On Monday, Aug. 20, Mission Health’s Board of Directors announced that if and when the Mission Health and HCA Healthcare (HCA) transaction closes, each Entity Legacy Foundation under its current umbrella will receive $15 million dollars over a three-year period to improve the health and wellbeing of their community.
Rowena Buffett Timms with Mission Health reiterated that none of the existing foundations within the Mission Health system are part of the contemplated transaction with HCA.
“They are independent and will remain so,” she said. “However, since their purpose will no longer be to give funds to their local hospital or care facility, the foundations will be redefining their goals and purpose.”
Currently, there are five Legacy Foundations: Blue Ridge Regional Hospital Foundation; CarePartners Foundation; Highlands-Cashiers Hospital Foundation; Mission Hospital McDowell Foundation and Transylvania Regional Hospital Foundation. Angel Medical Center doesn’t have a foundation so one will have to be created to receive the funds.
H-C Hospital Foundation Chairman Walter Clark said he is pleased with the proposed arrangement.
“We will add the $15 million to the $25-$30 million we now have in funds, assets and property and will decide how it will be spent if all this goes through; likely on health and wellness programs, education and a grant program,” he said.
Clark said a little over four years ago, Mission Health basically saved H-C Hospital and has done a good job all the way around adding that H-C Hospital CEO Jackie Medland is a “breath of fresh air.”
“If it wasn’t for the philanthropic citizens of Highlands and Cashiers and then Mission, H-C Hospital would have closed a long time ago. You just can’t operate small, rural hospitals anymore and we needed Mission,” said Clark.
According to Clark, before Mission took over operations and became the owner of everything that was H-C Hospital – land, buildings, equipment – the hospital was losing $3.5 million a year. In 2017 it only lost $750,000 which Clark attributes to Mission’s mode of operation and its scaling back. He doesn’t know what the 2018 “loss” will be; probably similar, he said.
“We’re not out of red zone yet, but we are working on it. It’s been good. We realized we couldn’t keep losing money each year.”
When Mission took over, the Foundation’s sole purpose was, and continues to be, to support the hospital and take care of loses at the end of the year and that will continue through 2018.
In addition, the foundation is currently spending $2.5 million of capital to spruce up the Eckerd Living Center and the hospital because it’s imperative the hospital campus is kept in good shape, said Clark.
“We have to protect our investment. We are running the show as if the HCA acquisition isn’t going to happen. If the day comes when it’s a done deal and the Attorney General signs off, we will have to stop spending money on the hospital because HCA is a for-profit and we can only deal with non-profits. At that point we will be a newly reorganized community foundation similar to the Highland-Cashiers Community Foundation and will focus on health and wellness and the socioeconomic issues associated with that.”
The $15 million each of proceeds from Mission Health’s sale to HCA Healthcare will be disbursed to the foundations over a three-year period beginning with $5 million upon closing of the contemplated transaction – likely the first of the year for year one, and at the same time for year two and three.
“The terms of the disbursement of funds in years two and three will be contingent upon each foundation’s previous year’s progress and its commitment to continue to develop community capacity to improve the health and wellbeing of its citizens and a successful start to improving the health and well-being of their communities, including a focus on the local social determinants of health,” said Chairman of the Mission Health Board Dr. John R. Ball.
When asked about that part of the arrangement, Mayor Pat Taylor said he is dissatisfied.
“I see no need for those funds to be parceled out to our foundation over a three-year period based on some vague notion that progress has to be made toward providing community wellness,” he said.
“The Highlands-Cashiers Hospital Foundation has a legendary record of excellence that spans decades. The foundation should be given the full $15 million free and clear upon the sale of our hospital.”
Nor does he think the $15 million covers what the foundation has invested in the complex over the years.
“According to the agreement with Mission, the Foundation covered shortfalls in hospital operating costs over the past five years. If that is correct, a significant additional reimbursement to the foundation should be made. Furthermore, the cost of the Highlands-Cashiers Hospital buildings that Mission did not build, nor purchased, has not been factored into this proposal.”
Clark said the foundation board has a good relationship with the Mission board but told them that when the community looks back on all this it isn’t going to look good if the community doesn’t get anything back.
“Mission can’t promise Dogwood Health Trust will do right by us down the road, so it was strongly suggested that Mission give us something back up front,” said Clark.
However, he said he believes when all is said and done, Dogwood Health Trust – the mega foundation separate from the individual hospital foundations that will be formed following the sale – will be great for Western Carolina, including Highlands.
“I believe it will be a good working relationship – like a cousin/aunt relationship with the same mode of operation and goals. It just makes sense.”
Dr. Ball said arriving at the $15 million figure wasn’t a scientific process; Mission just wanted it to be a significant amount to make a significant difference while changing the structure and approach of the how the foundations address issues of health in their communities.
“It’s harder to move from raising money to a structure of giving money. What kind of programs will serve those things that cause people to get sick? Three years will enable the newly structured foundations time to get on their feet with $5 million the first year to build change in infrastructure and strategy,” he said.
Meanwhile, allegedly there is a movement afoot to insure the following: that all documents HCA/Mission submits to the AG must be available to the public; that Mission employees cannot control the new Dogwood Trust; that if any outlying facility is closed, the property must be returned to the community at no charge; and outlying facilities are guaranteed to be kept open for Medicaid and other patients.
By Kim Lewicki, Highlands Newspaper