North Carolina Attorney General Gives Blessing To Mission/HCA Sale, But With Changes

Jan 16, 2019

North Carolina attorney general Josh Stein will give his blessing to the proposed sale of Mission Health to HCA.  That means Western North Carolina's major health system will go from a non-profit to a for-profit in the coming months.  But before he gave his approval, Stein announced several changes to the proposed sale contract between the two sides after hearing from concerned community members and groups.  Stein made the announcement Wednesday afternoon in Asheville.

The changes to the proposed sale contract - called the asset purchase agreement - include extending the timeframe that HCA must keep services at Mission’s current rural hospitals from five to 10 years.  Those hospitals include McDowell Hospital, Angel Medical Center, Blue Ridge Regional Hospital, Highlands-Cashiers Hospital, and Transylvania Community Hospital.   Stein adds HCA would not be able to close any of those facilities in that 10-year time period without the approval of a local advisory board, as well as an independent monitor. 

The new agreement also includes defined framework to ensure the board of directors for the charitable foundation created by proceeds of the sale is more diverse.  Critics of the proposed Dogwood Health Trust feared the board - which would be responsible for awarding more $1-billion in the region - would not be representative of both the rural communities of Western North Carolina, as well as communities of color. The initial round of board appointments - made months before the attorney general had even begun to examine the proposed sale - included mostly people who lived in Buncombe County, home to Western North Carolina's biggest city Asheville and Mission's largest hospital.  Under the changes Stein unveiled Wednesday, no more than four members of the 15-member board can be from Buncombe County by January 1st, 2021.

Stein's office also examined whether the sale price of Mission Health - $1.5 billion - was fair market value, and Stein agreed that it was.  The attorney general had to give his approval of the sale before it could move forward because it involved the sale of a non-profit to a for-profit entity.  Stein says Mission's sale is one of the largest transactions involving 'non-profit assets' in North Carolina history.  A closing date for the sale has not yet been announced.

Stein made his announcement Wednesday at a press conference at the Murphy-Oakley Recreation Center in Asheville in front of many community members who expressed concern over the sale.  They included members of the Yancey County-based group SEARCH and elected officials like Buncombe County state representative John Ager, state senator Terry Van Duyn, and Highlands mayor Patrick Taylor.  Their initial response to the changes seemed positive, as evidenced by comments made to the attorney general during the open question time of the press conference.  Taylor in particular said the changes - including the longer commitment to services at rural hospitals - appeased concerns he and the Highlands town board had brought up in recent months about the future of Highlands-Cashiers Hospital.

FROM THE ATTORNEY GENERAL'S OFFICE -

Changes to the 'asset purchase agreement

Map of the future Dogwood Health Trust Board