So Smoky Mountain News has mined the other two newspapers covering this story — The Mountaineer and the Asheville Citizen-Times — along with press releases from HRMC and announcements by other organizations to put together this timeline.
When last week’s paper went to press on Tuesday, Feb. 25, two major events had occurred:
• First, on Feb. 24 the federal agency that monitors hospitals to ensure they comply with standards of care requirements yanks HRMC’s Medicare and Medicaid funding after it failed numerous inspections. The two federal programs account for 68 percent of the hospital’s revenue. Only five hospitals out of 6,700 nationwide received a similar penalty in 2007. Nursing mistakes are the primary reason cited in the revocation. Doctors meet and promise to continue treating those who show up at the ER regardless of ability to pay. Physicians also begin feverishly seeking privileges at Mission and WestCare so they can continue operating and keep money flowing into their businesses.
• That night, Feb. 24, HRMC CEO David Rice resigns after an emergency meeting of the hospital board meeting. Rice says the fallout from the loss of funding is so severe a “shift in leadership is called for.” Rice knew of the potential to lose the federal Medicaid and Medicare funding on Feb. 13, but did not relay that to the hospital board. The hospital board, doctors, county commissioners and others are completely shocked by the loss of Medicaid and Medicare. Chief Operating Officer Al Byers is named interim CEO, and hospital officials say they have $20 million in reserves to try and ride out the funding crisis.
• The Asheville Citizen-Times reported that state lawmakers met on Feb. 24 to formulate a plan at the state level to help HRMC. Details of what they want to do have not been reported.
Wednesday, Feb. 27
• Dr. Aloha Bryson, a former doctor at the hospital, files a lawsuit against HRMC in which she claims that two patients died because of mistakes made by nurses. She also claims that nurses slept and texted on their phones while at work. She alleges in the lawsuit that her warnings about problems were ignored and that she was forced to resign for bringing them up. HRMC has not comment on the lawsuit.
• The Asheville Citizen-Times (ACT) reports that Director of Nursing Shirley Harris resigns from HRMC, the second high-level official to quit as the turmoil surrounding the hospital continues to unfold. The paper also reports that The Compass Group has been hired to help the hospital regain its Medicaid and Medicare funding status (see related story in this week’s edition).
• The ACT reports that Haywood County is paying up to $1,000 per day to hire extra emergency transport personnel and for additional ambulances to transport patients to nearby hospitals. County officials met and worked out the emergency plan as soon as they were informed of the hospital crisis.
Thursday, Feb. 28
• Although it was suspected earlier in the week, hospital officials confirm that it will be a minimum of 30 days — and probably more — before the hospital can begin getting Medicaid and Medicare reimbursements.
• Doctors begin urging the hospital board to look into options other than merely trying to regain its Medicare and Medicaid funding status, including the possibility of a merger. Doctors also say in the Feb. 29 Mountaineer that they plan to stay at the hospital and see it through the crisis.
• At a special meeting of the hospital board, a purple-ribbon campaign is unveiled as a means of conveying public support for the hospital.
• It is also learned that HRMC’s HealthGrades rating, the basis of a major public relations campaign that kicked off in January, has been revoked. The company that does the HealthGrades ratings only works with hospitals that have a Medicare contract. Once the hospital gets its Medicare status re-instated, the rankings can once again be used.
Friday, Feb. 29
• HRMC’s problems go from bad to worse as it is forced to withdraw from the Blue Cross and Blue Shield of North Carolina health care network. Blue Cross officials said the hospital agreed to drop out of the network until it corrects problems cited by federal inspectors. Crescent, a smaller provider of physician services for employers, also suspended the hospital from its network. Haywood County Schools send a memo to its employees notifying them to seek health care elsewhere.
• Dr. Nancy Freeman, chair of the hospital board, tells the ACT that many believe it was a November 2007 death that triggered the investigations that led to the hospital’s loss of Medicaid and Medicare funding. Freeman told the paper that while the death triggered the investigation, it was not cited in the reports that led to the loss of funding.
• Also, Rep. Heath Shuler, D-Waynesville, discusses the hospital’s situation with the federal Center for Medicare Services, hospital staff and state lawmakers. Shuler spokesperson Andrew Whalen tells the ACT the congressman is trying to help regain federal funding.
Monday, March 3
• Officials from The Compass Group take part in several public meetings explaining their plan for rectifying HRMC’s problems and helping it regain Medicaid and Medicare funding. Throughout the day there is a huge outpouring of support by employees, the medical staff, patients and ordinary citizens who express hope the hospital will pull out of its financial crisis. Compass says it will take a minimum of 30 to 60 days, maybe longer, to get the job done.
• As patient loads at the hospital drop, the first reports surface of workers having their hours cut.
• The hospital board meets again Monday night to discuss Compass’ plans for the hospital. It goes into closed session but makes no announcements afterward.
• The medical staff of the hospital urges the hospital board to keep it informed of any potential merger or acquisition discussions.