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Stein blesses Mission sale after negotiating sustained rural coverage

After negotiating changes to ensure sustained hospital facilities in rural counties and greater geographic representation of a new health care trust, North Carolina Attorney General Josh Stein announced Wednesday that he would not object to HCA’s acquisition of Mission Health System’s assets.


As a result of extensive negotiations with the Attorney General’s Office, HCA has strengthened its commitments to provide healthcare services, the Dogwood Health Trust has agreed to make its board more representative of the communities it will serve, and the parties have agreed to enforcement measures that will ensure compliance with this agreement, Stein's office said. These commitments will be included in a revised asset purchase agreement and letter agreement. More information about these commitments is available here.

“Access to healthcare is truly a life or death issue,” said Attorney General Josh Stein. “We kept that fact in mind as we conducted our review of this transaction. After extensive negotiations, I am satisfied that this new agreement protects healthcare in western North Carolina, ensures that the full value of Mission’s assets will continue to be used for public purposes, and requires that the Dogwood Health Trust will be independent and representative.”

“I am also pleased that HCA agreed to enforcement measures – this ensures that my office has the ability to take legal action should HCA fail to comply with the commitments it has made.”

North Carolina law authorizes the Attorney General to review any transaction in which a nonprofit corporation sells substantially all of its assets.

The Attorney General has dedicated substantial department time and resources in carrying out this responsibility regarding the sale of Mission Health System. Since May 2018, the review and negotiation has been a top priority of attorneys in the Department of Justice.

With changes over the next year, Dogwood Health Trust board will be fully representative of the people of Western North Carolina and it will be accountable to the public. Dogwood will roll off two current board members over the next year and an additional current board member in 2020. Dogwood has committed that by Jan. 1, 2020, its board will include no more than five members from any one county, and by Jan. 1, 2021, its board will include no more than four members from any one county. The trust board must include at least one member from each of the five regions with a regional hospital and a second member from the McDowell Hospital region by Jan. 1. The South Central region, which includes Transylvania and Henderson counties, would get one member by Jan. 1, 2021.

Following discussions with the AG's office, the Dogwood board has already increased its diversity from no people of color to being 27 percent people of color.

HCA committed to build a 120-bed mental health facility in Asheville. It cannot reduce the scale of those plans under the sale agreement.