NEW HANOVER COUNTY — Questions over patient safety continue to follow Novant’s New Hanover Regional Medical Center as it again receives a mid-tier rating in a national hospital safety report.
Novant’s New Hanover Regional Medical Center received another “C” grade in the Spring 2026 Leapfrog Hospital Safety Grade, extending a multi-year stretch of similar performance in the national hospital safety rankings.
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Leapfrog is a nonprofit organization evaluating hospital safety and quality nationwide, issuing biannual scores for nearly 3,000 hospitals each spring and fall. Since Novant Health acquired NHRMC in 2021, the hospital moved from a “B” grade in 2022 and 2023 to a “C” in 2024 — a rating it has now held for three consecutive cycles.
“It’s the same old-same old,” Jon Martell, founder of the Cape Fear Five Star Project patient advocacy group said.
The hospital continues to score below national averages on patient outcome measures tied to surgical care and complications, while performing better in categories related to infection prevention protocols and hospital safety systems.
Leapfrog’s scores are based on patient outcome data from the Centers for Medicare and Medicaid Services and Leapfrog hospital-reported survey data. CMS data typically reflects care delivered 1.5 to 5 years earlier, while Leapfrog survey data captures more recent hospital-submitted metrics covering 2024 to 2025. Both are processed over several months before public release, creating a lag between care delivery and reported results.
Novant leadership has pointed to the delays in the report, arguing the ratings do not fully reflect current performance, stating most recent improvements have not yet been captured in CMS data.
Despite the lag, the latest report shows several persistent patient safety concerns at NHRMC. The hospital remained significantly worse than the national average for the metric “dangerous objects left in a patient’s body,” with a rate more than eight times higher than the average hospital.
Measures tied to serious surgical complications also continued trending below national benchmarks. The hospital also remained above national averages in deaths from serious treatable complications and post-surgical sepsis.
“Some of that older data, that is where our top opportunities have been and where we have made significant improvements in terms of our patient experience,” Dr. Heather Davis, Chief Clinical Officer for Novant’s coastal region, told Port City Daily. “It’s the same plan, same message, same trajectory that we’re on.”
However, some categories worsened compared to the fall 2025 report. The rate of surgical wounds splitting open and serious breathing complications after surgery both increased from the previous reporting cycle.
Davis and Novant President Laurie Whalin said the hospital expects improvements to be reflected in future Leapfrog reporting cycles, repeating a point leadership has made in response to previous reporting cycles.
Leadership pointed to its internal improvement strategy, including its Vision 2030 plan which serves as the health system’s long-term roadmap for its coastal region, including New Hanover Regional Medical Center. The plan focuses on empowering care teams, advancing safety and quality, improving patient experience, strengthening operational performance, and expanding access to care.
“We know that will eventually translate into the ‘C’ grade moving into a ‘B’,” Whalin said.
Novant also tracks internal performance data through Vizient, a private hospital benchmarking system. Leadership said those internal metrics show improvement, though they are not included in Leapfrog scoring and are not made publicly available.
Despite the poor grade, NHRMC did show stronger performance in several infection prevention and patient experience categories.
The hospital performed better than the national average in preventing MRSA infections. It also outperformed national benchmarks in limiting C. difficile infections, a bacterial infection that can cause severe diarrhea and intestinal inflammation in hospitalized patients.
Patient survey data, self-reported from Novant to Leapfrog, also showed improvement in nurse communication and staffing-related measures. Hospital leadership has previously linked those gains to initiatives such as “patient progression rounds,” where care teams coordinate daily treatment and discharge planning.
The county sold the hospital to Novant for 1.5 billion, from which The Endowment was funded for $1.25 billion and has grown to more than $1.7 billion to date. Part of the agreement included the health system use “reasonable best efforts” to position the hospital in the top 10% nationally in patient satisfaction.
New Hanover County Commissioner Rob Zapple, the only commissioner on the five-member board, to vote against the sale at the time, said the county does not have enforcement authority under the 2021 purchase agreement.
“Legally, at least we’re being told by our county attorney, there’s nothing we can do to force them into making sure that we have the top 10%,” he said. “They bought the hospital, Novant owns it. We are now part of a much larger chain of hospitals.”
Zapple also said the Leapfrog and CMS measures, while useful, do not capture the full picture of Novant’s investment and impact on the community.
“They’re just two indicators,” he said. “They don’t capture what Novant is trying hard to do in our community.”
He pointed to major capital investments since the 2021 acquisition from the county, including a new surgical tower at the NHRMC main campus and the Scotts Hill hospital expansion; it will have 66 additional beds and emergency department capacity in northern New Hanover County.
“It’s hundreds of millions, if not a billion dollars, worth of new hospital and medical treatment coming into our community,” Zapple said.
Jon Martell, a former physician who founded the patient advocacy group Cape Fear Five Star Project in response to Novant’s low grades and service of care, argued the health system’s investments do not necessarily address the hospital’s patient safety concerns. “It’s just infrastructure,” Martell said of the building additions.
His Five Star Project is focused on hospital accountability, patient safety outcomes, and transparency surrounding Novant’s management of NHRMC.
“If you expand to make things three times as big to serve more people, that’s great, but it doesn’t change the quality of service,” Martell added.
Zapple added while the county cannot legally compel performance changes, it can continue to raise concerns to hospital leadership.
He also referenced what he called “rumblings” of UNC Health expanding its presence in southeastern North Carolina, including interest in the Wilmington area, though no specific hospital project has been announced.
“Each one would kind of prod the other to do a good job because the patients — that means our citizens — are going to go to the one that they perceive to have the best service and the best care, so that’s I think the positive nature of competition,” Zapple said.
Martell stated the Five Star Project has remained in communication with county commissioners about pushing Novant to provide greater transparency surrounding efforts.
“We’d love to see the internal data showing the improvements,” Martell added, noting they should want to publicly demonstrate patient safety improvements contrasting reports like Leapfrog.
Martell added that following the group’s protest outside a county commissioner meeting last September, local leaders have appeared more willing to raise concerns and questions with Novant leadership regarding patient outcomes and accountability.
The Five Star Project will hold another demonstration outside Novant’s NHRMC on Saturday, May 16, from 11 a.m. to 1 p.m. at the hospital’s main entrance.
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