Message from John: Making NHRMC a Great Place to Work and Receive Care

October 03, 2019
The upcoming year is one in which NHRMC has an opportunity to evaluate the best way to secure its future for employees, the medical staff and our community. 

The vote by the New Hanover County Commissioners last Monday night allows us to explore different options, from restructuring to partnering with other healthcare organizations. While there are some who want to cast doubt on the integrity of the process, how we’ll move forward, and what it will mean, I want to assure you that every step taken to date, and every step that will be taken in the future, is being made with the best interests of our patients, community, employees and providers top of mind.  

We want to strengthen our organization as a great place to work and receive care. This is our motivation for moving forward and will be central to our evaluation of our options.

We will not let you down.

The process that led to the announcement of the vote was deliberate, thoughtful and aligned with our commitment to doing the right thing, for you, the members of our team, as well as the extended community of our patients and partners. 

While New Hanover County Manager Chris Coudriet and I have talked about some of the research and options considered prior to the vote in public and employee forums, there is still some misunderstanding in the community, so I want to share more of the background with you to further explain how we got to this point.

We began discussions with members of our Board of Trustees and New Hanover County Commissioners when it became impossible to ignore the realities we face and the cost of positioning ourselves to succeed in the future.  

Through the hard work of our strategic initiative teams, we have wonderful plans for achieving better access, value and health equity while also improving quality, employee and physician engagement. These initiatives have the potential to advance our mission and improve the overall health of the region. Yet they also require significant investments in new staff, providers, locations, services and technology.   

Rather than be resigned to the restrictions of our current situation, we considered what we could do to overcome them so we could keep growing stronger and meet the needs of our rapidly growing population. It’s through those discussions we began talking about all the options, up to and including a sale.  We recognized that partnering with a larger system potentially could give us access to the scale and capital needed to move forward with our plans in a way, and at a pace, we could not achieve as a stand-alone system.

My concern, from the beginning, was what this would mean for staff. I did not want to introduce the unease a discussion of this type naturally brings without carefully going through a thoughtful process to evaluate whether the ultimate outcome could make this extraordinary effort worthwhile. It would be irresponsible, and completely insensitive to our team and our community, to do otherwise.

With this in mind, we, along with our Commissioners and members of our Board of Trustees, decided to engage Navigant, our strategic consulting firm, to more thoroughly explore a full range of possibilities.

Among the options discussed, was a plan to establish a parent corporation that would allow NHRMC to borrow money to invest in buildings and services outside New Hanover County, something that is not possible in our current structure. This solves some of our issues but could still leave us far short of the necessary scale and capital requirements that will carry us well into the future. 

We also asked Navigant to do a high-level assessment of the market that included reaching out to a few health care systems that Navigant selected based on their system size, capacity to invest heavily in our market, structure for managing hospitals and physician practices, growth plans, and geographic proximity. This was to learn more about how those systems work with other health systems to add services, support employees and medical staff, advance quality of care, provide charitable care, invest in community partnerships and programs, and structure local governance for organizations within their systems.  This kind of assessment is work Navigant does for health systems across the country. A request of this kind is not unusual and health systems take part in these confidential information exchanges as a normal part of business. 

Navigant also prepared a rough estimate of NHRMC’s value, based entirely on market data. No health system was asked, or provided, any information related to a potential purchase price. 

At no time did anyone from NHRMC talk with the other hospital systems about the research or any potential partnership.

The proprietary information gathered was shared with Commissioners and members of the Executive Committee of the NHRMC Board of Trustees to see if it made sense to move forward.  This preliminary step was done confidentially, to allow more certainty before making a public announcement.

The majority of Commissioners found the responses to be encouraging enough to proceed with plans to announce a vote on whether to start a formal, public exploratory process. State statutes require only 10 days to announce a vote before it is held. NHRMC and county leaders agreed that 10 days was not enough time, so we made the announcement six weeks before a potential vote to allow more time to talk about it with employees, the medical staff, volunteers, donors, the business community, our community partners, members of the media, and the general public. 

This work has been done according to state statutes, and with what is right for our employees and citizens at the forefront of our minds. There are no back-door dealings. The research done early in the process was solely to understand the state of the market and the potential for bringing some support for healthcare to this region. It is not binding and is not a step to any agreement.  It is evidence of just how seriously we take our obligation to do the right thing for a group of people, and an organization, we care deeply about.

When we form the Partnership Advisory Group to develop priorities and a request for proposals, the team will begin a process that will be very public and take more than a year, with many points for public review and input. We have said from the beginning, if this process does not reveal a partnership model that will benefit the community more than what’s possible for NHRMC operating with county support, it will not move forward. It’s that simple. 

This will all become apparent when we move into the next phase and the public process unfolds. I encourage you to have an open mind and continue to learn about what is possible, as I will do. 
Our community looks to NHRMC, in times of storms and uncertainty, to exude strength, compassion, calm, and confidence.  It’s who we are and what we do. This opportunity we have been given by the county can help us secure a brighter future, with more resources to grow our team and our ability to better serve our patients and community. 

We are in this together. We all want what is best for our region and the amazing people who work at NHRMC, every day, saving lives and supporting those who come to us for care and comfort.

Thank you for all you do. I look forward to moving forward together with you to explore our future.