoly on healthcare in Western North Carolina, today signed a legal brief in support of a district court’s ruling that halted the merger of two hospital systems in New Jersey.

Stein joined 24 other state attorneys general in filing the amicus brief with the United States Court of Appeals for the Third Circuit, arguing that hospitals facing less competition have the ability to charge higher prices without providing improvements to the efficiency or quality of care.

Asked by Asheville Watchdog to comment on why he entered the out-of-state legal fray over the proposed merger of Hackensack Meridian Health and Englewood Healthcare Foundation, his office responded:

“North Carolina, like other states across the country, has seen a wave of hospital consolidations over the past few years. While our office has a limited role in reviewing transactions related to consolidation, we are concerned about what they mean for North Carolinians’ health care.”

“Filing this brief is part of our continued efforts to do everything in our power to make sure that North Carolinians have access to affordable, quality health care, especially in rural and underserved areas in our state,” Stein’s statement to The Watchdog read.

But in the brief, Stein joined the other attorneys general in writing: “Mergers that substantially increase provider market share in local markets lead to increased healthcare costs in local communities and raise the overall cost of healthcare within the States . . . without any substantial improvements in quality for consumers.”

The $1.5 billion purchase of the six-hospital Mission Health System gave HCA a monopoly on healthcare in Western North Carolina. HCA raised prices by 10 percent six months after the sale, and in 2020 Mission Hospital ranked second among HCA’s 183 hospitals for the highest net patient revenues. The hospital’s safety ratings declined in the most recent ratings period.

Stein’s office has received hundreds of complaints from citizens and health care providers about rising costs and declining quality of care at Mission Hospital since he approved the sale to HCA. Stein has said he is “very concerned” about the reports.

In an interview with Asheville Watchdog in late August, Stein said that state law limited his ability to halt the sale of the Mission system to HCA despite “conflicts” uncovered by his investigation of the proposed transaction. Stein has not responded to The Watchdog’s questions about the nature of the conflicts his investigators reported finding.

Because of the law’s restrictions, Stein said in August, he would have no choice but to make the same ruling today as he did in 2019, when the 20 members of Mission Health’s volunteer board of trustees voted unanimously to sell to HCA, despite considering only one other bid. — Peter Lewis

[This post was updated to include a response from the attorney general’s office.]

Dogwood Trust Is Searching For New Chief Executive

October 4, 2021Read more

Susan Mims, MD

[UPDATED Oct. 29] Dogwood Health Trust is looking for a “seasoned, collaborative and humble executive” to be chief executive officer of the $2 billion private nonprofit healthcare foundation, Dogwood announced Oct. 4. The Asheville-based trust is currently led by Interim CEO Susan Mims.

Dogwood announced plans to interview finalists for the position in December and to select a permanent replacement by early next year.

Susan Mims, MD

Dogwood announced plans to interview finalists for the position in December and to select a permanent replacement by early next year. Asked if Sims was a candidate for the permanent CEO position, a Dogwood spokeswoman said, “Out of respect for the confidentiality of all candidates, Dogwood Health Trust will not make that information public.”

Mims, a physician and public health expert, is a former member of Mission Hospital’s leadership team. She was appointed Dogwood’s interim CEO in October 2020 to replace Antony Chiang, who abruptly left the trust in September 2020, less than a year after he was hired with great fanfare and minutes before he was scheduled to speak at a news conference in Asheville.

In the year since Chiang’s departure, no one on Dogwood’s leadership team has responded to Asheville Watchdog’s repeated questions about Chiang’s sudden departure, and Chiang has not responded to requests for comment.

The Dogwood board selected Chiang from among 125 candidates to become Dogwood’s first chief executive. Witt Kieffer, the Massachusetts-based executive search firm that handled Chiang’s hiring, will once again conduct the search for the next CEO.

The Dogwood Trust was created with proceeds from the sale of the Mission Health System to HCA Healthcare in 2019. The Trust’s mission is to “dramatically improve the health and well-being of all people and communities across 18 counties and the Qualla Boundary in Western North Carolina.”

In general, a private foundation must distribute 5 percent of its net assets each year to maintain tax-exempt status. Claiming $2 billion in assets this year suggests that Dogwood intends to distribute at least $100 million a year to support housing, education, economic opportunity, and health and wellness in the region. — Peter Lewis

[This news item was updated and corrected Oct. 29 to remove an erroneous assertion that Susan Mims planned to step down when a permanent replacement is chosen. The Watchdog regrets the error.]

Developers Withdraw Charlotte Street Request

September 17, 2021Read more

After nearly a year of intense opposition from community activists, the developers of the proposed 101 Charlotte Street development formally withdrew their application to the City of Asheville for special permission to exceed current zoning restrictions along the near-northside Asheville corridor.

The out-of-state developer, RCG of Massachusetts, and its local landowner partner,

The out-of-state developer, RCG of Massachusetts, and its local landowner partner, Killian Chestnut Residential Properties, planned to tear down and replace a dozen century-old homes with a new apartment complex, parking garage, retail space, office space, condominiums and rowhouses on the nearly seven-acre 100-block of Charlotte Street.

On Friday, the development team withdrew its request for a variance from the city that would have allowed buildings along Charlotte Street to be five stories tall, significantly taller than current zoning regulations allow. The withdrawal means that, at least for now, development will proceed under current zoning guidelines intended to prevent over-development.

Opponents, including the Preservation Society of Asheville and Buncombe County (PSABC) and the Charlotte Street Neighborhood Association, cheered the news, but said their fight to save the existing homes was not over.

“While we are very pleased that the developers are no longer moving forward with the project, the future of this block remains uncertain and there are a number of complicated zoning issues at play,” the PSABC wrote on Facebook. “We will continue to monitor the situation and to encourage the developers to work with us and the community towards a project we can all support.” — Peter Lewis

Not-so-happy Labor Day: Study ranks North Carolina “worst” for working women

September 6, 2021Read more

For the second straight year, North Carolina ranks last overall in the United States for meeting the needs of working families, and especially in meeting the needs of working women, according to an annual study by Oxfam, the international anti-poverty organization.

The study, called the “Best and Worst States to Work in America 2021,” found that North Carolina “provides no support for workers’ rights to organize,

The study, called the “Best and Worst States to Work in America 2021,” found that North Carolina “provides no support for workers’ rights to organize, does not exceed the federal minimum wage, and has very few worker protection policies.” In ranking North Carolina at the bottom for working women, Oxfam cited the lack of a mandate for paid leave, no accommodation for pregnancy, and no protection against sexual harassment.

Oregon topped the list of “best places to work,” which surveyed working conditions in all 50 states plus the District of Columbia and Puerto Rico.

Unlike many other states, North Carolina has not raised its minimum wage beyond the federal minimum wage of $7.25 an hour, a level not changed since 2009, or the federal minimum tipped wage of $2.13 an hour, which has not increased in 30 years. In theory, employers of tipped wage earners are legally obligated to ensure that tipped employees earn at least the state minimum wage if tips fall short. However, the Oxfam report said, enforcement of this mandate is “paltry at best.”

Notably, women make up 69 percent of the tipped minimum wage workforce, and 36 percent of them are mothers, half of whom are single mothers, according to the report.

Asheville-based nonprofit Just Economics, which studies wage and cost of living issues in western North Carolina, put the 2021 “living wage” for the Asheville metro area at $17.30 an hour. The figure is calculated using the Universal Living Wage Formula, which is based on a 40-hour work week, the Fair Market Rent for Asheville determined by the federal Department of Housing and Urban Development, and another HUD guideline that no more than 30 percent of a person’s gross monthly income should be spent on housing.

HUD determined that the Fair Market Rent for a safe apartment in Asheville is $1,255 including utilities for a two-bedroom apartment. The statewide average for North Carolina is $919.

The 2019 Bowen Report on housing needs for the City of Asheville found that 46.8% of renters were cost burdened, meaning they spent more than 30 percent of their income on housing, and 19.4 percent were severely cost burdened, paying more than 50 percent of their income on housing. And that report was completed before the latest surge in Asheville housing prices.

In a meeting Sept. 2, the city’s Affordable Housing Advisory Committee noted that no houses were for sale in Asheville for less than $275,000. In August 2021, the real estate company Redfin reported, Asheville home prices were up 22.1 percent compared to last year, selling for a median price of $428,000. — Barbara Durr

Cawthorn targeted by panel investigating Jan. 6 attack

September 5, 2021Read more

[Sept. 5] Western North Carolina Rep. Madison Cawthorn is among the Republican members of Congress whose records are being targeted by the special committee investigating the fatal Jan. 6 attack on the U.S. Capitol, The New York Times is reporting.

The committee has asked technology firms to preserve the phone and social media records of 11 far-right members of Congress,

The committee has asked technology firms to preserve the phone and social media records of 11 far-right members of Congress, including Cawthorn, Lauren Boebert of Colorado, Matt Gaetz of Florida, Marjorie Taylor Greene of Georgia, and Jim Jordan of Ohio, the newspaper reported.

“These are the individuals who have been publicly supportive of Jan. 6 and the people who participated in the insurrection on Jan. 6,” Rep. Bennie G. Thompson, Democrat of Mississippi and the panel’s chairman, told The Times.

“We need to find out exactly what their level of participation in this event was,” he said. “If you helped raise money, if you provided misinformation to people, if you served on a planning committee — whatever your role in Jan. 6, I think the public has a right to know.”

Cawthorn rallied the crowd at a pro-Trump protest just before the attack on the Capitol. During the attack, while hiding in the basement, he called a right-wing radio show to say the rioters were “paid by the Democratic machine” and that he had carried loaded weapons into the Capitol.

At a recent GOP meeting in Macon County, Cawthorn said people arrested for their roles in the attack are “political prisoners” and warned of “bloodshed” over a “rigged” American election system. Among a number of provocative and misleading statements at the Macon rally, Cawthorn said in response to a question that “we are actively working on” plans for another similar protest in Washington. — Sally Kestin

Mission Nurses’ Union Calls for Public Protest, Citing Patient Safety

September 1, 2021Read more

[Sept. 1] The labor union representing registered nurses at Mission Hospital said nurses will stage a protest Thursday morning to call attention what it called “patient safety and unsafe working conditions” at Asheville’s flagship hospital system.

Among other complaints, the National Nurses Organizing Committee of National Nurses United asserted that HCA Healthcare-owned Mission Hospital scheduled symptomatic,

Among other complaints, the National Nurses Organizing Committee of National Nurses United asserted that HCA Healthcare-owned Mission Hospital scheduled symptomatic, COVID-positive nurses to work at the hospital, and failed to provide nurses with adequate masks, gowns, gloves and other personal protective equipment.

In a statement, Hannah Drummond, a registered nurse in Mission’s emergency department, said hospital administrators have ignored “months” of staff complaints about safety standards, including staffing. “We have a duty to the Asheville community to provide optimal care, and we will continue our advocacy until Mission is a safe place for our patients,” she said.

“We’re disappointed that the labor union would attempt to pull people away from patient care for a rally during COVID and not follow the mutually agreed upon process that they requested as recently as July,” JC Sadler, Vice President for Communications and Community Strategy at the North Carolina Division of HCA Healthcare, said when asked by Asheville Watchdog for a response to the union’s statement. “Caring for our patients and employees safely is our priority. We have ample PPE for our colleagues, require universal masking, and follow CDC protocols for returning employees to work.”

The protest is scheduled for 8 a.m. Sept. 2 at the corner of Biltmore Avenue and Hospital Drive. — P.L.

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By GREG BURNS

Earlier this month, Gannett’s Michael Reed had an opportunity to set a new course for the nation’s biggest newspaper company after disappointing financial results in August.

Instead, he doubled down.

Reed doubled down on cost-cutting, promising to cut $200 million to $240 million from “declining parts” of the business — primarily print. He doubled down on paying off debt, which tops $1.34 billion. Most of all, he doubled down on boosting digital subscriptions, while also promising to expand a unit that specializes not in journalism, but in selling web services to small- and medium-sized businesses.

At a Wall Street conference just weeks after he posted a $53.7 million quarterly loss and warned of a loss for the year, Reed said his long-term strategy remains unchanged. Gannett’s print business will continue to fall, but its smaller digital businesses will grow. In two years, he pledged, digital revenues will grow enough to more than make up for the decline in Gannett’s “legacy” business.

“We cross the inflection point in 2024,” said Reed, the company’s chairman and chief executive officer. “The math is that simple. You see overall stabilization and it starts to grow.”

So far, Wall Street isn’t buying it. Gannett stock plunged 70% to $2.10 on Sept. 20, from a peak of $7 a year earlier, as Reed’s optimistic forecast for 2024 failed to move the share price higher. Also leaving investors unmoved was his decision to invest $1.2 million of his personal fortune in Gannett stock shortly after reporting the second-quarter loss. The stock spiked on the news, then went down again even more.

“I know there’s a lot of skepticism,” Reed said at the Sept. 9 investor conference. “I feel good about our future, and I would say that’s evidenced by the fact that just a couple of weeks ago, I bought 500,000 shares of stock in Gannett because I believe so much in the future.”

A Big Risk Ahead

The big risk is that Gannett keeps doing what it did in the second quarter: The decline in print accelerates, while revenues from digital businesses fail to compensate. The company’s debt load gives it little room for error and, as Jim Friedlich, CEO of the nonprofit Lenfest Institute for Journalism, observed, “Declining earnings are never a good thing for credit ratings of debt-laden companies.”

Still, one of the few Wall Street analysts who follows the stock expects Gannett to come close to hitting Reed’s 2024 digital target, despite an industrywide decline in pageviews at local news websites. Douglas Arthur of Huber Research predicts digital will account for 42% of total revenues in 2024, up from a little over one-third today, but not the 50% or more of revenue as Reed has pledged.

Arthur said his projection comes with a caveat: “I and (the) company have tended to be overly optimistic on the revenue outlook.”

And as Friedlich noted, reaching a tipping point where digital growth outpaces the decline in print is “something of a Pyrrhic victory, since it reflects the fact that print has declined so much that there’s not much left to lose.”

The digital gains that Reed anticipates will likely need to come from a smaller base of newspapers. Industry insiders say Gannett is shopping at least 60 of its nearly 500 publications, after dumping more than 100 since 2020. A spokeswoman did not address specific numbers but said the company has made changes “to better align its portfolio of products with our ongoing digital transformation while remaining committed to local journalism.”

Four Gannett weeklies in Massachusetts and another in New York state were recently snapped up by CherryRoad Media, an acquisitive tech company from New Jersey that has purchased dozens of Gannett newspapers over the past two years.

Jeremy Gulban, CherryRoad’s CEO, said Gannett is playing to its strengths by shedding smaller papers in more isolated markets. “This is a tough time for the newspaper business. They’ve got to play the best hand they can,” he said. “They have a national brand in USA Today and strong regional markets.

“No one disputes that print revenues will continue to decline,” Gulban said. “It has to be replaced with digital revenues and the question is, how much and how fast?”

Progress can’t come soon enough for Gannett. The company has limped along since being acquired by GateHouse Media in a highly leveraged deal that closed in late 2019, shortly before the pandemic. GateHouse took the Gannett name and promised to cut $300 million in annual costs while whittling down its punishing debt, which it has done.

A Gannett spokeswoman said the company will pay down between $100 million and $200 million in debt principal during 2022. “We are firmly committed to debt repayment and believe Gannett has a solid outlook, as we continue delivering and making progress.”

Cost-Cutting a Calling Card

Cost-cutting has been Reed’s calling card since the acquisition. The two companies had about 25,000 employees when they combined, a spokeswoman told The Associated Press at the time. By the end of 2021, the ranks had dwindled to 13,800 in the U.S. and 2,500 abroad, according to Gannett’s government filings.

This year, layoffs are multiplying. Poynter reported that Gannett laid off 400 employees in August and shut down an additional 400 open positions. Reed told investors he is seeking to accommodate the talent drain by increasing automation and outsourcing customer service, accounting and other basic corporate functions.

And while dozens of journalists were among those cut in August, Reed said Gannett is “not focused” on newsroom cuts. “We understand content is a big part of our growth strategy,” he told investors. “We’ve had to do some work in this area given this environment, but it is a small part of the overall cost reduction program … very small.”

The cuts were necessary because of a rapid and severe degradation in the business between March and April, Reed said. Digital advertising revenues were hammered in part by changes that Google made to enhance data privacy, which hurt programmed ad placements. Under pressure from inflation, consumers cut back spending on discretionary items like newspaper subscriptions. The costs of fuel and newsprint were sky high. And, most impactful, a tight job market left the company without carriers to deliver print newspapers, interrupting service and sparking cancellations.

Reed said he’s making the investment needed to hire and retain carriers but expects to continue cutting costs in 2023. “A natural question would be, are we cutting too much, are we cutting into the bone? The answer is no,” he told investors. “We are pulling forward cost actions that we would have taken in future years that are associated with the declining parts of our business.”

Green Shoots

All is not bleak. Gannett has a stable commercial printing and distribution arm, for instance, and its paid obituaries and legal notices continue to perform well, Reed said. The company is using data analysis to deliver more personalized, sought-after content. Some new products such as a crossword app have worked out, and the number of website users who are registered, as opposed to remaining anonymous, now tops 10 million. That gives the company millions of likely targets to convert into paid users.

The brightest spot is Gannett’s Digital Marketing Solutions unit, which helps businesses such as plumbers, dentists and restaurateurs increase their local digital presence, maximize their advertising reach and convert leads into paying customers. It’s growing and profitable, and Reed said it could be worth as much as $2 billion if it were a standalone company.

So, is a spinoff in the offing? Lenfest’s Friedlich notes the long history of newspaper companies separating stronger businesses from declining newspaper operations — including the 2015 separation of broadcaster Tegna Inc. from Gannett’s legacy publishing business.

“Sadly, this leaves the newspaper business without a growth engine and the remaining company in need of further cost reduction,” he said. “Investors win and news readers lose.”

Analyst Arthur of Huber Research doubts the marketing unit would grow as fast if it were a standalone company, without “so many long-term local relationships from its newspaper legacy business,” he said. Arthur pegs its value at $700 million, far less than Reed’s estimate, but still more than double Gannett’s $318 million market value as of Sept. 20.

Asked if the company is planning a spinoff, a spokeswoman said, “Our Digital Marketing Solutions segment is an important element of Gannett’s business strategy.”

At Northwestern University’s Medill School of Journalism, Media, Integrated Marketing Communications, senior associate dean Tim Franklin sees Gannett in “a race against the clock,” he said.

“The question is whether Gannett can grow digital subscriptions and marketing services fast enough to offset the accelerating print declines — and do it in the face of headwinds like decades-high inflation and an economic slowdown,” said Franklin, who serves Medill as a professor, John M. Mutz Chair in Local News and director of the Medill Local News Initiative. “They’ll need to make this transformation work at the same time they have the pressures of servicing a huge debt load. And they’ll need to pull this off while not cutting their newsrooms too deeply. Because ultimately, consumers aren’t going to hand over their credit cards for digital subscriptions unless there’s a compelling value in the news coverage they’re getting.”

Even as Gannett races to meet its digital goals at a pace comparable to “dog years,” Franklin said, “None of this important corporate reengineering will work if the news reports aren’t meeting reader needs.”

About the author: Greg Burns is editor of the Medill Local News Initiative. He was an editorial board member, columnist and business editor at the Chicago Tribune and a reporter for BusinessWeek magazine and the Chicago Sun-Times. He launched his career at the Anderson (S.C.) Independent-Mail.