Gibbins Advisors, the independent monitor of HCA Healthcare’s compliance with the terms of its 2019 purchase of Mission Health, did not submit an application to Dogwood Health Trust to remain in that role and will end its work in the coming months.
Gibbins co-founder and Managing Director Ronald Winters told Asheville Watchdog about the decision in a statement Wednesday, a day after the submission deadline.
“While we were encouraged by Dogwood’s board and management to participate in the RFP process, after careful consideration we decided it is a good time to pass the baton to someone new,” Winters said. “We love this community and hope to continue the many good friendships with community members and leaders we made during our time as Independent Monitor.”
Gibbins’ decision came after Dogwood announced in early January that it would open a request for proposals for a new independent monitor. That application was open to Gibbins. At the time, Winters was non-committal whether Gibbins would submit a proposal to Dogwood, saying he needed to review application materials.
Dogwood did not immediately respond to The Watchdog’s request Wednesday for comment.
Since Dogwood put out the request for proposals, the U.S. Centers for Medicare & Medicaid Services found that Mission was in immediate jeopardy, the most severe sanction a hospital can face.
Starting Feb. 1, the hospital has 23 days to fix the issues that caused the immediate jeopardy or lose its Medicare and Medicaid funding, which would threaten its financial viability.
The specifics of the incidents that led to CMS’ finding have yet to be made public. However, a CMS letter to Mission CEO Chad Patrick mentioned six conditions in which the hospital failed to meet standards: governing body, emergency services, nursing services, patients’ rights, quality assurance, and laboratory services.
“We are closely watching Mission’s required implementation of an approved Plan of Correction addressing the recent CMS survey,” Winters said in his statement to The Watchdog.
Dogwood CEO Susan Mims told The Watchdog in January that Gibbins would continue to work for her organization “until we have a new independent monitor in place.” The new contract will start April 1, according to Dogwood’s request for proposals.
Dogwood is responsible for overseeing HCA’s compliance with the terms of purchase of Mission, as required by the attorney general. The independent monitor is paid by Dogwood, not HCA or Mission Health System.
Mims said then that Dogwood had asked Gibbins to undertake “additional responsibilities” in 2023, including community engagement and education and engagement with the attorney general’s office.
These extra activities “exceed those required under the Asset Purchase Agreement (APA),” Mims said, referring to the set of commitments that Attorney General Josh Stein required before he approved the $1.5 billion sale.
Dogwood’s announcement followed Stein’s lawsuit against HCA and Mission, which was filed Dec. 14 and alleges that HCA has violated at least two of fifteen agreements it made when it purchased then non-profit Mission, specifically not keeping oncology and emergency care services at Asheville’s hospital at the levels it committed to at the time of the sale.
Stein’s office did not immediately respond Wednesday to a request for comment on Gibbins’ exit.
Gibbins’ role was to track compliance with the terms and report on findings each year. Its duties included keeping major Mission Health facilities open, continuing to provide certain key services, continuing policies for uninsured and charity care, and making significant capital investment in promised projects and programs, according to the website Gibbins dedicated to sale oversight.
While the new independent monitor will have some different responsibilities than Gibbins had, many tasks will remain the same: reporting to the attorney general’s office, documenting HCA’s compliance with the sale agreements and engaging with and educating the public.
As required by the purchase agreement, HCA must submit an annual report on compliance to Dogwood and the independent monitor by the end of April.
“We are preparing and will submit the supplemental information requests that support the 2023 Annual Report evaluation process,” Winters said.
Asheville Watchdog is a nonprofit news team producing stories that matter to Asheville and Buncombe County. Andrew R. Jones is a Watchdog investigative reporter. Email arjones@avlwatchdog.org. To show your support for this vital public service go to avlwatchdog.org/donate.
Who could blame Gibbons? I’d run as fast and far from HCA as I could.
Dogwood is a fox in the henhouse. I don’t trust them any more than HCA.
Yep. So incestuous, and looks like a lot of cya and gaslighting going on. All of this light into formerly dark corners is a whole new game.
In my opinion Gibbins failed at its role and knows it. But don’t worry, they got paid!
Regrettably, Gibbons had to work within the framework of the agreement and that they did. The fault is with the parameters of exactly what they could investigate. HCA is no fool. All aspects of this deal are airtight from the NDA’s the Board was forced to sign to the kind of oversight that Gibbons was able to provide. Go back and read prior Watchdog articles on the subject to gain a better understanding of the issues involved.
How can I get in with apart of the lawsuit on how I was treated in the ER. 3 visits to determine I had a broken back and sacrum.
Gibbins Advisors failed to see any issues with the items they were “monitoring” for the Dogwood Trust and I am not surprised they bailed out. I believe the recent CMS/HHS audits uncovered several deficient areas that were part of the Independent Monitors scope of work. I hope the Dogwood Trust gets an IM that is more competent in digging into this “Immediate Jeopardy” system.
The ship is sinking and the rats are swimming away.
seems pretty clear Gibbons and Dogwood were not doing their jobs. Glad one of them stepping away
Interesting that the Dogwood Trust is participating in a robust RFP process, not like the Mission board which did not.
They should be sued for false reporting as there were clearly issues and they reported that everything was just fine and they found no deficiency
Dogwood has the responsibility to review the compliance for HCA. What a joke. Dogwood needs to be reviewed as well. This whole thing is flawed and it hurts Asheville. Very sad
“While we were encouraged by Dogwood’s board and management to participate in the RFP process, after careful consideration we decided it is a good time to pass the baton to someone new,” Winters said.
What I’m hearing here is “We’re getting the hell out of Dodge”
I called Mission Hospital administration today and asked for the CMS case number associated with the current investigation. They did not know it or would not give it. I cannot turn anyone up in DHHS that knows it. I filed yet another complaint, today, 2.8.2024, with the Office of the Inspector General. I indicated that I believed that the Mission Hospital Pharmacy needed to be included in the items being investigated and as per the Watchdog report, the Mission Pharmacy is not part of the investigation. I was not assigned a case number by OIG but did receive an email back from the Office of the Inspector General that my complaint had been received. Within the body of that complaint I included the above complaint I filed with the NC BOP.