NEW HANOVER COUNTY — Residents expressed their concerns to the New Hanover County commissioners this week, urging them to hold Novant Health accountable for patient care and safety standards.
READ MORE: Former physician asks commissioners to hold Novant accountable to ‘five-star’ rating
ALSO: Novant NHRMC gets ‘B’ safety grade per new report
About 30 demonstrators gathered outside of the New Hanover County commissioner meeting on Sept. 2 to demand commissioners address poor patient safety ratings at Novant New Hanover Regional Medical Center. The demonstration was organized by Jon Martell, a former physician and founder of the Cape Fear Five Star Project, a group established in 2024 with the goal to push for improved healthcare quality at the hospital.
Specifically, the Five Star Project is requesting commissioners require Novant to create a five-year strategic improvement plan with measurable milestones and provide semi-annual public updates on progress. About 3,400 people have signed a petition in support of these requests over the last year.
Novant Health bought the county-owned hospital in 2021, its purchase agreement with the county outlining Novant has to make “reasonable best efforts” to position and maintain the hospital’s spot in the top 10% nationally for quality metrics. These metrics include patient outcomes, safety, readmission rates, and patient-reported experiences.
“The question is, then, are they making all reasonable efforts?” Martell said to Port City Daily Tuesday. “Novant hasn’t been willing to step up and say: ‘Hey, these are the efforts we’re making, here’s our plan, here’s our strategy,’ but contractually, they need to be making those efforts.”
Hospitals receive ratings from government and private agencies, which cover patient safety, including infections, errors, and injuries. Two leading ratings services, the Leapfrog and Centers for Medicare and Medicaid reports, are widely recognized and respected by policymakers and healthcare professionals.
Both Leapfrog and CMS gather data from hospitals over the course of a year, primarily through hospital-submitted surveys and electronic records. Leapfrog issues its hospital grades biannually in the spring and fall, while CMS releases its star ratings quarterly.
The most recent Leapfrog report from spring of 2025 assigns NHRMC a “C” grade for fall 2024 to spring of 2025. NHRMC received a “B” grade from Leapfrog from 2022 until 2024, but they’ve declined since Novant purchased the hospital from the county for $1.5 billion in 2021.
The hospital’s CMS star rating has also lessened since Novant’s acquisition. The hospital’s rating was consistently three stars before the sale, but it has been rated two stars since 2021. This includes the CMS report released in April 2025.
Recent CMS data shows patients treated at NHRMC are 20% more likely to die from surgical complications compared to those who seek treatement at UNC or Duke. This is a data point highlighted by the Five Star Project.
“We are not just dealing with statistics — we’re talking about real people dying or being permanently harmed due to preventable failures,” Martell said.
By comparison, Duke University Hospital received a four- out of five-star rating from CMS and an “A” grade from Leapfrog for spring of 2025, while N.C. Memorial Hospital at UNC received five stars from CMS and an “A” from Leapfrog.
However, Novant Health has maintained external ratings are not as reliable as their own internal review process. Novant Health uses the Vizient clinical database to track its performance. Vizient is a healthcare performance improvement company providing data, analytics, and consulting services to its member hospitals.
Port City Daily asked for Vizient data, but was told it was for internal use and is not made publicly available.
Dr. Heather Davis, Novant Health Chief Clinical Officer for the coastal region, said while data from Leapfrog and CMS reports can be valuable, the data gathered through Vizient captures a “more complete picture” of the hospital’s current standing, since both Leapfrog and CMS use data gathered from the previous year.
“It gives us a more recent look at performance and it also allows us to see trends very early on,” Davis said. “So if there is something that we need to focus on, or while we have tasks for task forces or committees or work groups in those areas, it allows them to continuously look at more real-time data and performance to make sure that we’re either continuing to have a high level performance or if there’s areas we need to improve, we can focus some of the work in those areas.”
In response to Martell’s request for a five-year action plan, Davis said Novant already has a similar plan in place. Vision 2030, endorsed by Novant’s coastal review board in 2024, is a plan for the next five years focused on sustainable healthcare through safety and quality of care, team member engagement and patient experience and access.
The Vision 2030 plan includes a multi-million-dollar investment in a new electronic health record system called “Dimensions,” designed to consolidate systems and improve overall patient experience, quality, and safety.
To help address community concerns, NHRMC president Laurie Whalin told Port City Daily the hospital has what’s called the “HeRo Playbook,” which outlines team members’ roles in fostering a “zero harm, maximum quality” experience at NHRMC. In part to achieve this, team members meet for daily huddles where they recount any safety and quality issues from the previous day and identify safety issues anticipated for the current day.
As a community member herself, Whalin said she “stands firmly” that the hospital is a safe place to come: “We want our community to be proud of this place, and that is what we’re committed to on a daily basis.”
For the community, Martell said the risks associated with poor care are “twofold.” One is forced by circumstances, where people have to go to a two-star hospital for care due to proximity and location.
“There isn’t an alternative around,” Martell explained. “There’s the other risk that people take because they’re very afraid of this hospital. They will cut and run — you know, they’ll drive for three hours to get to Wake Med or Greenville and there’s certainly a risk with that.”
Speaking to the risks, residents anecdotally recounted their time at NHRMC during Tuesday’s commissioner meeting.
After Wilmington resident Stephen Agnelli attended the protest, he recounted his story in front of New Hanover County elected leaders. Agnelli’s son passed away at NHRMC in 2021 after suffering from kidney issues. Agnelli said his son’s death was preventable.
“By the time the doctors figured out what was wrong with him, his heart already stopped,” Agnelli said. “There were five of them in there trying to resuscitate him, to no avail. I saw him die. My wife saw him die right in front of us. I suffer from PTSD from it to this day, all on account that Novant does not know what they’re doing.”
More recently, Agnelli said his wife went to the hospital in May for an ablation for AFIB. After the procedure, Agnelli said his wife had symptoms of numbness along one side of her body and after discussing the symptom with a nurse, she was allowed to go home. A few days after the procedure, Agnelli said his wife suffered two strokes, as well as one during the procedure. He pointed to poor communication as the reason for their issues.
“None of the staff informed the doctor that she, the patient, his patient that he did the procedure on, had a stroke during the procedure,” Agnelli told Port City Daily. “When we went to see him, he said: ‘Nobody said anything to me.’ This is the communication you have. It’s a rotten hospital.”
Another community member, Wendy Wagner, told PCD she was supporting Five Star at the picket line due to friends who endured complications during surgery at NHRMC. While she explained she received good care at the hospital in the past, Wagner found Novant’s track record concerning.
“I hear so many stories of senior citizens that have either lost their parents or had very bad experiences in the emergency room,” Wagner said. “I myself would go directly to Duke if I needed any medical care.”
Speaking during public comment, resident and UNCW professor Denise Henning described her experience with NHRMC. In 2023, she said her husband came to the emergency room for a bad cough and congestion, later learning he had pneumonia after waiting nearly two days for a diagnosis.
Her husband then had a heart catheterization to avoid congestive heart failure, but his main artery was dissected during the procedure. Upon seeking information on her husband’s condition, she said no staff member was there to help. Henning told commissioners she had to “make the most painful decision of her life” to turn off her husband’s life support.
“This is my reality, this is my trauma,” she said. “Long waits, preventable mistakes, a doctor who didn’t care enough to apologize, no communication, and it cost the life of the man of my world. It cost the life of my children’s father.”
Commissioner Rob Zapple told Port City Daily his “heart goes out” to the members of the public going through difficult medical experiences. As far as action from the commissioners, Zapple said they are not the “enforcers” of the county’s contract, but emphasized a public pressure approach.
Zapple was the only commissioner to vote against the purchase agreement with Novant in 2020, then made up of board members Julia Olson-Boseman, Jonathan Barfield, Woody White and Patricia Kusek. Zapple explained the previously county-owned hospital offered a “direct connection” between citizens and top management. People could call a commissioner like Zapple and get the help they needed.
Zapple said a next step is to continue to meet with Novant Health leadership and figure out what Novant and the county can do to address any issues.
“We need a first-rate hospital in this community,” Zapple stated. “Even though I opposed the sale of it, I want to do everything I possibly can at this point to make the hospital a five-star hospital. The fact that the quality ratings are as low as they have been does nobody any good. It’s not what anybody who lives in New Hanover County wants.”
Regardless of what commissioners decide to do moving forward, Martell said the Five Star Project is not going away. Their next steps include starting programs to train community members to be patient advocates. The goal is to equip individuals with the skills to navigate the healthcare system for themselves or their family members, especially in situations like long emergency room wait times without answers.
“This issue is bigger than the Five Star Project,” Martell said. “It’s on people’s minds. It’s very important and it is not going to go away.”
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