PENDER COUNTY — During a special-called meeting last Friday, Pender County commissioners unanimously approved hiring a health consulting firm to navigate the search for a possible new provider at its county-owned hospital.
New information has come to light as to why they’re on the hunt for other options. Commissioner chair Jackie Newton told Port City Daily the commissioners wanted to be more involved in future decisions on the county’s health care.
“Novant doesn’t have the opportunity for Pender County or commissioners to have representation and a voice on the board to direct how they operate,” Newton said. “That’s concerning.”
Novant Health operates a roughly 20-member statewide board of trustees, with two members from the coastal region including Brian Eckel, co-founder of Cape Fear Commercial and Jason Thompson, owner of American Property Experts. It also has a local Novant Health Coastal Board of Managers, which includes 17 trustees, at least 12 living in the area and three being physicians.
A spokesperson for Novant said there are no provisions prohibiting or requiring Pender representation on either board.
Pender Medical Center also has a separate board, which includes appointees from the Pender County Board of Commissioners.
“It’s important we partner with a managing entity who would be more receptive to our needs as we go forward,” Newton said. “And I don’t see that with the way Novant is currently structured.”
The current lease agreement with Novant expires July 2023, which was carried over from when it bought New Hanover Regional Medical Center in February 2021. Pender County owns the 3.7-acre facility at 507 E. Fremont St., though NHRMC has operated the hospital for the last 23 years. Commissioners have been seeking a change in its healthcare provider for three years.
Newton was clear the board is not closing the door shut on Novant completely, only seeing through due diligence to keep all options open.
“We have a fiduciary responsibility to make the very best decision for our citizens because this is a decision that has long-term effects and affects all age groups across the board and all socio-economic groups equally,” she said. “I don’t know why [Novant] is so averse to us taking it to market.”
According to a presentation Novant NHRMC president Shelbourn Stevens and Pender hospital president Ruth Glaser gave to commissioners in November, NHRMC helped “stabilize” Pender’s rural facility, and has infused more than $60 million into Pender health operations and tripled employees’ salaries.
“Novant is committed to Pender County and the hospital and we’re looking forward to moving forward,” Glaser, publicly in favor of sticking with Novant, told commissioners in November. “If you rewind and look back over the last 23 years, those are the things to anticipate; continue operations as is, the status quo.”
Though commissioners haven’t outright stated problems with Novant New Hanover Regional Medical Center managing Pender Medical Center, NHRMC has faced a litany of issues over the last year due to staff shortages. A federal report confirmed NHRMC was not maintaining adequate staff to meet the needs of incoming patients arriving by EMS.
Regulators for the Centers for Medicare and Medicaid Services found NHRMC was in jeopardy of losing its Medicare contract on June 29, after the death of an elderly woman in the waiting room prompted an inspection. CMS found issues with NHRMC’s quality assessment, performance improvement and governing body.
Based on staff recommendation, the board voted unanimously (commissioner Jimmy Tate was absent) to use Ascendient to help in the search for a new provider.
Ascendient’s proposal provided a contract range of $100,000 to $320,000, “depending on phases needed and milestones met,” according to assistant county manager Allen Vann.
He confirmed commissioners have only approved phase one — costing from $20,000 to $30,000 — with four available to purchase.
The first will provide insight into the current partnership between Novant and Pender Memorial, specifically detailing what’s working, what isn’t, and the county’s priorities and expectations for the future.
The second phase, $10,000 to $15,000, would use the research to develop criteria for success. It also would evaluate the pros and cons of staying with Novant as a healthcare provider versus searching for another entity.
If commissioners wanted to look further into other providers, it would be covered in phase three, costing $20,000 to $25,000. The firm would assess “post-Novant” scenarios and create a short list of potential partners.
The last and most expensive phase, $50,000 to $250,000, would result in a new agreement for Pender Memorial.
According to Ascendient’s proposal, phases are “often fluid and not linear” and may even overlap.
Newton told Port City Daily commissioners will address beyond phase one as they go, depending on the amount of assistance needed from Ascendient.
However, “the icing on the cake” was the more “palpable” cost of services with Ascendient, according to Newton.
In September, the board debated hiring Juniper Advisory to handle the provider search, but the fee, $850,000, was a point of contention. Commissioners voted it down 3-2.
Two-thirds of the money would have been used for Juniper to transition the hospital to a new provider, according to former commissioner and chair David Piepmeyer. The other portion would have helped guide the commissioners with the identification and selection of possible providers.
Commissioners Tate and Fred McCoy said the price tag was too high of a burden on taxpayers. McCoy was the only one to stand firm on not wanting to hire an outside firm at all, rather handle the process internally.
Tate also preferred a more local firm, as Juniper is based out of Chicago.
Ascendient has its headquarters in Chapel Hill and was founded by North Carolina native Dawn Carter in 1994. It works with health systems, physicians, government agencies, public health departments and more to convert needs assessments into specific community health plans. Ascendient focuses on identifying gaps, disparities and strategizing ways to address the needs, according to its website.
Its submitted proposal notes Ascendient specializes in rural healthcare and has worked with “every major health system in the state.” Its client base consists of Wilmington Health, Atrium Health, UNC Health Care and companies from Maine to Florida.
Four firms submitted proposals to the county. After staff interviewed all of them, one dropped out, leaving three for consideration.
Staff and commissioners discussed the proposals and recommended consultants during closed session Friday, Dec. 16, but voted to approve Ascendient in open session.
The firm will begin immediately, county manager David Andrews said.
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