Effective post-transaction Monitor of a 7-hospital system
Mission Health System
For five years, Gibbins Advisors served as Independent Monitor of HCA’s $1.5 billion acquisition of Mission Health System, overseeing compliance with commitments to facilities, services, charity care, and capital investment.
TEAM Ronald Winters, Clare Moylan, Thomas Urban, Ginger Smith, Bradley Williams
Situation Overview
In January 2019, HCA acquired Mission Health System in Western North Carolina in a $1.5 billion transaction that included seven hospitals and other healthcare facilities. As part of the approval process, the North Carolina Attorney General required an Independent Monitor to oversee HCA’s compliance with its contractual commitments in the purchase agreement.
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Summary
Sector:
Hospitals and rural healthcare
Approx. Size:
Seven hospitals
Our role:
Independent Monitor
Key Results
Identified key issues which Dogwood Health Trust and the NC Attorney General took up with HCA, holding HCA accountable for compliance with the obligations of the purchase agreement.
Role
Gibbins Advisors was appointed Independent Monitor in October 2019 (approved by the Attorney General, HCA, and Dogwood Health Trust). Our responsibility was to review HCA’s ongoing compliance with commitments such as:
Keeping major Mission Health facilities open.
Continuing key service lines.
Maintaining charity care policies for uninsured patients.
Making significant capital investments in promised projects and programs.
Approach
Conducted compliance audits of HCA’s adherence with commitments.
Reported findings to Dogwood Health Trust, enabling them to raise concerns with HCA and negotiate solutions where necessary.
Community engagement through town hall meetings across Mission Health’s service area.
Established and managed a dedicated Independent Monitor website for public updates and intake of community feedback.
Quarterly meetings with the North Carolina’s Attorney General office.
Key Accomplishments
Provided independent oversight of a $1.5 billion hospital transaction with significant community impact.
Identified key issues that were taken up with HCA by Dogwood and the NC Attorney General.
Created transparency and fostered trust through consistent public engagement and open communication channels.
We have proven acumen to work with all stakeholders to serve in the Independent Monitor role and provide the transparency that instills confidence and an understanding of the monitoring process.
