David Rice, CEO of Haywood Regional Medical Center for 15 years, resigned Monday in the wake of a financial crisis resulting from the hospital’s loss of its Medicare and Medicaid status.

“I think the fallout is so negative, I think a shift in leadership is called for,” Rice said. “The CEO always takes the responsibility. It is what CEO’s do. You have to protect the industry.”

The hospital board unanimously accepted his resignation after an hour-long closed meeting Monday evening. Prior to the meeting, board members said they were disappointed that Rice had failed to tell them of the brewing crisis until it imploded.

Rice said stepping aside will clear the way for the hospital to move forward rather than allow questions of his leadership to fester and interfere with the more important issues at hand.

“I think it is for the good of the hospital and the good of the community if I was to retire,” Rice said. “It will get the negative focus off me personally so the hospital can move forward. It just cleans the way and gets rid of some of the negativity and clears the way for a more positive direction.”

Ironically, Rice was just elected chair of the North Carolina Hospital Association.

“I will probably set a record as the shortest term,” Rice said of that role.

Rice, 68, had been planning for retirement in a couple years anyway, something the hospital board was aware of.

“We have had succession planning for the past three years internally to make sure we had internal talent within the ranks to pull from,” Rice said.

In a speech to a countywide meeting of doctors Monday night, Rice dropped the name of Eileen Lipham, a hospital vice president.

“I hope you will not overlook her for future leadership of this hospital,” Rice said.

For now, Al Byers, the chief operation officer of the hospital, will serve as acting CEO.

From the top

When Rice came to Haywood Regional in 1993, the hospital by all accounts was in shambles. Rice is credited with turning around the hospital financially and rebuilding its reputation as a trusted, quality health care institution in the community.

“The only way I could pull this thing out was to ask you all to stand behind me and stand behind the hospital,” Rice told doctors during his speech Monday.

Along the way, Rice built up what he called a “war chest” of $20 million in reserves.

“You have a well-equipped, outstanding hospital,” Rice told doctors.”

The crisis that prompted Rice’s resignation was a series of failed Medicare inspections primarily due to nurses improperly dispensing medication. Some within the medical community say that those problems can be traced right to the top.

Rice has been accused in recent years of fostering an overbearing culture and climate at the hospital. Numerous nurses and doctors have accused the hospital administration of being dismissive and unresponsive to their needs and concerns.

That, in turn, led to a large number of nurses leaving. The high turnover in nursing could have played a role in protocols for dispensing medication to patients not being followed.

“This is a breakdown not only because of nursing turnover, but in terms of nursing leadership to provide backup support for new or inexperienced nurses,” said Dr. Mark Jaben, a former ER doctor at Haywood. “If you have a certain core of experienced nurses on the floor they can serve that function. But when there gets to be so much turn over, you don’t that kind of turn over to support it.”

Jaben is an outspoken critic of hospital administration, butting heads with Rice many times before his practice was eventually ousted.

Rice reassured the medical community that however dire things seem in the short term, the hospital will pull through.

“The hospital can turn this around,” Rice said. “It is going to take a lot of sweat and a lot of hours.”

Prior to Rice’s resignation Monday, county Commissioner Mary Ann Enloe said the county will not let the hospital close and will intervene if the hospital board is unable to fix this problem on its own.

“We will have to be involved. I will lead the charge if it becomes necessary to get this taken care of,” Enloe said. “There are things that the hospital board can do immediately to start restoring credibility to that hospital. Let’s see if they do that.”

Doctors, patients, nurses, ambulance drivers — even hospital board members — were unaware of a crisis brewing at Haywood Regional Medical Center that jeopardized its Medicare and Medicaid status and, as a result, the future of the hospital.

By Julia Merchant • Staff Writer

Emergency rooms crowded with mentally ill patients. Sheriff’s deputies spending 96 hours supervising one individual. A sick man or woman whose situation is growing more dire by the second. It all adds up to a recipe for disaster — and North Carolina’s mental health care system is in imminent danger of becoming just that.

Every morning, the dispatcher for Haywood Emergency Medical Services starts his shift with a call to the emergency room of Haywood Regional Medical Center.

“Is there an orthopedist on call today?” the dispatcher asks.

An article that appeared in The Smoky Mountain News opinion section two weeks ago based on an anonymous interview with several nurses from the Haywood Regional Medical Center Emergency department prompted a rebuttal from hospital employees last week.

All three Haywood Regional Medical Center board members were reappointed this week for another three years by the Haywood County commissioners.

By Michael Rey

I would like to offer some words of support for those Emergency Department Nurses at Haywood Regional Medical Center who were brave enough to contribute to the debate over recent changes there (I am referring to the article that appeared in The Smoky Mountain News on April 24). Even speaking anonymously, they have all put their jobs on the line.

The board of the Haywood Regional Medical Center heard a glowing report last week on how the hospital’s emergency department is going following an abrupt transition four months ago.

One of the top issues that emerged during county commissioner interviews of hospital board applicants last week was the need for better-trained, better-paid and additional nurses at Haywood Regional Medical Center.

The rift between Haywood Regional Medical Center administration and the medical community needs to be repaired, and public confidence in the hospital restored, Haywood County commissioners said last week.