Becker's Hospital Review

15 CFO / FINANCE 'Critically understaffed': Lawmakers, patients and staff blast HCA's takeover of Mission Health By Ayla Ellison P atients, staff and elected officials are raising concerns about HCA Health- care's management of Mission Health one year aer the for-profit company acquired the Asheville, N.C.-based health system. Nashville, Tenn.-based HCA completed its purchase of Mission Health, a six-hospital system, in February 2019. As part of the deal, an independent monitor was hired to oversee HCA's compliance with obligations stemming from the acquisition. Gibbins Advisors, the firm hired to monitor compliance, has held four meetings across Western North Carolina to hear from local residents about HCA's first year operating Mission, according to the Asheville Citizen Times. e fourth meeting, held Feb. 10 in Asheville, brought the same results as the previous three — employees, patients and politicians are displeased with the takeover. During the meeting in Asheville, state Sen. Terry Van Duyn, D, shared concerns from her constituents regarding patient safety, phy- sician disenfranchisement and charity care. e concerns were detailed in a letter co- signed by Democratic state Reps. John Ager, Susan Fisher and Brian Turner, Asheville Mayor Esther Manheimer and Buncombe County (N.C.) Commission Chair Brownie Newman. "e time for patience in the transition has passed and the time for real conversation with HCA leadership about these problems has come," Ms. Van Duyn said, according to Asheville TV station WLOS. Former patients and hospital staff also raised concerns. Jennifer Kirby, RN, a nurse at Mission Hospital for 15 years, said the facil- ity is "critically understaffed," according to the Asheville Citizen Times. ough Gibbins Advisors' purview pertains to the 15 obligations within HCA's asset purchase agreement with Mission Health, the firm is logging all feedback. e organi- zation said it expects HCA to issue a com- pliance report within the next few months, which will be followed by hospital site visits. "We emphasized [during the meetings] that the independent monitor is not involved in resolving individual or group concerns or grievances, but to the extent those comments are indicative of compliance issues that fall within our scope, they will be used in our evaluation process," Gibbins Advisors said in a statement, according to WLOS. n CHS nears end of divestiture spree after shedding more than 90 hospitals By Ayla Ellison F ranklin, Tenn.-based Community Health Systems has been busy selling, spinning-off and closing hospitals over the past four years. CHS began refining its portfolio in 2016 with the spinoff of Quorum Health, which included 38 hospitals and CHS' hospi- tal management and consulting business. Over the next three years, CHS sold or closed dozens of hospitals. In 2017, CHS sold 30 hospitals and announced plans to divest another group with combined revenues of $2 billion. The com- pany made progress toward that goal in 2018 and 2019, selling 26 hospitals and closing three others. CHS is near the end of its hospital sell-off spree, according to the company's presentation at the J.P. Morgan Healthcare Conference in San Francisco on Jan. 15. CHS officials said they expect the remainder of the divestitures to close by mid-2020. Shrinking its hospital portfolio has helped CHS reduce its debt load. The company carried $13.88 billion in long-term debt when it announced its divestiture plan at the end of 2017. CHS' long- term debt totaled $13.29 billion as of Sept. 30. The company's net debt has shrunk by $1.6 billion since Dec. 31, 2016, according to the presentation at the J.P. Morgan Healthcare Conference. n South Carolina hospital sued over debt collection practices By Ayla Ellison L exington Medical Center in West Columbia, S.C., allegedly uses unlawful debt collection practic- es that violate federal bankruptcy rules. A lawsuit filed Jan. 10 by three former patients alleges the nonprofit hospital seized their tax refunds to cover past-due medical bills after they filed for bankruptcy. Federal law requires companies to pause collection efforts after someone enters bankruptcy, according to The Post and Courier. Lexington Medical Center uses South Carolina's Setoff Debt Collection Program to withhold patients' tax refunds to cover delinquent bills. In 2015, Lexing- ton Medical Center collected $15.6 million from tax refunds. That number grew to $19.2 million in 2017, according to the report. Lexington Medical Center did not immediately re- spond to the complaint. A spokesperson told The Post and Courier that "it would be inappropriate to comment on pending litigation at this time." Lawyers representing the former patients are seek- ing class action status. They filed the lawsuit on behalf of anyone from whom Lexington Medical Center has unlawfully collected debt. n

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