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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Impact Health to Lead Landmark Rural Health Initiative in Western North Carolina

 Impact Health to Lead Landmark Rural Health Initiative in Western North Carolina

 NC Department of Health and Human Services names Impact Health Region 1 NC ROOTS Hub Lead, advancing coordinated rural health priorities across 19 counties

 

FOR IMMEDIATE RELEASE

 

ASHEVILLE, N.C. — The NC Department of Health and Human Services has selected Impact Health as the NC Rural Organizations Orchestrating Transformation for Sustainability (NC ROOTS) Hub Lead for Region 1. In this role, Impact Health will lead implementation of the North Carolina Rural Health Transformation Program (NCRHTP) in Western North Carolina (WNC).

 

NCRHTP is supported by $213 million in federal funding from the U.S. Centers for Medicare and Medicaid Services. The statewide program aims to improve health outcomes, expand access to care, and create a more connected and sustainable rural health system that serves all North Carolinians.

 

The NC ROOTS Hub model creates regionally governed networks that bring together healthcare providers, behavioral health organizations, and community partners to address the unique needs of rural communities. Impact Health will lead WNC’s network across 19 counties and the Qualla Boundary in Region 1.

 

Laurie Stradley, DrPH, CEO of Impact Health, said the state’s designation builds upon Impact Health’s proven role as a regional convener and collaborator — an approach shaped by its work with regional partners through the NC Healthy Opportunities Pilot.

 

“It’s a great privilege to be selected as the Region 1 ROOTS Hub Lead,” Stradley said. “Our proposal reflects the lessons and expertise gained through Healthy Opportunities. Over the next several years, we will focus on strengthening, expanding, and sustaining efforts that are already working in WNC, while improving coordination and communication across partners.”

 

Regional Priorities & Partners

Over the next five years, Impact Health and other NC ROOTS Hub Leads will support rural communities by:

• Improving behavioral health and substance use services
• Enhancing care coordination across regions
• Leveraging digital tools to improve outcomes
• Expanding access to primary care
• Strengthening healthcare through workforce development

 

Currently, Impact Health is in the process of convening rural hospitals, primary care providers, behavioral health organizations, federally qualified health centers, local health departments, community-based organizations, and social service agencies to complete a regional needs assessment and asset-mapping process. Findings will inform the Region 1 Hub Action Plan and guide investments to strengthen rural health infrastructure across the region.

 

During the first year of the five-year initiative, Dogwood Health Trust will provide capital to support implementation and establish the Region 1 NC ROOTS Hub, Stradley noted.

 

“NCRHTP operates under a unique funding structure,” she said. “We would not be able to lead this work on behalf of our region without the partnership and collaboration of Dogwood Health Trust.”

 

“Healthy rural communities depend on dynamic and connected systems,” said Dr. Susan Mims, President and CEO of Dogwood Health Trust. “This is an opportunity to strengthen the relationships, partnerships and systems that help people access and receive high-quality care close to home. Dogwood is proud to support Impact Health as it brings community organizations and local providers together around a shared vision for healthier rural communities.”

 

North Carolina is presently home to more than 3.5 million rural residents, the second-largest rural population in the nation.

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About Impact Health
Impact Health is a regional nonprofit organization serving the 19 counties of Western North Carolina and the Qualla Boundary. Through collaboration, innovation, and strategic partnerships, Impact Health brings together health care providers, community organizations, and public agencies to improve health outcomes, expand access to care, and build healthier communities.

 

About Dogwood Health Trust

Dogwood Health Trust is a private foundation dedicated to dramatically improving the health and well-being of all people and communities across Western North Carolina. Through strategic investments, partnerships, and collaboration, Dogwood works to create opportunities for every person to live healthier, more fulfilling lives.

 

The North Carolina Department of Health and Human Services manages the delivery of health- and human-related services for all North Carolinians, especially our most vulnerable people – children, elderly, disabled and low-income families. NCDHHS serves as the lead state agency for North Carolina’s Rural Health Transformation Program aimed at improving health care for rural North Carolinians and their communities.

 

Stevens Amendment Disclosure: This news release is supported by the Centers for Medicare and Medicaid Services (CMS) of the U.S. Department of Health and Human Services (HHS) as part of a financial assistance award totaling $213,008,356.47 with 100% funded by CMS/HHS. The contents are those of the author(s) and do not necessarily represent the official views of, nor an endorsement, by CMS/HHS, or the U.S. Government.

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Nine N.C. counties in exceptional drought as statewide drought continues

RALEIGH – Localized heavier rainfall in parts of North Carolina may help alleviate demand for water for irrigation or other uses but did not lead to substantial improvements in the state’s drought conditions. 

According to the classifications released by the North Carolina Drought Management Advisory Council on Thursday, nine counties around the Triangle and eastern Triad remain in exceptional drought, the highest drought classification. Brunswick County is also classified as experiencing exceptional drought. Another 46 counties are in extreme drought, 31 counties are in severe drought and 14 counties are in moderate drought. 

“Parts of the Triangle saw more than 4 inches of rain or more this past week, but to substantially improve our drinking water supplies, it has to rain upstream of the reservoirs,” said Linwood Peele, supervisor of the North Carolina Department of Environmental Quality Division of Water Resources Water Supply Planning Branch. “It matters where the rain falls, and how fast it falls. The rain helped conditions here, but we need the lakes and reservoirs to fill back up, the groundwater and aquifers replenished and soil moisture restored.” 

Parts of North Carolina, including areas around Raleigh and Charlotte, saw 4 to 5 inches of precipitation in a seven-day period, according to the U.S. Geological Survey, but other parts of the state recorded none, or less than a tenth of an inch. Reservoirs around the state remain below normal, according to the U.S. Army Corps of Engineers. 

“It does help when we have rainfall like this, it helps because people don’t need to use as much water for irrigation or outdoor water use,” Peele said. “But to really help, we need those reservoirs to refill, and that will take time. We’re in a huge deficit.” 

Rainfall totals are down more than 23 inches in Wilmington, more than 22 inches in Boone and more than 15 inches in Raleigh compared with historical averages for the same period, according to the NC State Climate Office. Streamflow and groundwater levels continue to stay below normal or at record lows in parts of the state. 

For counties in exceptional or extreme drought conditions, or D4 and D3 classifications, water systems are advised to follow their Water Shortage Response Plans and adhere to water use reduction measures. Systems must report weekly water use and conservation status online at the DWR’s Water Use Reporting website. The public should check with their local water supply system for any information on water use restrictions that may be in place.  

“If a water system is asking people to cut back on non-essential water use, they should listen,” Peele said. “The more people do it, the longer the water should last. This is something we have to conserve our way out of.” 

DMAC is a collaboration of drought experts from various government agencies in North Carolina, Virginia and South Carolina, and organized by DWR. DMAC members meet weekly and submit their drought condition recommendations to the National Oceanic and Atmospheric Administration, the U.S. Department of Agriculture and the National Drought Mitigation Center for updates to the U.S. Drought Monitor, a map of the nation’s drought conditions. DMAC’s drought map is updated weekly on Thursdays, based on conditions through the previous Tuesday. To view North Carolina’s drought map, visit www.ncdrought.org. 

To learn more, visit our drought education page.

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Mission Health Launches 50 Techs in 50 Days Hiring Campaign

ASHEVILLE, NC — July 1, 2026 — Following the success of its recent 90 Nurses in 90 Days recruitment initiative, Mission Health has launched a new hiring campaign focused on strengthening other essential clinical care teams. The 50 Techs in 50 Days campaign aims to recruit 50 professionals for critical roles, including imaging, sterile processing, respiratory therapy, surgical technology, and pharmacy.

These positions play a vital role in supporting patient care across the health system and are part of Mission Health's continued investment in building a strong healthcare workforce to meet the growing needs of Western North Carolina. As part of the campaign, Mission Health will host a virtual hiring event on Wednesday, July 9, beginning at 11 a.m., giving candidates the opportunity to connect directly with recruiters and learn more about available positions. Those interested in these roles at Mission Health can register for the virtual hiring event by visiting careerevents.hcahealthcare.com/ClinicalHiringEvent

Individuals interested in joining the Mission Health team can learn more about these current opportunities by visiting https://careers.hcahealthcare.com/50ClinicalTechs or to see all opportunities, visit MissionHealth.org/careers.

ABOUT MISSION HEALTH 

Mission Health, based in Asheville, North Carolina is part of HCA Healthcare and serves as the leading healthcare system for Western North Carolina and the adjoining region. Operating 1,219 licensed beds across six acute care hospitals and one inpatient rehabilitation hospital, Mission Health offers numerous satellite practices, post-acute care provider CarePartners and the region’s only ACS-verified level I trauma center. As the largest employer in the region, Mission Health is committed to improving the health and wellness of the people of Western North Carolina. For more information, please visit MissionHealth.org or @MissionHealthNC. 

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Mountain Findings Awards $20,000 Impact Scholarship to Highlands High School Senior Claire Worley

 Mountain Findings Awards $20,000 Impact Scholarship to Highlands High School Senior Claire Worley

HIGHLANDS, NC — Mountain Findings, a 100% volunteer-run non-profit organization, is proud to announce Claire Worley as the recipient of the 2026 Impact Scholarship Award. Worley, a graduating senior at Highlands High School, will receive a $20,000 four-year scholarship to support her upcoming studies at the University of North Carolina at Chapel Hill.

The Impact Scholarship Award recognizes a graduating senior who demonstrates financial need and a deep, firsthand understanding of the Mountain Findings mission through active volunteerism. Over the past year, Worley worked extensively alongside the organization's volunteers, assisting shoppers, moving furniture, loading vehicles, and operating the register.

Worley’s long-term career goal is to become a critical care nurse, providing vital medical services both domestically and internationally. By lessening the financial burden of higher education, Mountain Findings aims to empower students like Worley to achieve their academic goals and drive positive future change through their careers and life actions.

According to Dan Rupp, President, "We are incredibly proud to support Claire as she takes this next big step toward her dream of helping others.  She has been an invaluable asset to our volunteer team, and we know she will bring that same dedication to her nursing career."

This award is part of a broader commitment by Mountain Findings to support local youth. This year, the organization handed out $64,000 in scholarships to Highlands High School seniors. Additionally, Mountain Findings continues to endow approximately $40,000 in scholarships to past recipients to support them through the completion of their degrees.

About Mountain Findings:

Mountain Findings is a 100% volunteer-run non-profit organization dedicated to supporting the local community and investing in the future of area students through financial aid, ongoing scholarships, and financial support in college, trades, certification, and technology programs.

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State Shifting NEVI Strategy to Put EV Charging Stations Where Needed Most

Photo provided.

 PRESS RELEASE 

NOPRTH CAROLINA DEPT OF TRANSPORTATION

JANUARY 27, 2026

RALEIGH – North Carolina transportation officials are hoping a strategic shift will allow them to buildout electric vehicle charging stations in more places where they are needed.

The N.C. Department of Transportation plans to scale back the number of EV charging stations it had originally committed to build along interstates and highways and put more of the state’s National Electric Vehicle Infrastructure (NEVI) Formula Program funds toward infrastructure in communities, rural areas and highways where less coverage exists.        

New federal NEVI Program Interim Final Guidance was issued in August that gives states greater flexibility to determine where EV charging stations can be placed.

“The revised guidance enables the department to focus its support for the build out of a statewide EV charging network in areas of the state where there are fewer chargers and greater needs,” said State Transportation Secretary Daniel Johnson. “By focusing on areas of need, it helps ensure that all North Carolinians and those traveling in every corner of the state can access the EV charging network.”

North Carolina received $109 million in NEVI funding from the Federal Highway Administration to build out EV infrastructure along a network of approved alternative fuel corridors​ and in communities.

The first round of the EV charging station buildout started in 2024. Five businesses are now under contract to build and operate charging infrastructure along the state’s major highway corridors in the so-called alternative fuel corridors, or AFC. These corridors are federally designated interstates and highways such as Interstate 40 and U.S. 64 where the first phase of the buildout is occurring. The corridors are strategically located to support alternative fuel vehicle travel, reduce EV owners’ range anxiety, and encourage cleaner transportation. 

New Guidance 

NCDOT had originally planned to build 50 stations along the alternative fuel corridors. But the new NEVI guidance removed strict requirements like a stipulation that there be only 50-miles of space between charging stations along the AFC. 

Also, the new guidance allows states to consider where existing privately developed EV charging infrastructure exists so states can ensure the NEVI-funded projects will not be in direct competition with existing privately developed infrastructure. Since the NEVI program began, several private firms built and now operate charging infrastructure in areas on the AFC originally identified as possible sites for companies interested in applying for NEVI funds.         

“Most of North Carolina’s alternative fuel corridors are fully built out based on the existing charging stations and those charging contracts that have been awarded,” said Heather Hildebrandt, NCDOT Statewide Initiatives manager. “We want to help ensure that the firms receiving NEVI funds will continue to be economically viable.”  

As a result, the NCDOT decided to scale back the NEVI-funded EV charging stations from 41 additional locations to 16 locations along the alternative fuel corridors. 

Putting fewer resources along the AFC will allow NCDOT officials to redirect more of the NEVI funding to develop charging infrastructure in areas, such as rural towns or even highways such as Interstate 26 in the mountains, where fewer EV charging stations exist.    

NCDOT published a map of the 16 sites and a list of the exits and crossroads​ for each charging cluster along the AFC on its website last week. 

The agency plans in late March to issue a request for proposals for businesses interested in applying for NEVI funds to build and operate charging stations in those areas. Businesses interested in applying for funding will have 45 days to respond to the request. 

“We hope that publishing the map now will give developers enough time to explore whether they wish to be part of this process,” said Heather Hildebrandt, NCDOT’s Statewide Initiatives manager. 

The NEVI Program is structured to reimburse private companies up to 80 percent of the cost to construct and operate electric vehicle charging stations for a five-year period. After five years, the charging stations will continue to operate without government support.

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DEQ Extends Purple Air Quality Forecasts in Western NC Due to Wildfires; Code Orange in Macon County

 

PRESS RELEASE (03-27-2025)

NC DEPT OF ENVIRONMENTAL QUALITY

RALEIGH – Smoke from South Carolina wildfires has the potential to create very unhealthy air quality in Transylvania and Henderson Counties on Friday, and other nearby counties, including Buncombe County, may also experience unhealthy air quality from smoke. Residents are urged to take precautions.

The N.C. Department of Environmental Quality’s Division of Air Quality (DAQ) is forecasting the following Air Quality Action Days for Friday:

• Code Purple for Transylvania and Henderson counties
• Code Red for Buncombe, Swain and Polk counties
• Code Orange for Henderson, Rutherford and Macon counties

These forecasts will be in effect starting at midnight tonight and remain all day Friday, but may be modified or extended. For the most up-to-date air quality forecast information, visit the Air Quality Portal.

Several Code Purple, Red and Orange Air Quality Action Day forecasts remain in effect through midnight Thursday. (See image for Thursday's update forecast below).

Code Purple is very unhealthy air quality. The general public is urged to avoid long or intense outdoor activities. Sensitive groups particularly susceptible to health impacts, including children, older adults and people with asthma or heart conditions, should avoid all outdoor physical activity in these conditions.

Code Red means prolonged exposure to the air may be unhealthy for anyone. All residents should consider reducing prolonged or heavy exertion outdoors and taking more breaks. Anyone sensitive to air pollution should avoid long or intense outdoor activities.

Code Orange signifies air quality that is unhealthy for sensitive groups. Children, older adults and people with asthma or heart conditions should limit prolonged or heavy exertion outdoors, take more breaks and watch for symptoms such as coughing or shortness of breath.

The Table Rock fire in South Carolina is producing prodigious amounts of smoke that may be carried northward into North Carolina on Friday. Additionally, several other wildfires continue to produce smoke in the region, including multiple fires in Polk County.

Smoke can carry elevated levels of fine particulate matter, or PM_2.5, which consists of particles smaller than the width of a human hair. These particles can reach deep into the lungs and aggravate asthma and other lung conditions and have been linked to heart conditions.

DEQ’s website has a list of resources for keeping safe around wildfire smoke.

State law prohibits the open burning of yard waste or land clearing debris on Air Quality Action Days of Code Orange or above. To report violations of the open burning rules, contact the DAQ regional office that serves your county. This restriction is in addition to any local or state burn bans. The N.C. Forest Service on Thursday issued a burn ban for all of North Carolina.

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