HCA/Mission Acquisition

On January 16, 2019, NC Attorney General Josh Stein traveled to Asheville to announce that he does not oppose the sale of Mission Hospital System to HCA as long as:

  • HCA and Mission parties complete the changes to the Asset Purchase Agreement that were negotiated with the AG’s office
  • Dogwood Health Trust executes a set of changes negotiated with the AG’s office and laid out in a letter agreement

Click on the links below to read the materials provided by the AG’s office.

HCA/Mission Asset Purchase Agreement amendments:

Dogwood Health Trust changes

The link below takes you directly to the North Carolina Department of Justice website’s News Releases and Advisories section on the HCA/Mission deal.  Take a look around, there’s a lot of good info on the NCDOJ site for North Carolina’s citizens and consumers.

Press Release – AG Josh Stein does not object to HCA/Mission deal

With the major announcements on January 16, 2019 about the acquisition, the articles written specifically about that are listed alphabetically by outlet below:

2018.12.04 Read this announcement from Attorney General Josh Stein entitled I WILL FIGHT TO PROTECT HEALTHCARE IN WESTERN NORTH CAROLINA”.

A video of the Gov. Jay Nixon’s Listening Session from Oct 23, 2018 is available at the link below; the first one is the entire hour and forty minutes.  Shorter ones on specific topics are below that one.

The videos were created by Trillivision of Burnsville, NC.

Listening Session Video – One hour and forty minutes

Mission-HCA Transaction - What's Important

Gov. Jay Nixon on items to consider with regard to the sale – 3 minutes

Carmen - DHT Board

Carmen Ramos-Kennedy on the composition of the Dogwood Health Trust Board – 2+ minutes

Rural Hospital Amb Service snippet

Jacob Willis on the need for ambulance service in rural communities – 3 minutes

Rural Economy

Jacob Willis on the economic impact of rural hospitals – 1+ minute


Below you will find links from various sources specifically about the proposed HCA/Mission Acquisition, announced on March 21, 2018.  Articles are organized alphabetically by source, then by date.

The entire Asset Purchase Agreement, including the Schedules, Exhibits, and other documents can be downloaded here.

Of particular interest to those of us in Mitchell County and Yancey County are the sections listed below which can be downloaded for review.  They describe the organization of the Hospital Advisory Board, the Operations of the Hospitals, and the Services of the hospitals.

A coalition of WNC citizens and organizations interested in the Mission/HCA sale has written a position paper on the transaction which was delivered to Special Deputy Attorney General Jennifer Harrod on Oct. 26, 2018.  You can download and read it here.

The original announcement of the plan to sell to HCA is available here: Mission Health Announcement

On August 31, 2018, Mission Health’s Board of Directors announced they have entered into a definitive agreement for HCA to acquire Mission Health.  Read the press release here: 2018.08.31 Mission Health Press Release_APA Signing_FINAL

Mission Health set up a website devoted to the topic of the acquisition, Mission Health Forward .  The Frequently Asked Questions (FAQ) section of that site has a lot of answers about the transaction.  If the question you’re interested in is not addressed, you can submit your own question on the FAQ page.

On July 16, 2018, Mission Health System announced the creation of Dogwood Health Trust, the planned successor foundation from the potential sale of Mission Health to HCA.  Read the press release here.

The new foundation plans to address core Social Determinants of Health (SDOHs) and well-being in Western North Carolina.  A new interactive map tool is available to analyze the which areas of the state are affected by various SDOHs, and to what extent.  The website can be found here.  A description of how to use it is located on the Resources page of this website.

On August 23, 2018, Dogwood Health Trust announced additions to its initial Board of Directors.  Read the press release at this link:  2018.08.23 Dogwood-Health-Trust_Board-of-Directors-Announcement.

On August 20, 2018, Mission Health’s Board of Directors announced that if and when the Mission Health and HCA Healthcare (HCA) transaction is closed, each Entity Legacy Foundation will receive a distribution of $15M to improve the health and well being of their community.  Read the full press release at this link: Mission Health Press Release_Rural Health Investments_FINAL.

On August 3, 2018, the non-profit Communities for Older Adult Health and SEARCH co-hosted the WNC Conversion Health Foundation Forum on the campus of UNC-A in Asheville.  Read an article about it here.

( For articles on Rural Healthcare and the closing of L&D at BRRH, please visit here )

American Academy of Family Physicians (AAFP)

Appalachian Regional Commission


Asheville Citizen Times

Asheville Free Media

  • Click on the “Play October 25 Show” at this link  


Blue Ridge Public Radio

Business NC

Carolina Public Press

Daily Yonder

Facebook Live broadcasts

  • 2018.07.30 What Joining HCA Means for Our Rural Communities – The link below the photograph will take you to the video of a Facebook Live event where representatives of Mission Health System discuss their recent visit to rural HCA hospitals in Central Tennessee.  Participants are: 
    • Kathy Guyette, MSN, RN, NEA-BC, Senior Vice President, Patient Care Services & President Regional Member Hospitals, Mission Health, 
    • Rebecca W. Carter, MSN, RN, FACHE, President & Chief Nursing Officer, Blue Ridge Regional Hospital
    • Brian Barrow, MD, Chief of Staff, Transylvania Regional Hospital.

2018.07.30 Photo of FB Live Event

2018.07.30 What Joining HCA Means for Our Rural Communities

  • 2018.07.24 Mission Health & HCA: Process & Progress  – The video link below the photograph will take you to a one-hour video of a Facebook Live event where representatives of Mission Health System discuss the latest on their plans to join HCA Healthcare; you can also see questions that the viewers posted during the event.  Some of Mission’s board members and team members recently visited HCA hospitals and successor foundations in Austin, Texas.  Participants were Bill Hathaway, MD (Chief Medical Officer), John Ball, MD (Chair of Mission Board), Jill Hoggard Green (Chief Operating Officer, Mission Health and President, Mission Hospital), Janice Brumit (Inaugural Chair of Dogwood Health Trust), and Karen Olsen (Chief Nursing Officer).

Olsen, Brumit, Hathaway

2018.07.24 Mission Health & HCA: Process and Progress

  • 2018.06.12 Transforming Health and Wellness in Our Community – The video link below the photograph will take you to a one hour and 2 minute video of a Mission Health leadership team discussing the foundation that will be created from the proceeds of the sale to HCA, which they call the “successor foundation”.  Participants from left to right below are Ron Paulus (President and CEO), Susan Mims, MD, MPH (VP and Chief of Pediatrics), Sonya Greck, MSN, RN (Senior Vice President), and Lakesha Day (Director of Diversity and Inclusion)
  • 2018.05.08 Answering your questions about Mission Health and HCA – The video link below the photograph is a one hour and 15 minute video of Mission leadership answering questions about the acquisition from the public via a Facebook Live broadcast.  Participants from left to right below are Dr. John Garret (Vice Chair of Mission Health Board of Directors), KarenVernon, Dr. Ron Paulus (President and CEO), and Dr. John Ball (Chair of the Mission Health Board of Directors).

All the panel

Haywood County, NC – sale to for-profit Duke LifePoint and resulting Foundation

Hendersonville Lightning

HIStalk – Healthcare IT News & Opinion

Huffington Post

Inside Philanthropy

Kansas City Star

Macon County News

Mitchell News Journal

Modern Healthcare – Modern Healthcare is a healthcare business news, research, and data media outlet which publishes an informative e-newsletter with articles pertaining to the Mission/HCA acquisition.  You can create a free subscription to the newsletter here.

Below are some links to articles, but if you haven’t subscribed you probably won’t be able to access them.

2018.12.26 – After bitter closure, rural Texas hospital defies the norm and reopens

2018.11.21 California DOJ greenlights Catholic Health Initiatives – Dignity merger, with conditions – Tara Bannow  (note, this is not a link, you must have a subscription, but it’s free)

With a free subscription to Modern Healthcare you can read the article above about the merger of these two non-profits, but more importantly, about the conditions that were put on the merger.  The merger’s review had a particularly rigorous review process including public meetings and written comments.  The conditions also include maintenance of emergency and women’s healthcare services for 10 years, and the California Justice Department will be closely monitoring compliance with the conditions.

Mountain Xpress

National Committee for Responsive Philanthropy – NCRP

News & Observer


New York Times

Nonprofit Quarterly

North Carolina Health News



Savannah, GA – Chatham County Hospital’s acquisition by HCA

Smoky Mountain News

Student Loan Planner 

The article below is about the Public Service Loan Forgiveness program which is a tax-free forgiveness program for medical student loans after 10 years of service at a non-profit hospital.

The Mountaineer

Transylvania Times

Washington Post

WLOS – News 13 (Asheville TV station)

Yancey Common Times Journal