The State of NC Healthcare

More Changes in NC Healthcare

Posted in NC Healthpress by writemyline on 30 June 2009

The Charlotte Business Journal reported back in April that Carolinas Healthcare System (CHS) will “manage” Haywood Regional Medical Center and WestCare Health System. Mission Health System Hospital in Asheville was also considered by the BODs of both western NC hospitals.

Carolinas Healthcare System has gained a considerable hand in four community-based hospitals in this year alone. In the early spring, CHS announced management contracts with Stanly Regional Medical Center in Albemarle and Scotland Memorial Hospital in Laurinburg. With the addition of Haywood and WestCare, CHS owns, leases, or manages 25 hospitals in the Carolinas. The expansion of CHS continues outward despite its $551 million loss in 2008 earnings.


Haywood proposal is “secret for now.”

Posted in NC Healthpress by writemyline on 13 February 2009

Becky Johnson of The Smoky Mountain News has a lengthy article discussing Haywood Regional Medical Center and WestCare’s direction towards a partnership with either Carolinas HealthCare or Mission Hospitals. Read it here.

On Stanly Regional Medical Center and Scotland Memorial Hospital

Posted in Grassroots, NC Healthpress, Reform-in-progress by writemyline on 12 February 2009

John Lowder’s recent article In the Stanly News and Press (1 Feb. 2009) discusses Stanly Regional Medical Center’s (SRMC) management service agreement with Carolinas HealthCare System (CHS). It is a well-written statement with significant points of discussion that speaks directly to Stanly County citizens. It identifies the issues and circumstances leading to the SRMC Board of Directors’ decision to deepen the hospital’s relationship with CHS. Articles similar to Lowder’s Making change work for the community appeared about the same time in The Exchange and The Fayetteville Observer; however, these articles announce a management contract between CHS and Scotland Memorial Hospital in Laurinburg.

It is not surprising that CHS is the largest healthcare organization in the Carolinas. It is a very aggressive one in terms of acquisitions, mergers, leases, and management contracts. The Charlotte-based business has ties to 25 facilities from North Wilkesboro NC to Charleston SC; two additional hospitals in western NC are currently considering affiliate proposals. Russ Guerin, CHS executive vice president of business development and planning comments in the Charlotte Business Journal that Carolinas HealthCare management relationships, such as those with Stanly Regional and Scotland Memorial, can lead to mergers and leases.  

Integrating CHS’s large academic healthcare model into Stanly and Scotland’s smaller healthcare culture will be challenging. Technically speaking, the contract provides that the autonomy of the small hospitals remain; however, the management association with Carolinas HealthCare will be very visible in the public eye as well as the professional one. This could tax the confidence of some folks. Stanly and Scotland have histories that are entirely built on their local communities. Shifting their identity towards a corporate giant is unsettling; and, to some people, equates to a departure from certain long-held values of the community.

Indeed, management is a necessary component of any healthcare delivery system; but the public and professional perception of management weighs heavily on patients and their families. Perhaps the decision of Scotland and Stanly boards to deepen their relationships with Carolinas HealthCare System will prove financially fruitful and beneficial to the health of the community; but if and how much community citizens and local healthcare professionals will benefit financially is questionable, especially given the current chaotic state of the US economy. And the greater community, including physicians and healthcare professionals, could wait months, or perhaps even years, before the trickle-down effects of change deliver a substantial and beneficial outcome.

Smaller geographic areas, particularly rural ones and those with increased over-65 and disabled populations, are bound to the services closest to home. For some, there is no element of choice when it comes to health services; and when this is the case, public trust is absolutely critical. The role of organizational healthcare leadership in small boroughs and rural areas has a primary obligation to its service area population because there is no local competition providing other options.  Regardless of the business, service, or industry, public trust is critical for security and progress. And fostering and maintaining trust requires forthrightness, especially when it comes to healthcare issues.

In regards to SRMC, there are statements in need of clarification for the benefit of Stanly County citizens:

John Lowder writes: “Control over Stanly Regional will remain within the community. The Board of Directors will continue to govern the medical center and will retain ownership of all assets. The Board will make decisions in the best interests of the community and our same management team, led by Al Taylor, will run the medical center.”

Scott White, spokesperson for Carolinas HealthCare, says something different about the contract with SRMC in the Hickory Record: “We’ll hire the executive officers and manage the hospital on behalf of the board.”  (Hickory Record, 28 January 2009)

White’s and Lowder’s conflicting statements are very troublesome for the public. Merging the two statements suggests that CHS will hire the existing SRMC executive staff, including CEO Al Taylor. If that is, indeed, the case, then “control over Stanly Regional” will not actually remain in the community because its executive staff will not be appropriately vested by SRMC and its board of directors. Clarification and a more detailed disclosure of CHS’s management contract would be a positive step towards preserving public trust.

Another thing lacking is substantion of SRMC’s claim of a long-standing relationship with Carolinas HealthCare by physicians and healthcare professionals close to home. Public confidence is better built on relationships with the first line of care–primary care physicians, family doctors, specialists, and other healthcare providers, not management.  Moreover, how involved were Stanly physicians in the board’s decision? 

 Healthcare reform is an undeniable paradigm shift occurring at all levels of American society, from grassroots to corporate giants. It is a phenomenon that will ultimately redesign systems of healthcare delivery, finance, and management. It is a phenomenon in which organizations like Stanly Regional Medical Center and Scotland Memorial Hospital along with hundreds of other independent non-profit hospitals in the US will lead and represent the healthcare culture of small communities. On the other hand, Carolinas HealthCare System and other corporate giants will aggressively protect their own interests and profitability; small community-led healthcare will not be a top priority in reformation from their perspective.

 Indeed, change can be positive and work for small communities when citizens are directly involved in the process. Patients and families in Stanly and Scotland counties have that opportunity now by expecting their leaders to listen and respond with diligence and honesty.

The headlines: Carolinas HealthCare, Scotland, Stanly

Posted in NC Healthpress by writemyline on 31 January 2009
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Carolinas HealthCare System to “manage” Stanly and Scotland

Posted in Grassroots, NC Healthpress, Reform-in-progress by writemyline on 30 January 2009

The Charlotte Business Journal featured an article by Jennifer Thomas this week that announces a management service agreement (MSA) between Carolinas HealthCare (CHS) and two independent NC hospitals: Scotland Memorial Hospital (SMH) and Stanly Regional Medical Center (SRMC). The article, CHS to manage two more hospitals, appeared on January 28.

Thomas writes that CHS’s 10-yr. contract with Stanly begins March 1 and with Scotland on April 1. The article does not disclose the financial terms of the two contracts; however, the article suggests that the 10-yr. contract could mean a merger later on down the road. Russ Guerin, executive vice president of business development and planning at CHS,  is quoted: “managing independent local hospitals is a business line of (CHS).”  He also comments that such agreements have the potential for mergers.

Interestingly, CHS and Stanly’s recent request for a certificate of need for a 40-bed rehab facility was denied by N.C. Division of Health Service Regulation (NCDHSR) because the two organizations failed to demonstrate need and cost-effectiveness. The facility would have been built in Cabarrus County. CHS and Stanly are appealing the State’s decision. 

Both Stanly and Scotland serve local communities and are significant providers of care “close to home.”  People age 65 and over constitute 14.6% of Stanly County’s population. In addition, 20% of the county’s total population consists of disabled citizens over the age of 5. In Scotland County, 11.6% are 65 and up and 22% disabled.  Stanly’s older population exceeds the state/county average of 12.2%; and both, Stanly and Scotland, exceed the state/county average of 17% disabled. (Census Bureau)

“Close to home” care is a big concern for many of the folks affected by big hospitals swallowing up smaller ones. CHS is the 3rd largest public system in the country and the largest in NC. It owns, leases, or manages 25 hospitals from North Wilkesboro NC to Charleston SC, including SRMC and SMH.

See press releases on the Carolinas Medical Center website:

Stanly Regional Medical Center Partners With CHS

Scotland Regional Health Care System Partners with CHS

Carolinas HealthCare Salaries

Posted in NC Healthpress by writemyline on 15 January 2009

Well, well, well…We finally get the bottom line on Carolinas HealthCare System executive salaries. Yesterday’s Charlotte Observer headline reads: Carolinas HealthCare discloses its top pay packages. For the first time in nearly a decade, Carolinas Healthcare System reveals executives’ pay.

CEO Michael Tarwater  recieved a total compensation of $3.5 million in 2008.  One has to wonder how many financially-struggling sick or injured people made that 7-figure salary possible. How many had to max out their credit cards or empty their kid’s college fund to pay for healthcare? AND – how much of that $3.5 came from Medicare and Medicaid?

What could possibly justify such a large salary package, especially when our economy is suffering like it is?

What could $3.5 million pay for?  How about 5 heart transplants or 11 bone marrow transplants or treatment for 175,000 cases of early-stage cervical cancer.  $3.5 million would cover about 120,000 hours of nursing care or annual salaries for about 56 experienced RNs.  It would also cover annual medical costs for 300,000 diabetics.

This debate needs to be a public one. It’s not just about healthcare executive salaries; it’s about insurance premiums and co-pays, Medicare, Medicaid, and private funds — all of which contribute to compensation packages.

Are there reasonable compensation limits for healthcare executives? Absolutely.

Recent NC health headlines

Posted in NC Healthpress by writemyline on 26 November 2008

Republican Sen. Richard Burr (N.C.) is in a position to have a significant influence on health reform… Read this article from The Hill.

Novant opposes CMC-NorthEast tower. Read about this at the Charlotte Business Journal.

The N.C. Institute for Constitutional Law has filed a lawsuit challenging the constitutionality of the state law that determines the awarding of health-care facilities and equipment. Winston-Salem Journal

CIGNA HealthCare has been recognized as the top-ranked health plan in North Carolina for the second year. Read at Market Watch.

Dominion Healthcare in Durham has agreed to reimburse the NC Deptartment of Health and Human Services more than $1.6 million. Read the article in Winston-Salem Journal.

Rex Healthcare has been named in Top 200 Hospitals in Coding Study. Read on Carolina Newswire

VA Hospital in Salisbury may end surgical and ER services. Read the full article.

UNC selected by U.S. Agency for Healthcare Research and Quality for important cancer treatment study. Read here.

VOCA Corporation and Residential Healthcare Affiliates of North Carolina MR  bids for an intermediate care facility for the mentally retarded in Guilford County. Read at News-Record.

Carolinas Healthcare System holds hearing in Kannapolis. Read in the Salisbury Post.  Also read the follow-up article, “Proposed diagnostic imaging center draws ire of physicians, citizens.”

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Healthcare Professionals on Healthcare Reform

Posted in NC Healthpress, The Vote 2008 by writemyline on 19 October 2008
The Public Knows the Candidates’ Views on Healthcare Reform, But Do the Candidates Know What Healthcare Professionals Think?
“ASHEVILLE, N.C., Oct. 14 /PRNewswire/ — Senator McCain believes it to be a responsibility; Senator Obama, a right. While both candidates believe that healthcare reform is a high priority, they disagree on the methods necessary to fix this problem. But do they know which plan physicians support? A new study from DoctorDirectory of more than 900 physicians of all specialties was designed to assess attitudes on universal healthcare as it relates to the upcoming election.” [Read more]

Will Breazeale (R-District 7-NC): FAIR HEALTH PLAN

Posted in NC Healthpress, Political Health by writemyline on 7 October 2008

Will Breazeale

Republican Nominee, District 7-NC, U.S. House





11 SEP 2008


1. This plan agrees with Sen. John McCain’s plan on many fronts: portability, guaranteed access, affordability, tort reform and transparency. Will Breazeale has worked hard with research and interviews conducted all over District 7. Interviews were conducted with hospital CFOs, physicians, patients, the poorest of Americans, the middle class and business owners. This plan has chosen a different and unique way to fund and fix our health care problems.

2. This plan also acknowledges our government’s need to eliminate the $75 Trillion budget deficit ($9 Trillion direct and $66 Trillion of unfunded promises).




16% GNP to 9% GNP for Health Care NOW!

$2 Trillion is spent every year on our health care. (16% of our Gross Domestic Product). With cost savings listed below, we can finally reduce this cost to 9% of GDP!




-Health Care Insurance Company Competition

The government can create competition among private health care companies by dividing the country into 10 regions for a bidding war to cover the uninsured and underinsured with huge contracts awarded to a private companies. Competition ALWAYS lowers costs!


-Privately Administered, Government Awarded Contracts

The government awards the contracts by regions to the low bidder, but the Private Insurance Company like Aetna, Blue Cross, etc., will ADMINISTER the program. The government will never run an efficient health care system like a private company can. This lowers costs!


-Lawsuit Reform

The government will mandate that EVERY state will form an independent commission to review medical lawsuits before they go to trial. ANY lawsuit that is classified as frivolous and loses in court, will force the losing side to pay ALL lawyer and court costs for both sides. Frivolous lawsuits will go away overnight. This lowers costs!


-No More Emergency Room Abuse

-Anyone using the Fair Health plan will have to pay a $500 deductible for non-emergency use of any emergency room before being seen. This will end emergency room abuse which will lower costs and keep more emergency rooms open. This lowers costs!


-Rewards for Wellness

Anyone meeting the Presidential Council for Physical fitness goals for their age and gender will be charged 9% less for their health insurance costs. This rewards wellness and reduces costs to the patient and insurance company!


-No More Free Care for Illegal Immigrants

-The health care bill for illegal immigrants is estimated to be 15% of our total health care costs. The Fair Health plan will finally collect premiums from illegal immigrants for their health care while calling for a direct deduction for all costs from their country of origin’s foreign aid. This lowers costs!


-Level Playing Field for Businesses

-The Fair Health plan will take health care concerns off the table for businesses who cannot afford health insurance for their employees. This will allow recruitment of talented people for all businesses and make it easier to start a small business with less capital investment. Our citizens have to be healthy to get a job. Covering all 47 Million uninsured Americans will create a healthier workforce for business.


-Complete Portability

The Fair Health plan AUTOMATICALLY insures someone the day they lose their job. No more expensive COBRA. The Fair Health plan also insures ALL pre-existing conditions as well as covering dental and vision needs.



Want to purchase health insurance on your own, use your company health care or use your Health Savings Account? Fine! You can opt out of the Fair Health plan at any time!


-National Health Care Sales Tax for Uninsured-9% vs. 8%

Paying for it!!! EVERY person living in the United States will be charged an additional 9% on everything new item or service they buy for the Fair Health plan UNLESS they prove with a biometric card or a fingerprint reader linked to a database that they have their own health insurance.


-Elimination of Medicaid saving $Billions!

Fair Health makes it possible to eliminate Medicaid as we know it saving our government billions of dollars. Employers or states can help lower income people pay some of the 9 or 8% Fair Health tax with a system of prebates.


3. This is a REAL and creative plan. McIntyre’s plan is too general and lacks vision. Questions and comments are always welcome and considered! Call 910-409-7023 or email



Will Breazeale

Republican Nominee, District 7-NC, U.S. House

Sunday Morning Paper…NC Healthcare

Posted in NC Healthpress by writemyline on 27 September 2008