HCA Monitoring Report for 2025, Noting Two Areas of Potential Non-Compliance Public invited to attend a community Q&A webinar on Aug. 4, 2026

 Dogwood Health Trust and Independent Monitor Release

HCA Monitoring Report for 2025, Noting Two Areas of Potential Non-Compliance

Public invited to attend a community Q&A webinar on Aug. 4, 2026

 

Special Invitation for Media Partners: Dogwood will host a media opportunity via Zoom on Tuesday, July 28 at 10 a.m. with Rachel Ryan, general counsel for Dogwood Health Trust and Gerald Coyne with Affiliated Monitors to address any questions. Please email media@formationpr.com if you plan to attend. A Zoom link will be provided with email confirmation.

Asheville, N.C., July 24, 2026 – Today, Dogwood Health Trust and the Independent Monitor are releasing the annual compliance monitoring report and their letter to the North Carolina Attorney General’s Office (AGO). The release of the report follows Dogwood’s letter to the AGO sent on July 22, stating its intention to notify HCA Healthcare, Inc. (HCA) of two instances of potential non-compliance with the Asset Purchase Agreement (APA) for Mission Health System, as outlined in the Independent Monitor’s (IM) annual report for calendar year 2025.

Dogwood and the IM are extending a special invitation to the public to attend a community Q&A webinar on August 4, 2026, to learn more about the process and findings. Both the letter and the annual monitoring report are available on Dogwood’s website.

The 2025 calendar year monitoring report represents the seventh annual compliance review cycle for HCA and is the third annual report delivered by Affiliated Monitors, Inc. since being named the Independent Monitor in 2024.

 

What are the instances of potential non-compliance?

The IM’s report identifies two instances of potential non-compliance, found in Sections 7.13(a) and 7.13(h).

• Section 7.13(a) pertains to the continuation of services as outlined in the APA. In addition to degradation of Emergency and Trauma Services and Oncology Services currently being addressed by the NC Attorney General’s Office in the NC Business Court, the report notes the cessation of Industrial Rehabilitation services at CarePartners and continued diminishment of access to certain other services at Mission Hospital, Mission Children’s Hospital Reuter Outpatient Center and CarePartners.

• Section 7.13(h) notes that HCA shall remain “enrolled and in good standing” in Medicare and Medicaid. On Oct. 17, 2025, Mission Hospital received a 23-day notice of termination of its Medicare and Medicaid provider agreement. After revising its initial corrective action plan to meet the Centers for Medicare and Medicaid Services (CMS) requirements, the hospital’s Enhanced Plan of Correction was approved. Mission continues to work with CMS under that plan and has until July 26, 2026, to complete implementation. 

 

“The Asset Purchase Agreement guides our monitoring and assessment process, directing us to conduct an annual review of HCA’s compliance with the APA for the previous year,” said Rachel Ryan, general counsel for Dogwood Health Trust. “At the same time, Dogwood and the IM are also aware of and monitoring issues occurring in real time that have the potential to affect future compliance reporting.”

 

For example, the 2025 compliance report and Dogwood’s notice to the NC Attorney General note that while HCA took the necessary actions to return itself to good standing with CMS, Dogwood “would be remiss not to state” that shortly after, in January 2026, Mission Hospital received another Immediate Jeopardy finding. The finding has subsequently been lifted, but oversight has continued under an Enhanced Plan of Correction.

 

Ryan notes that Dogwood is engaged in active, ongoing monitoring and continued discussions with HCA and the Attorney General’s Office with a focus on compliance.

“We have come to know and greatly respect the Western North Carolina community, particularly those who have so passionately expressed their feelings to us about not just the quality of healthcare in the region, but how healthcare impacts quality of life,” said Gerald Coyne of Affiliated Monitors, Inc. “Similarly, while we do not minimize the challenges facing Mission Hospital, it is important to realize that the overwhelming majority of those who staff the hospital remain singularly focused on providing the best medical care possible to those they encounter, sometimes under the most challenging of circumstances.”

Coyne and Ryan encourage community members to continue to share their experiences with the Independent Monitor. The IM website is the primary place where community members can share their experiences and concerns.

“We appreciate everyone who made time to attend the community meetings held in 2026,” said Coyne. “Whether it was individually with a small group or at one of our larger community meetings, your voices help us tremendously.”

How can I learn more about the 2025 calendar year compliance report for HCA?

Dogwood will host a Community Q&A webinar with the Independent Monitor on Tuesday, Aug. 4, from 9 to 10 a.m. Together, they will review the findings from the report, review the requirements of the APA, and respond to questions. Community members can register to attend here and are encouraged to submit questions in advance.

 

What happens after Dogwood notifies the NC Attorney General of instances of potential non-compliance?

Per the Independent Monitor’s monitoring timeline, the Attorney General has 30 days from receipt of Dogwood’s letter to provide notice to Dogwood if the AGO decides that Dogwood has failed to adequately exercise its right to enforce certain obligations of HCA. Then, on or before October 28, Dogwood must issue a notice of potential noncompliance to HCA. Throughout this process, Dogwood will continue to engage HCA in discussions to address the identified compliance instances and their resolution.

 

Where can I find more information about the Asset Purchase Agreement and the monitoring process?

The IM Website has helpful information and resources, including the Asset Purchase Agreement, a summary of HCA’s commitments, the monitoring timeline as outlined in the APA, and Frequently Asked Questions. Dogwood Health Trust’s website maintains a library of compliance reports and documents.

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Dogwood Health Trust
Dogwood Health Trust is a private foundation based in Asheville, North Carolina with the sole purpose of dramatically improving the health and wellbeing of all people and communities of 18 counties and the Qualla Boundary in Western North Carolina. Dogwood Health Trust focuses on innovative and equitable ways to address the many factors that contribute to overall health and wellbeing, with a focus on housing, education, economic opportunity, and health and wellness. Dogwood Health Trust works to create a Western North Carolina where every generation can live, learn, earn and thrive, with dignity and opportunity for all, no exceptions. To learn more, please visit dht.org.

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Angel Medical Center CEO Column for January 2026

 

Let’s Set Our 2026 Health Resolutions More Realistically — to Have Higher Chances of Success

 10, 9, 8, 7, 6, 5, 4, 3, 2,1…welcome to 2026! As I get older, life seems to be passing by much more quickly — it feels like it was summer just yesterday! In November, we talked about gratitude. In December, we talked about giving back. In January, we typically make plans and set intentions for the coming year and hope for health, wealth, and happiness. The goal is a life that is balanced and fulfilling.

It seems natural to create resolutions and plans for the new year and future. It is also natural to create lofty goals because we feel that we need to take drastic action and transform from fat to skinny, go from high cholesterol to healthy levels, or convert ourselves from “wimpy” to Arnold Schwarzenegger. I am not sure about you, but I’m already sweating — and not from the workout I need to be doing or the health changes that I should make — but from anxiety!

It is human for people to overestimate their abilities and create goals that are not realistic. They do sound good. Everyone wants to be smarter, prettier, healthier or more motivated. One of the flaws is our lack of self-love and confidence. This leads to “what if” statements and excuses. Success in health and life starts with confidence and self-worth, or the ability to believe in ourselves. Hopefully, that comes with getting older, increased self-knowledge, and becoming a little more forgiving of ourselves. Many of the setbacks we have with resolutions include overdoing it and hurting ourselves somehow, or creating some other kind of health problem. If you have health issues, it is best to consult your primary care provider about what you can safely do.

There are also programs designed to help those who have health limitations. Angel Medical Center’s Cardiopulmonary Rehab program is designed to help people after heart attacks and cardiac diagnoses, as well as those with pulmonary issues like congestive heart failure. There are also trainers who specialize in helping you create healthy milestones to aim for, to limit the possibility of harm. Ask your provider if you qualify for this program and inquire about a referral.

Sometimes our will power and motivation wane over time, especially if our resolutions were too lofty or unrealistic. Example: I may feel full, but there always seems to be a special place for desserts and I’m somehow able to fit them in. It’s all too easy to stumble, weaken, and indulge in that cake, especially when I’m tired or stressed. There are many examples of situations where something stressful, large or small, hits us and the healthy intention goes out the window. After that first stumble, it becomes harder to get back on track. Again, we’re human, so a more realistic approach is to climb back on the horse again — all is not lost if you just re-commit to your goal and give yourself some compassion.

One important suggestion I have for the new year is to start planning your healthcare now. Take responsibility for your annual visits, wellness care, and health knowledge. Read up to learn more about any conditions you’re living with, and don’t hesitate to start a conversation with your provider.

Just like a New Year’s resolution, if you create a plan now and pace yourself, you’re more likely to keep up with making and going to your needed appointments, scheduling your screenings, and making sure you fit in that all-important annual wellness exam. If you delay and try to do everything at once, it can end up being costly and burdensome, which is discouraging and makes you more likely to lose sight of or abandon the crucial steps you must take to care for your overall health.

I look forward to a great 2026. We are blessed to live in this wonderful community, and we need to continue to focus on reaching out to those in need and seeking out opportunities to make a difference for our own self-care, as well in the lives of others.

Clint Kendall, FACHE, MBA, MSN, BSN, RN, is Chief Executive Officer/Chief Nursing Officer of Angel Medical Center. He started his career as a nurse, and that perspective still informs his work and passion for the patient experience. Clint holds a Master’s Degree in Business Administration, Nursing, and Health Care Management from the University of Phoenix, and a Bachelor of Science in Nursing from Western Carolina University. Clint has also earned the Certified Professional in Patient Safety (CPPS) certification, and is a member of the American College of Healthcare Executives (ACHE), the American Organization of Nurse Executives (AONE), and the American Nurses Association (ANA).

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Dogwood Health Trust and Independent Monitor Release HCA Monitoring Report for Calendar Year 2024

PRESS RELEASE (07-29-2025) 

DOGWOOD HEALTH TRUST

Dogwood Health Trust and Independent Monitor Release
HCA Monitoring Report for Calendar Year 2024

Report notes three areas of potential non-compliance; acknowledges resolution of two issues

Asheville, N.C. – On July 29, 2025, Dogwood Health Trust and the Independent Monitor (IM) released the annual monitoring report assessing the compliance activities of HCA Healthcare, Inc. operating under the Asset Purchase Agreement (APA) for Mission Health System during calendar year 2024. In addition to releasing the report to the public on July 29, Dogwood provided notice to the North Carolina Attorney General’s Office (AGO) that it intends to notify  HCA of three issues of potential non-compliance, as outlined in Affiliated Monitors’ report to Dogwood Health Trust. Both the letter and the compliance report are available on Dogwood’s website.

The monitoring report identifies three instances of potential non-compliance for 2024, including the provision of Emergency and Trauma Services and Oncology Services at Mission Health; failure to remain “enrolled and in good standing” in Medicare and Medicaid; and issues with Uninsured and Charity Care policies. While the review found HCA addressed two of the three areas of compliance, the report notes the organization was potentially non-compliant for much of 2024.

“This review process can be confusing at times,” said Rachel Ryan, general counsel for Dogwood Health Trust. “The Asset Purchase Agreement guides our monitoring and assessment process, directing us to conduct an annual review of HCA’s compliance with the APA for the previous year. At the same time, we know the community is interested in sharing their experiences that happen in real time, and that is why engaging with the Independent Monitor is so very important.”

Potential Non-compliance

One issue of potential non-compliance remains unresolved: APA Section 7.13 (a) - Continuation of Mission Hospital/Care Partners Services. In the IM’s report for 2023, Affiliated Monitors stated, “We believe that the Superior Court – and not the IM – is the most appropriate forum to resolve this issue.” Because this case remains pending in Superior Court, the IM once again has determined that HCA Healthcare is potentially non-compliant with the terms of the APA.

Areas of Compliance

On Dec. 19, 2023, and through June 11, 2024, HCA was under Immediate Jeopardy findings by the Centers for Medicare and Medicaid Services (CMS) and the North Carolina Department of Health and Human Services following a survey of operations at Mission Hospital. During 2024, HCA took the necessary actions to return itself to good standing with CMS, and therefore, its potential non-compliance for this issue has been resolved.

HCA also resolved a potential non-compliance issue related to its Uninsured and Charity Care policies. HCA adopted a revised Uninsured and Charity Care Policy, effective Jan. 1, 2025, that states HCA will not “pursue litigation activity that involves suing patients or filing liens on patient bad debt accounts.” Because of this change, HCA’s potential non-compliance with this issue has been addressed.

“We remain focused on engaging the community in our monitoring process,” said Gerald Coyne of Affiliated Monitors, Inc. “Our website is a primary place where community members can share their experiences and concerns, but even better is joining us when we’re in the community and holding community meetings. We appreciate everyone who made time to attend the meetings held in 2024. Whether it was individually with a small group or at one of our two larger community meetings, your voices help us tremendously.”

Next Steps

Dogwood will host a Community Q&A webinar with the Independent Monitor on Thursday, Aug. 7, from 12 to 1 p.m. to provide an opportunity for community members to learn more about the 2024 monitoring report, have their questions addressed and share additional feedback. Community members can register to attend here. Participants are encouraged to submit questions in advance.

Per the monitoring timeline, the Attorney General has 30 days from receipt of Dogwood’s letter in which to provide notice of its findings pertaining to issues of potential non-compliance, as noted in the report and letter. Throughout this process Dogwood will continue to engage HCA in discussions to address the identified compliance issues and their resolution.

About Dogwood Health Trust

Dogwood Health Trust is a private foundation based in Asheville, North Carolina with the sole purpose of dramatically improving the health and wellbeing of all people and communities of 18 counties and the Qualla Boundary in Western North Carolina. Dogwood Health Trust focuses on innovative and equitable ways to address the many factors that contribute to overall health and wellbeing, with a focus on housing, education, economic opportunity, and health and wellness. Dogwood Health Trust works to create a Western North Carolina where every generation can live, learn, earn and thrive, with dignity and opportunity for all, no exceptions. To learn more, please visit www.dht.org.

***END PRESS RELEASE***

Editor's Note: Read the 40-page 40 DF [LINK]

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Open House Held for New Helicopter Base and Hanger at Angel Medical Center

There was an open house at the new helibase at Angel Medical Center in Franklin. There was a private ceremony and remarks for the local board and elected critters that started at 2.30pm before it was open to the media and the public at 3.30pm, so there will be no video of that portion of the open house. Macon Media arrived as the private event ended and took some photos of the helicopter, the people present, and the new facilities. The photos are in chronological order and if you click on any photo, it will embiggen to a larger size for those who want a closer look. 

Previously:

Ribbon Cutting held at new Angel Medical Center in Franklin [LINK]

Franklin Community Celebrates Groundbreaking of New Angel Medical Center [LINK]

New Angel Medical Center Design Nearly Complete, Groundbreaking to Happen Before End of Year [LINK]

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Author/Photographer: Bobby Coggins Published at 4.20pm on Tuesday, September 24, 2024

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Ribbon Cutting held at new Angel Medical Center in Franklin

Image by Bobby Coggins as the ribbon at the new Angel Medical Center is cut. Video of the event and the tour will be published Thursday. A Facebook Live video of the event can be seen on the Macon Media Facebook Page. [LINK]

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Call 828-507-2735

PRESS RELEASE (09-13-2022) 

HCA Healthcare North Carolina Division | Mission Health 

 Franklin, N.C. (Sept. 13, 2022) – Community members and elected officials, along with hospital staff and leadership, gathered this morning for the ribbon cutting ceremony at the new $68 million Angel Medical Center in Franklin, NC. The new hospital, at 124 One Centre Court, Franklin, is slated to open at 6 a.m. on Sunday, Sept. 18.

“On behalf of Mission Health and HCA Healthcare, I want to thank everyone for the countless number of hours that have been spent making the new Angel Medical Center project a reality. We are proud to be here to celebrate a true investment in rural healthcare and in the Franklin community,” said Greg Lowe, President, HCA Healthcare North Carolina Division.

The new 82,500 square foot hospital builds on HCA Healthcare’s commitment to the town of Franklin and continues the current clinical offerings while enhancing and developing additional services based on the community's future needs.

“When you look around our region and across our nation you will see areas where communities are suffering due to the lack of adequate medical facilities. We here in Franklin are very fortunate and extremely grateful to our Angel Medical Center Board of Trustees and Mission Health for the foresight in making this amazing investment in our community. I honestly can’t think of another location comparable to Franklin that can boast of a new 82,500 square foot hospital with an investment of more than $73 million dollars,” said Franklin Mayor Tom Horton. During the ceremony, Blue Jazz and Delphine Kirkland performed the National Anthem as the American flag was raised for the first time at the new Angel Medical Center.

The new hospital is a state-of-the-art healthcare facility offering the most up-to-date clinical services and integrating the latest wireless technology available. Within our new facility are housed: 

 3 operating rooms 
 An endoscopy suite 
 And a 17-bed emergency department 

Our new rooms were designed with patient comfort in mind. The new facility will have a 30-bed inpatient unit capacity with: 

 5 acuity adaptable beds 
 20 medical surgical beds 
 And 5 observation beds 

As we prepare to open the doors to this new facility, we also look forward to kicking off work on a heliport for MAMA here at Angel Medical Center -- a $4.6 million investment allowing us to better respond to community needs. Construction on the heliport will begin this fall with work to be completed by early 2023. The new heliport will house both the MAMA crew and MAMA 2 helicopter. 

“Today marks a special milestone in HCA Healthcare and Mission Health’s commitment to healthcare services in Western North Carolina. The construction of our new Angel Medical Center has built on and supports the vision for healthcare in our region. Our new facility also allows us to continue providing compassionate patient care that has been associated with our hospital, but now do so in an environment offering the very latest in advanced medical care in a beautiful healing environment for years to come,” said Clint Kendall, CEO of Angel Medical Center.

Among community members in attendance were:

 Kevin Corbin, NC Senator District 50
 Karl Gillespie, NC State Representative District 120
 Gary Shields, Macon County Commissioner, District 2
 Jack Horton, Mayor of the Town of Franklin
 Amy Owens, Franklin Town Manager
 Justin Setser, Franklin Town Planner
 Chief Bill Harrell, Franklin Police
 Sheriff Robbie Holland

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