UPDATE: Commissioners voted 3-2 against going with Juniper Advisory — a Chicago consulting firm that would act as a project director to guide the county in its search for alternative providers. The hospital’s agreement with Novant expires July 2023; the county can continue the search on its own or re-sign its agreement.
PENDER COUNTY — The operating agreement between Novant Health Pender Medical Center (formerly Pender Memorial Hospital) and the county expires next summer. Instead of automatically renewing its contract, commissioners are moving forward in exploring all options.
At Tuesday’s meeting, the board will vote on Juniper Advisory to lead the search. The nonprofit consulting firm out of Chicago focuses on healthcare partnerships, mergers and acquisitions.
READ MORE: Deep Dive: Did rural counties get left out of $1.25 billion New Hanover endowment deal?
If approved, it will act as a project director to establish criteria, identify entities for possible health care, review proposals, and present recommendations to the board on providers to manage Pender Memorial’s daily operations.
Pender County owns the 3.7-acre hospital property at 507 E. Fremont St. in Burgaw, though New Hanover Regional Medical Center has had a lease agreement with the county for 23 years. Having opened in 1951, the 86-bed facility serves 21,000 patients annually (including Novant Health Imaging in Rocky Point).
Over the last two decades, NHRMC has provided more than $20 million in upgrades to the hospital’s facilities and services. When Novant Health purchased NHRMC in early 2021, operations of Pender Memorial came with the transition.
Over the last few months, the county has moved toward seeking alternative healthcare providers as the agreement’s termination on July 17, 2023 nears.
“This was the result of a couple year’s worth of meetings,” chairman David Piepmeyer said at an Aug. 1 board meeting. “We didn’t do this in haste.”
Discussions about switching providers were underway three years ago, though Pender County commissioners put it on hold until the Novant NHRMC sale was complete. It extended the hospital’s lease agreement in 2019 and again with Novant in 2021.
Piepmeyer told Wilmington Business Journal in April, if Novant addressed the board’s concerns, goals and expectations, the search to pursue other providers would “go away.”
Commissioner Jackie Newton confirmed the board met with Novant officials earlier this year to discuss preliminary plans for restructuring healthcare services in the county.
“While in some ways impressive, those plans as presented may well be insufficient for our current and future needs,” Newton said but would not give further details.
A Novant spokesperson explained discussions included a “recommended alternative” to the agreement but also would not answer followup questions as to what that included.
“Since taking over the operating contract, Novant has demonstrated a commitment to continuing New Hanover’s legacy of improving care in the communities we serve,” the spokesperson said, adding that Pender hospital is an important location as it provides rural communities access to medical care.
Two months ago, the county released a request for qualifications for an individual or firm to oversee the process of acquiring or choosing a different provider.
If Juniper Advisory is approved as project director, it will have until April 1, 2023 to cull potential healthcare bidders. Considerations the county has listed include Atrium Health, UNC Health, Duke Health, Vidant Health, WakeMEd, or Cone Health.
“The selected provider must be able to start services on or before June of 2023, when the current contract expires,” according to the request for qualifications.
Novant isn’t precluded from consideration in Pender’s search; the RFQ lists it as well.
Regardless as to whether the healthcare entity is chosen, it already has made its footprint in the southern section of the county in Scotts Hill. Roughly 25 miles south of the Burgaw hospital, at the Pender and New Hanover County line, construction is slated to begin this year on a 66-bed acute-care facility and medical complex, approved in April 2021.
READ MORE: How one physician started a revolution in Scotts Hill, recruiting investors and NHRMC along the way
“Healthcare access is a factor and consideration which greatly affects economic growth and development,” Newton said.
Pender County is one of the fastest growing in the state, having experienced 15% growth since 1990 and a 0.7% increase in jobs over the last year. It’s expected to reach 38% in job growth over the next decade.
“It is a quality-of-life issue for individuals who are considering a move to Pender, much as the quality of our schools and other resources,” Newton said about the hospital. “All citizens have a right to rely on continuity in the quality of health care provided.”
Though attracting physicians and nurses to the rural county has long been a problem, as noted in Pender’s 2018 Community Health Assessment — considered a health roadmap through 2022. It indicated there are 2.8 primary care physicians for every 10,000 of Pender County’s 60,000 residents (New Hanover has three times as many, 7 per 10,000; the population is almost four times as Pender).
Nationwide, healthcare staffing shortages have been aggravated further by the pandemic, but problems compiled in recent months at Novant NHRMC. It resulted in the Centers for Medicare and Medicaid Services marking NHRMC in “immediate jeopardy,” with the threat to revoke the hospital’s Medicaid and Medicare contracts. The federal agency investigated NHRMC in June after a patient coded in its emergency department lobby.
READ MORE: Fed report confirms Novant’s insufficient staffing, nurses detail to PCD problem extends beyond ER
Its IJ status has since been removed, and the hospital has put in place an action plan to increase staff and strengthen its procedures and protocols. The status wasn’t applied to other hospitals in the Novant NHRMC portfolio, such as Pender.
Newton said the current provider search is not propelled by recent issues Novant NHRMC has been facing. Both she and Piepmeyer told Port City Daily the board simply wants to explore every possibility in Pender hospital’s future.
“No one should be against this, as it is just good business,” Piepmeyer said. “We are trying to maximize and elevate the quality and quantity of medical services offered to all citizens for Pender County by considering all options and offers that may be available before our current operations lease runs out.”
The Pender County Board of Commissioners will meet at 4 p.m. at the public assembly room, 805 S. Walker St., in Burgaw. The meeting can be livestreamed here.
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