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WestCare wants out of hospital partnership with Haywood

fr medwestoutThe hospitals in Jackson and Swain counties formally declared last week that they want out of the partnership forged nearly three years ago with Haywood’s hospital — however, it’s not at all clear whether the leaders of Haywood Regional Medical Center will agree to let them leave.


Dissatisfaction has risen up through the ranks of the medical community and hospital staff, who claim WestCare has been relegated to a backseat status while Haywood has been steadily built up as the flagship of MedWest.

WestCare employees were pleased by the news of the board’s vote to try to pull out last week.

“They made the right decision,” said Stephanie Sutton, who works in WestCare’s cafeteria. “Not that Haywood is a bad hospital, but sometimes you just need to be on your own.”

That independent streak is commonly held in the Jackson medical community.

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“For it to have a sense that we have our own hospitals, we will take care of our own people and work toward our own goals,” said Roni Decker, a nurse at WestCare. “We just need to get our hospital back.”

When WestCare and Haywood Regional Medical Center united under the MedWest banner, they left the door open for dissolving the partnership down the road. But to dissolve MedWest, three-fourths of the MedWest board members have to agree.

Since MedWest’s board is comprised equally from both sides — seven each from Haywood and WestCare — WestCare would need at least some of the board members from Haywood to side with them in a vote to dissolve.

Even if Haywood agrees to let WestCare exit gracefully, MedWest as an entity isn’t going anywhere any time soon.

“It took a long time to put together, and you can’t take it apart overnight,” said Mark Clasby, a member of the MedWest board from Haywood County. The contract that created MedWest outlines a long and arduous process should it disolve.

Steve Heatherly, the CEO of WestCare, admitted that WestCare’s formal vote to pull out of the partnership doesn’t make it a done deal.

“This action is the start of a decision-making process,” Heatherly said.

WestCare does have another option if the Haywood side of MedWest tries to keep them from leaving. An escape clause was written into the creation of MedWest that lets either side out if its financial stability was at risk, or if it can claim a breach of contract by Haywood. Going down that road could mean an expensive and protracted arbitration.

The vote by WestCare’s board last week asking to be released from MedWest has been more than year in the making.

“It was a very difficult decision. We went into this two years ago with very great hopes,” said Bunny Johns, chair of the WestCare board. “Over the last two and a half years things have changed dramatically.”

WestCare leaders have tried to be tactful in describing their reasons for wanting out.

“I think all the major stakeholders went into MedWest almost three years ago now hoping for and expecting different results,” Heatherly said. “Simply over time it became the perspective of the WestCare board and medical staff that MedWest wasn’t producing those results.”

While WestCare seems to blame MedWest for struggling finances and a drop in market share, Haywood’s hospital leaders disagree. The MedWest merger simply coincided with a particularly difficult time.

“Rural hospitals throughout the country are struggling,” Clasby said. “There are so many factors and lot of them are beyond our control.”

Doctors in Jackson County played a significant role in the decision by WestCare’s board. The medical community has been urging the hospital board to pull out of the MedWest affiliation with Haywood for months.

Johns said that the board values the input of the medical community, but added that the board had many of the same concerns regardless of the pressure coming from physicians.

“When they came to us we certainly listened. No board can ignore their medical staff and it was important that we listen to them,” Johns said. But, “I think we were asking those questions early on because the financial results were not what we wanted them to be.”

Johns said WestCare tried to right its course within the MedWest structure before resorting to pulling out.

“We actually did a number of things to try to set the situation up to be successful. Most of those did not work,” Johns said.

Now, doctors in Haywood County may play an equally large role in whether the Haywood’s representatives on the MedWest board let WestCare bow out. Haywood physicians fear WestCare may be bailing on MedWest in order to enter a new partnership with Mission Hospital in Asheville, which could put the squeeze on Haywood’s medical community.

The seven Haywood members of the MedWest board will also presumably take their cues from the separate Haywood Regional Medical Center board.

The board of Haywood Regional discussed the situation for than two-and-a-half hours in a private meeting Monday evening (Sept. 24), but did not emerge with an answer. HRMC Board Chairman Cliff Stovall said it would be “premature” to make a decision of this magnitude so quickly.

“Our duty, for this board that met tonight, is to do what is right for the people of Haywood County,” Stovall said after the meeting. “Therein we can’t make some snap decision.”

The Haywood Regional board issued a statement after the meeting that vaguely alluded to legal due diligence that will ultimately have to be part of the decision.

“The Haywood Regional Medical Center Board of Commissioners continues to analyze and evaluate all the parties’ obligations to each other and their constituents arising out of the formation of MedWest, and in doing so will continue to focus on what is in the best interests of the residents of Haywood County,” the statement read.

The statement also alluded to renewed commitments from Carolinas HealthCare, which has a management contract over MedWest and is actively trying to hold the partnership together. It has 32 hospitals under its umbrella.

According to the statement, Carolinas HealthCare System’s has made a commitment “to provide a broader range and higher level of cost-effective management services to MedWest.”

Technically, whatever becomes of MedWest, so goes Carolinas HealthCare. Carolinas management contract is with MedWest. If it ceases to exist, there is no contract.

WestCare, however, asked Carolinas if it would stay on board with WestCare as an individual entity. Carolinas answer was no, according to Johns.

“They are not willing to move outside MedWest,” Johns said.

It remains to be seen, however, whether Carolinas was merely bluffing in hopes of keeping MedWest intact — or whether it truly isn’t interested in a management contract with the individual hospitals if they are no longer joined under MedWest.

While a formal answer from Haywood could be weeks or a few months away, WestCare is already showing signs of pulling back and disengaging from MedWest.

“We have already started working with a more Harris- and Swain-centric management plan,” Heatherly said.

It is unusual for hospitals to dissolve a partnership, according to Don Dalton with the N.C. Hospital Association.

Dalton said that while the business landscape of the hospitals may be in turbulence, those in the community should be confident in their hospital. After all, the turbulence is simply due to the hospital leaders trying to chart the best course for their respective institutions.

“The hospitals are trying to figure out a very dynamic and complex health care landscape today and in the future,” Dalton said. “The hospitals are trying to position themselves to best serve their communities.”

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