Sylva has a new town manager. Paige Roberson, 25, was promoted last week by the town board to the top leadership position.

Roberson has clearly impressed the town after stepping in to a part-time job as the director of the Downtown Sylva Association last summer.

Mayor Maurice Moody said that he believes Roberson will do an outstanding job for the town.

“I think she’s very well qualified — she’s a smart young lady,” Moody said. “The entire board is satisfied with this selection.”

Roberson, who last year graduated from Western Carolina University’s master in public affairs program, grew up in Sylva. Her mother was a long-time elementary teacher at Cullowhee Valley. Her father inherited the family’s hardware store, Roberson’s Supply, which was started by her grandfather. The family closed the store upon learning Lowe’s was coming to town. It had already been struggling since Walmart had opened, and the family decided surviving in Lowe’s shadow would be near impossible.

Roberson has a fierce appreciation for small businesses. Helping the business community of Sylva is going to be one of her passions.

Roberson hopes to bring a long-range approach to all of the town’s affairs. Lately, the town has been managed from year to year, without enough attention to where it is headed.

“We need to take a long-term approach to everything — projects, budgeting, ordinances,” Roberson said, identifying that as the town’s biggest challenge. “You have to plan with foresight. I think part of that comes from living here as long as I have. I think I am able to see the long term. ”

Moody said Roberson’s ties to Sylva “give her a leg up.” That, however, was not the deciding factor in her selection, he said.

“She does have a relationship with the community, but I think qualifications are more important than being local, though being a local individual does help.”

For her part, Roberson described herself as excited to be serving her hometown, although she admits she never thought when pursuing a career in public policy she would find herself at the head of her own hometown.

“I’m eager to do it,” she said, adding that she doesn’t feel apprehension about her lack of experience because the town has other veteran department heads.

The former town manager, Adrienne Isenhower, was forced to resign in September of last year after just a couple of years on the job. The town had brought in an interim town manager, Mike Morgan, who had recently retired from a long tenure as the town manager of Weaverville. Morgan was able to step in quickly to the role, but was commuting from Weaverville and was not interested in the job on a permanent basis.

Roberson will attend county and city manager training for eight months through the N.C. School of Government, one week a month, starting in September. During that time Morgan will continue as a consultant to the town to help bridge the gap.

Before taking a fulltime position with Sylva, Roberson worked in the Jackson County Planning Department.

Roberson went to undergraduate school at N.C. State, where she majored in economics. She planned to go to law school, with the intention of going into public policy. But during college, she interned three summers for N.C. Rep. Phil Haire, D-Sylva, in the General Assembly in Raleigh, and decided not to go to law school but instead get her masters in public affairs. She went through the two-year masters program in public policy and public affairs at WCU.

Her final semester, she was involved in the Cashiers comprehensive community planning project as an intern for the Jackson County planning department. In a case of opportune timing, she graduated just as the town was looking for a part-time director for the Downtown Sylva Association. The DSA had just been brought under the auspices of the town, and she was given a part-time job with the county planning department and worked for both the town and county.

In short order, however, the town promoted her to the role of assistant to the town manager and made her fulltime, before eventually selecting her as its new manager.

Roberson, in addition to her town manager’s duties, will continue in dual roles as Main Street director and head of economic development for the town.

“As a manager I hope to be proactive, fair, and consistent,” Roberson said. “By doing this and keeping the future in mind I will be able to serve Sylva effectively. I’m honored to be hired for this position. I love this community. I feel that my community knowledge and experiences being raised here will give me a good starting point.”

Most things in life start out small — acorns grow into oak trees, babies are reared into adulthood, small patches of green spread until they eventually cover the mountains each spring.

The latter is the focus of Jackson County’s annual festival Greening Up the Mountains, an event that has seen a lot of growth itself.

What started as a small Earth Day event has now grown to the largest festival in Jackson County. Attendance at the former mostly locals event has swelled to 10,000 to 12,000 each year during its 15-year existence.

“It’s kind of neat that it started as a little Earth Day parade in downtown Sylva,” said Emily Elders, an event coordinator. “It’s grown exponentially every year.”

The Greening Up the Mountains festival will be held from 10 a.m. to 4 p.m. on April 28 on Main and Mill Streets in historic downtown Sylva. The Downtown Sylva Association organizes the event, which celebrates the local economy, sustainability and traditional heritage crafts.

More than 200 vendors from all over the county — nonprofits, for-profits and others groups — will set up along the two streets, handing out pamphlets of information and peddling their handmade wares.  

“It’s a really good time to shop for incredible unique Mother’s Day or Fathers Day (gifts),” Elders said.

Even though the festival only lasts one day, the event offers for businesses and groups in Jackson County chance for greater exposure that last for years.

As a business owner, Matthew Turlington said the festival is a chance to broaden his customer base.

“You hope that it brings your standard customers and new customers,” said Turlington, owner of Penumbra Gallery and Studio.

The event draws new potential clients and more emails for their list-serves. This year, the downtown association will survey vendors and local businesses to get a concrete idea of how the local economy benefits from the festival.

“For me, that is the best part. The impact lasts,” Elders said. “It’s really been a lot of economic benefit, not just for the downtown.”

It’s also an opportunity for visitors to experience the best things about Jackson County all at once. As a Jackson County resident, Turlington said his favorite aspect of the festival is its incorporation of Appalachian history, from clogging to singing, and the young performance groups.

“I have always enjoyed the local young talent,” Turlington said.

Two music stages will feature Jackson County bands and heritage dancers. Between bands, multicultural dancers, such as Mexican Folkloric Dancers, Cherokee traditional dancers, the Liberty Baptist Men’s Choir and the Eternity Dance troupe, will perform.

“(The bands are) a pretty good mix this year too,” Elders said.

The traditional bluegrass and Americana bands will be on hand as well as folk and jam bands.

A third stage will be set up specifically for children’s enjoyment, along with the annual Youth Talent Show. Children’s activities include storytelling, face painting, an inflatable slide, the recycled materials Superhero Costume Contest and volunteer projects. This year’s event will also include a 5K run.

Schedule of events

Greening Up the Mountains starts at 10 a.m. and concludes at 4 p.m. on April 28 on Main and Mill Streets in historic downtown Sylva. www.downtownsylva.org.

The Smoky Mountain Stage in the Suntrust Parking Lot

• 10-11 a.m.: Tennessee Jed An Asheville-based bluegrass band with a bit of a rock feel.

• 11:15 a.m.-12:15 p.m.: Marshall Ballew A Sylva native and folk/Americana musician.

• 12:30-1:30 p.m.: Sugar Barnes & Dave Magill A duo with an old-fashioned blues sound.

• 1:45-2:45 p.m.: Moolah Temple Men’s Auxiliary A mix of electronic, lo-fi and choral music.

• 3-4 p.m.: Dan River Drifters A fast-paced bluegrass band based in Sylva.

Tuckaseigee Stage at Bridge Park Pavilion

• 10-10:45 a.m.: The Suite C:  An acoustic folk/indie band from Alabama.

• 11-11:45 a.m.: John-Luke Carter A singer-songwriter from Sylva.

• Noon-12:45 p.m.: PMA (Positive Mental Attitude) A Cullowhee-based reggae/jam band.

• 1-1:45 p.m.: Total War A Sylva-based indie/rock group.

• 2-2:45 p.m.: The Freight Hoppers A popular Bryson City-based old-time string band.

• 3-4 p.m.: Noonday Sun.

Triple Threat Kids’ Stage in Poteet Park

• 10-11:30 a.m.: Mountain Youth Talent Show

• 11:45 a.m.-12:30 p.m.: Triple Threat Performing Arts

• 12:45-1:15 p.m.: Junior Appalachian Musicians

• 1:30-2 p.m.: Sylva Children’s Theater

• 2:15-2:45 p.m.: Lions Gate Kung Fu Academy

• 3-3:30 p.m.: Burning Ones (The Father’s House of Prayer)

• 3:30-4 p.m.: White Dragon Martial Arts

When Dr. Bob Adams walked into a hospital-wide meeting of Jackson County doctors in early January, he believed he had finally mustered the critical mass to demand action, action that so far had been elusive despite a year of working internally to bring change.

But, he made a fatal miscalculation. The message doctors would ultimately send up the chain that night to the WestCare board of directors would be rejected.

Some doctors had become disillusioned with the Charlotte-based management firm that had been at the helm of the MedWest venture since its inception two years ago. They voted 31 to 3 to ask the board of directors to go to Mission Hospital, hear what it had to say and consider whether it would be a better partner.  

It’s rare for the majority of doctors at a hospital to make a formal and pointed request to their board of directors. The issue had been escalating for months by then, and as the community would later learn, had not yet reached its climax.

A core group of concerned doctors began meeting in early 2010, discussing their perception of problems at Harris, which was struggling financially and had lost 10 percent of its inpatient business to Mission. Initially, they took their issues up directly with MedWest CEO Mike Poore. Unsatisfied, however, they opened a line of communication with the hospital board of directors, sitting down with key members in one-on-one meetings.

SEE ALSO: Carolinas affiliation catalyst for doc's departure

By summer, however, the airing of concerns became a standing topic at the monthly meetings of all the Harris’ physicians, marked by a heated exchange or two with Poore before the roomful of doctors.

Eventually, Poore knighted the core group of concerned doctors with an official title — the “kitchen cabinet” committee — in an apparent attempt to address the issues.

Meanwhile, doctors ramped up their line of communication with the hospital board, a rather brazen move to go over Poore’s head.

“We go in and sit down and talk and start expressing our concerns directly to the board,” said Dr. Randy Savell, a long-time gastroenterologist at Harris. “They were surprised. They suggested they had no idea how things were.”

The meetings with the board continued for several weeks, and while the board members were willing listeners, the doctors couldn’t spur them to take action.

“We never got anywhere, but they were being very surprised and shocked and concerned,” Savell said.

Some in the core group oscillated between caring about the management structure and just going back to doing what they did best: caring for patients.

“After a while, you get worn out. You get tired of fighting,” said Dr. Earl Haddock, a pulmonologist at Harris.

Two of the doctors in the “kitchen cabinet” had been on the hospital board themselves but had resigned earlier that year after growing disenchanted.

“The thing that struck me is nobody asks questions,” Dr. Waverly Green said of why he resigned from the board. “If it was a place where there would be honest discussion and be about the future of the hospital, I am happy to be a part of that. but I am not going to sit in a room and rubber stamp things that to me make no sense.”

Between a rock and a hard place

The group of concerned doctors decided to take matters into their own hands. In December, some of them drove to Asheville for a behind-the-scenes meeting with the CEO of Mission, Ron Paulus. It was a renegade move, unauthorized by the rest of the medical community at large, but they liked what they heard.

So in early January, they called a meeting of all the doctors under WestCare and asked them to take a stand. Discussion dragged on for more than an hour.

Getting out of the MedWest partnership wasn’t an easy proposition. There was an escape clause built in at the three-year mark, but it could only be exercised by a three-fourths majority of the MedWest board, which was comprised equally of seven members each from WestCare — comprised of Harris and Swain hospitals — and Haywood Regional.

But, there was a little-known loophole. A clause in the MedWest contract allowed either side to pull out if the financial viability of one of the partners was at risk. It just so happened there was bad financial trouble brewing next door in Haywood. The Haywood hospital was running so low on cash, word on the street was it might not be able to make payroll.

To solve the short-term cash flow crunch, Haywood had gone up the chain to Carolinas for an emergency loan. Harris, however, was being asked to co-sign for the loan, putting its own revenue stream on the hook should Haywood default.

In realty, Harris would never be asked to cough up the money. Haywood’s revenue stream — about $100 million annually — along with all its equipment and its hospital building were also on the hook as collateral and would be tapped first before Harris would ever have to ante up. Essentially, there was more than $250 million guaranteeing a $10 million loan.

But, Carolinas was outside its comfort zone. This marked the first time it had ever loaned money to any of the 34 hospitals it manages. So it wanted the kitchen sink as collateral.

The Jackson doctors theorized the financial straits at Haywood were grave enough to exploit the loophole and engage in talks with Mission.

Little did the doctors know, however, that the WestCare board faced a grave choice — co-sign the loan to help bail out Haywood or comply with their own doctors’ request to meet with Mission. Doing both, it turned out, would not be an option. There was a catch to the loan with Carolinas. As long as MedWest owed Carolinas, the hospitals were prohibited from negotiating with a new partner.

Business-wise, it made sense. Carolinas didn’t want to prop up MedWest only to have it walk away still owing money. But to the unhappy physicians, it played out like a game of Mousetrap — and they were the ones sitting under the cage.

Harris board backs Carolinas

The WestCare board ultimately had faith in the MedWest venture and co-signed Haywood’s loan.

“We believe the future is bright for all three hospitals, even though the challenges are many. It is time to look forward, assuring the full potential of MedWest-Haywood, MedWest-Harris and MedWest-Swain is realized,” the MedWest board said in a statement this week. “Is this a short-term process? No, it is not. It will take months of hard work. But, we are confident in the expertise of our medical staffs and in the skill and dedication of all our employees.”

The doctors, however, felt ignored in their pleas to consider other options.

“We said ‘We aren’t telling you to dump Carolinas.’ We are just saying go talk to Mission and see if we made the best choice,” said Dr. Waverly Green, a pulmonologist at Harris. “Two days later, they signed documents that tied us up even tighter to Carolinas. That told me the board didn’t want input from the medical staff.”

One of the board members, Bob Carpenter, resigned from the board a few days later in a show of solidarity with the doctors.

“The bottom line is our hospital is in serious shape, and our trustees need to be looking at alternatives,” Carpenter said. “The community needs to keep pressure on the board to seek alternatives and do the right thing for this community.”

It turns out Harris was not merely hamstrung by Haywood’s loan. Harris was beholden to Carolinas for its own financial security as well. Carolinas had pulled strings to help Harris out of a pinch over an outstanding $15 million loan with BB&T, dating back to hospital construction projects a decade ago. Under terms of the loan, BB&T required Harris to have 75 days cash on hand.

Last year, Harris wasn’t able to maintain that balance and dipped below the cash-on-hand threshold that BB&T required. Carolinas tapped its relationships in banking circles, essentially putting in a good word for Harris, and convinced BB&T to temporarily relax its cash-on-hand requirement.

Harris currently has 56 days of cash-on-hand instead of the mandated 75. If Harris sent Carolinas packing, it could jeopardize the leniency BB&T had extended on the loan terms.

The door had been closed on any escape hatch Harris may have had, Savell said.

To be clear, the concerned doctors don’t believe in a conspiracy by Carolinas to make the hospitals financially dependent as a way of keeping MedWest intact. Adams thinks Carolinas just wasn’t paying close enough attention to the day-to-day operations, which after all is the expertise Carolinas was supposed to be providing in exchange for its management fee.

“They would never have allowed them to spend what they spent at Haywood without having the resources to back it up,” Adams said. “They would never have allowed Harris to be run in the ground even if that was a planned maneuver because it created a huge backlash. You don’t poison the components.”

John Young, a vice-president for Carolinas’ western hospitals, said that Carolinas doesn’t tell MedWest what to do — it’s the other way around.

“We work for the local boards. We have no control mechanism,” Young said.

A unique community of physicians

It’s rare to find physicians and hospital management in lockstep on everything. Now, however, the WestCare board must find a way to rebuild the fractured relationship with physicians.

“For every member of the medical staff that has talked to the board, to walk away feeling like nothing was going to be done was a difficult thing for us,” said Dr. Earl Haddock, a cardiologist at Harris.

It marked a departure from an amicable relationship the Jackson medical community had always had with its board of trustees.

“There was never any adversarial relationship. It was collaborative across the spectrum. We all worked together for the same goals. I think the thing that has been particularly uncomfortable for the medical community in these last two to three years is that relationship no longer applies,” Adams said.

A saying by a patriarch of the Harris medical community has been reverberating in Jackson County for nearly 40 years, handed down through practices and still preached to new recruits today.

“Sylva is where you can practice contemporary medicine in the old-fashioned style,” so the saying goes. It was coined by Bill Aldis, an internal medicine specialist who came to Harris in the mid-1970s.

Aldis was part of a dynamic trio of upstart internal medicine specialists who sought out Sylva after medical school as a place to make their mark, perhaps even a social experiment of sorts. Their mission: to take a rural hospital with a smattering of primary doctors and see how far they could take it.

“They were at John Hopkins together and decided they were going to find a place where they could make an impact,” said Dr. Joe Hurt, a retired pathologist who came to Harris in 1978. Hurt came partly because he was impressed by the three young internists who had thrown themselves headlong into building up a rural medical institution.

“There was a tremendous amount of potential,” Hurt said.

The energy was infectious. Each new specialist who came on board joined the recruiting crusade, putting their best foot forward as a medical community to build up their own ranks in partnership with the hospital.

“A lot of the recruiting parties and events were actually held at my house,” Hurt said. “Some of the contracts between partners were worked out at my house.”

In the decade from 1975 to 1985, the number of doctors practicing in Jackson County more than doubled, bringing in the county’s first orthopedists, pathologists, radiologists and surgeons. More by fate than design, the community attracted a certain breed of physician — those who didn’t care about the lack of a country club or golf course, Hurt said.

Those early efforts set Harris on a track that still persists.

“Harris has had a long-standing tradition of attracting very good physicians. Part of the attraction was for a small hospital, this had an exceptional medical staff. Well-trained physicians, very community-oriented. There was a rapport between the physicians and community that didn’t exist elsewhere. The hospital just had a very good reputation,” Green said.

All still support local hospital

There’s one thing both sides in the debate agree on: keep going to your local hospital.

“In terms of the services, we can and should provide in our local hospitals, we are as good as anyone in the country,” the MedWest board of directors said in a statement this week.

Undermining Harris is indeed the last thing those speaking out want to do.

“There are those who felt the community deserved to know. Hopefully, there will be enough of a outcry to have an impact,” Savell said.

But, the 2,000 employees of MedWest in Haywood, Jackson and Swain counties have surely felt the sting of the negative publicity during the past week.

“I care for every single patient with every ounce of my being,” said Heather Sheppard, a nurse at Harris and director of ICU. “I stand by the care that we deliver to every single patient at Harris.”

In Haywood County, a letter was signed by 29 doctors this week reinforcing their strength and resolve to provide excellent health care.

“We believe and have substantial data to corroborate that the care at Haywood hospital is, like the care at Harris hospital, something the community can take great pride in,” the letter states.

Dr. Joe Hurt, a retired pathologist at Harris, said going public was clearly a last resort for Adams after months of working through internal channels that got him nowhere.

“I don’t think any of them wished ill against the hospital,” said Hurt.

Savell agreed that’s not what this struggle is about.

“Good care is still there. Good people are still there,” Savell said.

Even those who have publicly stood beside Adams plan to stick with Harris to the end.

“I love what I do. I love the patients. I love the hospital, and by golly, we provide excellent care, and we want to get back to that,” Haddock added.

When the Med-West venture was coined two years ago, the premise was an easy sell. Together the hospitals would be stronger than going it alone.

Both Harris and Haywood hospitals had witnessed a troubling loss of patients to Mission — a loss so troubling in fact neither hospital could afford to continue as it was. They faced a cold, hard reality: turn the course, and fast, or they would be faced with financial insolvency.

Indeed, both hospitals hoped the MedWest joint venture would shore up the erosion of patients to Mission. Both, however, seemed to have different ideas of how that would play out on the ground.

Was there enough business for both to stay the size they were, or would one ultimately evolve into the big kid on the block under the MedWest umbrella — and if so, who?

Before the merger, and even now, Haywood and Harris competed very little. Fewer than 5 percent of patients from Jackson migrated to neighboring Haywood or vice-versa.

But with the future of their medical community on the line, 1 percent here and there suddenly seemed to matter quite a lot.

While the call by some Jackson doctors to withdraw from MedWest seems like a shot across the bow to their neighbors in Haywood, Jackson doctors said they didn’t intend it that way. They aren’t questioning the quality or caliber of health care at Haywood’s hospital or by Haywood doctors. Instead, it seems desperation amidst a shifting health care landscape has seized the day.

Next week: Read more about the specific concerns raised by Jackson doctors, an analysis of hospital market share, a snap shot of finances, and philosophical view points on the MedWest venture.

Four long-time physicians in Jackson County are leaving C.J. Harris hospital after becoming disenchanted with the direction of MedWest — and even more so with Carolinas HealthCare System, a giant network of 34 hospitals that MedWest is affiliated with.

Dr. Bob Adams, a hospitalist who is leaving Harris after 36 years, fears Carolinas plans to build up Haywood as a flagship to compete with Mission. He didn’t like where that would lead.

“Harris devolves and Haywood grows,” Adams postulated. “They are playing the corporate practice of medicine. I don’t want to be a pawn in somebody else’s power struggle and be used as a widget in a big business’ plan for their benefit.”

The president of Harris, Steve Heatherly, laments the loss of the four doctors — and the circumstances.

“It is unusual in the history of this organization to have physicians leave because they were not satisfied with the strategic direction,” Heatherly said.

Making matters worse, another seven doctors in the Jackson-Swain medical community have either already left or plan to leave — for a total loss of 11.

“It is unusual to have that level of turn over,” Heatherly said, even though only four of the 11 actually chalk up their departure to “dissatisfaction with the hospital.”

Lessening the blow somewhat, seven new doctors are moving to Jackson and Swain in coming months. They had already been recruited and were intended to bolster the physician ranks.

Now, however, the hospital will see a net loss instead of gain and a gap in a few key specialties.

Dozens of doctors, of course, aren’t going anywhere.

“We must not forget that we still have an extremely skilled and dedicated medical staff of nearly 230 physicians who are choosing to stay in our communities and work in our hospitals to take care of our patients,” Dr. Robin Matthews, an ob-gyn in Haywood County who chairs the Physician Leadership Council of MedWest.

Many of the 2,000 employees of MedWest have rallied to their hospitals’ defense during the past week.

“The hard decision is to stay here and fight for this place to succeed,” said Dr. Casey Prenger, the medical director of the hospitalist group at Harris. “We believe in our hospital and our community, and it is our privilege and honor to take care of you.”

There are huge challenges, however, facing Heatherly and MedWest: hold MedWest together, turn the corner financially, recapture market share from Mission, quell the doctor uprising, and recruit new doctors to fill the holes.

Resolving to make a stand

For the group of Jackson County doctors who went public with their concerns last week, the decision wasn’t an easy one nor was it taken lightly.

“They aren’t trying to hurt anything. They are trying to fix something,” said Dr. Gilbert Robinson, an anesthesiologist at Harris for 10 years.

Even those who spoke out aren’t certain now was the right time, or if it will do any good.

But, the ball was in Adams’ court. When he decided to go public, the core group who had been fighting alongside him during the past year to bring about change internally weren’t going to leave him on a limb by himself, so they reached out and grabbed on as well.

“I decided I wanted to let the community know what was happening to their hospital. The only thing that is going to change is if the community starts standing up for itself to Carolinas and the WestCare board,” said Dr. Waverly Green, a pulmonologist at Harris who is leaving as well.

Adams hopes the issues he raised aren’t construed as a parting shot or chalked up to sour grapes.

“They are portraying those of us who had concerns and discomfort about where we are as being disgruntled and outliers,” Adams said.

But in fact, hospital administration has gone out of its way to praise Adams and the others who are leaving.

“It is regrettable. They will be missed in this community. They are outstanding physicians who have provided years of service to this community,” Heatherly said.

Even doctors in neighboring Haywood, who rightfully have reason to be miffed by Adams’ shot across the bow at MedWest-Haywood, have been complimentary.

“He is a great doctor and wonderful human being. I just happen to disagree with them completely,” said Dr. Marvin Brauer, chief of staff at MedWest-Haywood and a hospitalist like Adams.

While Adams will soon be gone, others who support him will still practice at Harris and will continue carrying the torch to fix perceived problems.

SEE ALSO: Doctors take a stand out of fear for Medwest-Harris' future

Some of them are even on Harris’ payroll. Technically, the entity they are speaking out against writes their paychecks, putting them in an uncomfortable position at best, a vulnerable one at worst. Normally, few doctors would be willing to take a career gamble like that.

The difference at Harris likely comes down to their new president, Steve Heatherly. Heatherly has been with Harris since the 1990s, part of that time as a physician liaison and serving in a variety of vice president roles and as chief operating officer.

In hopes of quelling dissension among Jackson doctors, Heatherly was promoted two months ago as the president of Harris. It gave Jackson doctors one of their own at the helm — rather than the previous hierarchy where they answered to a single CEO for the entire MedWest venture, Mike Poore, who they were acutely aware hailed from Haywood and still had his base office there.

Jackson doctors have hope that Heatherly will help right the ship.

“I believe Steve is at the place he needs to be to help turn WestCare around, due to his experience and background and skill set. I don’t know of anyone else that would be better at this point in time,” said Bob Carpenter, a former MedWest board member from Sylva who resigned in January over the same issues troubling the doctors.

Even Adams agreed.

“I think the WestCare board and Steve Heatherly are doing their best to work with medical staff now,” Adams said.

Many doctors — even those who are in near lockstep with Adams’ pointed assessment of the MedWest landscape — wish he had given Heatherly more time to fix things before going public.

Dr. Randy Savell, a gastroenterologist doctor at Harris, said Heatherly faces a difficult future.

“He is between a rock and a hard place,” Savell said.

Heatherly’s boss is technically Carolinas, and he answers to them daily. But, he must also answer to the hospital board of directors, all the while winning the good graces of nurses and doctors by proving he will address their concerns.

The road ahead

Heatherly doesn’t downplay the reality that a hospital lives and dies by its doctors. If the doctors are good, people will get their health care locally.

“That leads to more volume through the hospital, which helps solve the business dilemma,” Heatherly said.

That business dilemma — dire financial straits for both Harris and Haywood — looms large in the debate.

Harris has lost more than 10 percent of its in-patient business to Mission Hospital during the past five years.

As a result, Harris is struggling financially and has been losing money for at least three years. It’s now in its third round of layoffs in four years.

“Our hospitals must confront the fundamental business reality that expenses cannot continue to be greater than revenue,” Heatherly said.

If the financial picture was rosier, the paranoia among Jackson doctors that Carolinas is trying to siphon its patients off to Haywood could simply melt away.

For now, Heatherly is stuck in a Catch 22. Rather than shrink, Harris must find a way to regain the market share lost to Mission.

“No organization can cut its way to prosperity, especially not a hospital, where quality patient care is our business. ‘Thrive-ability’ will happen when more patients come through our doors to see our brilliant doctors and caring staff,” Heatherly said.

Harris’ financial problems are largely because it lost several doctors back in 2006 and 2007, Heatherly said. When patients needed a doctor’s appointment, they were forced to look elsewhere and ended up walking right into the open, waiting arms of Mission in Asheville.

Heatherly, who started at Harris in the 1990s, had taken a hiatus for a few years to work for a physician management firm. When he came back to Harris in ?, job No. 1 was recruiting physicians to fill the void.

“The organization was having trouble recruiting physicians to replenish the supply to the local community, and it created a constrained access,” Heatherly said.

In 2008 and 2009, WestCare brought in 10 new doctors. It also bought out several private practices in order to put existing doctors on the hospital’s payroll — reflective of a national trend by doctors who increasingly prefer to work directly for a hospital rather than run their own private practices.

Those moves came at a financial cost, but Heatherly said the influx of doctors stopped the bleeding of market share. Unfortunately, it hasn’t come back up yet either.

“Now that we’ve had success in rebuilding our medical staff, we need more patients from our local communities using our local hospitals. Only then can we expect more positive financial results,” Heatherly said.

Heatherly’s belief in doctors as a core business strategy for the hospital seems genuine. He stresses it even when discussing other topics, like when the long-awaited renovations to Harris’ emergency room will be re-started.

“As we move forward, we have to assess that we have the right medical staff in place to offer ongoing appropriate access to care, and then those opportunities to evaluate facility expansion will be driven by the ability to generate sustained financial results,” Heatherly said.

Heatherly was speaking off the cuff, not reading from a prepared statement. But, his hospital administrator’s version of Alan Greenspan’s famous Greenspeak can be boiled down this way: doctors must be shored up first, which will bring back patients, which will bring back money.

The shell of a vacant four-story hotel sitting partially finished on Sylva’s main drag for three years is finally going somewhere.

Developers from Greensboro bought the vacant hotel along N.C. 107 for $850,000 and are promising to pump an additional $2 million into completing the project.

The hotel was partially constructed beginning in 2008 and has widely been considered an eyesore. It was supposed to become a Clarion Inn, but the original developers TJ Investments, the father and son team Thomas and John Dowden of Cashiers, went into bankruptcy. Alpharetta Community Bank of Georgia, which foreclosed after the men failed to payoff a $5-million loan, owned the hotel. The newly formed Sylva Hotel Group recently bought the property for $850,000.

Developer Stephen Austin said he and his two partners in the project have settled on a national hotel chain to brand the 78-room hotel, which includes a convention room and space for a restaurant, but added that they aren’t ready to disclose which one.

He said the bargain-basement purchase price made the deal a good venture.

“Sylva is not an extremely deep hotel market,” he said. “We’re going to do our very best to have a hotel that is worthy of our business.”

Austin said that the men’s pre-purchase market studies indicated that Sylva hotel occupancy rates run at about 50 percent, lower than the national average of more than 60 percent. Even after figuring that higher vacancy rate into the business plan, Austin said the getting-in price made it a sound investment.

“If you are going to build a new hotel, it helps to get in at a good price,” he said. “We’ll have a total of about $3 million in the project. We’re also excited to be able to take a piece of property and produce something of value, create an asset for the community.”

Austin said he and his partners are hoping to start construction soon and open the new hotel this year.

Town Commissioner Harold Hensley, who lives near the hotel, said he is excited that it sold and is going to be finished and used.

Five years ago, the town OK’d an exemption to its building height restrictions, allowing the proposed Clarion Inn to have four stories instead of three. The developers at the time claimed they needed a 75-foot maximum height instead of just 45 feet as mandated by town regulations.

Hensley said he believed the purchase was indicative that the local economy is starting to shake off the recessionary blues.

“I don’t know much about the details, but to me, it’s excellent news that this can move forward and progress,” Hensley said.

Paige Roberson, assistant to the town manager and director of the town’s Main Street program, echoed Hensley’s optimism. She said that at least two other vacant stores in town have seen movement recently. Cope’s Superette, a downtown newsstand that closed in December, is being reopened as an antique store; the crematorium of Moody’s Funeral Home is being repurposed as a doctor’s office.

With tunes that rush quickly along and take unexpected twists and turns, Sylva-based The Dan River Drifters are anything but lazy and predictable, like their name might suggest.

The band’s high-energy and sometime improvisational approach to bluegrass makes them an exciting group in which to listen.

Although they are relatively new to the Western North Carolina music scene, the group’s beginnings go back to a couple of the members’ childhood.

Long-time friends Jesse Lapinski and Andrew Lawson began playing open mic nights together and took the name The Dan River Drifters almost three years ago while attending Western Carolina University in Cullowhee. The calm, paddler–friendly Dan River runs through Stokes County, where Lapinski and Lawson lived as kids.

Over time, as the two made friends with other area musicians, the group expanded. Originally a duo, the band more than doubled to a quintet, adding Adam Bigelow, Tim Sheehan and Jesse’s younger brother Zach Lapinski.

“It just kind of fell into place,” Jesse said.

Jesse performs with the mandolin and guitar, while Lawson plays guitar and harmonica. Zach and Sheehan, who still attend WCU, play guitar and the five-string banjo, respectively. The most recognizable name on the band’s roster is Sylva Renaissance man Bigelow, who plays bass for the Drifters. Bigelow is heavily involved in many Jackson County community efforts, particularly environmental conservation. All five contribute to the group vocally.

“We are all good friends,” Lawson said.

Although bluegrass seems like the natural choice for bands in Western North Carolina, Sheehan was the person who really drew them to playing the genre, said Jesse, who used to play in a punk rock band.

At WCU, Jesse studied music education with a focus on jazz, from which the group took its improvisational style.

“Every time we do play, you will hear something new,” Jesse said.

The solo ad-libs give each band member to showcase his pickin’ skills.

“To me, when people solo, it’s like they are telling a story,” Jesse said.

During their shows, the Drifters play traditional bluegrass songs but mix in a fresh, high-energy sound. About one-third of the Drifters’ repertoire is songs they personally penned. Their tunes, most of which are collaborative efforts by Jesse and Lawson, take on some traditional bluegrass themes — murder ballads, moonshine and outlaws.

While the highest point in their career thus far came last April when they opened for the nationally known and locally loved Freight Hoppers, the Drifters most memorable performance was at a wedding in Cashiers with an enthusiastic audience. The wedding party had traveled in from Boston, and the Drifters had been asked to provide the music. Lawson said it was one of their best audiences.

“They loved it,” Lawson said. “I guess it makes them feel like they are from the mountains.”

Since most of its members have graduated from WCU, scheduling band practices has become more challenging. But, it has also allowed the band to expand its reach beyond Cullowhee and Sylva. Now that half the group lives in Asheville, the Drifters regularly perform at The Altamont Brewing Company and other venues around the city.

The next step is a CD — something they can give to venues to help them book gigs or sell to fans.

“Maybe a demo CD will get somebody to open the door for us,” Lawson said.

Hear them live

The Dan River Drifters will play at 8 p.m., April 14, at the Tuckaseegee Tavern on Depot Street in Bryson City. Or, catch them the following weekend on April 28 at Greening Up the Mountains in Sylva. The show begins at 11:45 a.m.

For a list of more performances or to hear their song “Blinkin’ Lincoln,” check out Dan River Drifters on Facebook.

With its obvious Cuban influences — the combination of guava and cream cheese, or even mango and cream cheese  — Mindy’s Bakery in Sylva is clearly not your typical mountain bakery.

But that’s not all that sets this small bakery apart: the five family members directly involved have graduated from or are currently enrolled at Western Carolina University. This family, who lives in Waynesville, is literally working its way through school one pastry at a time.

Raul and Mindy Guillama are the patriarch and matriarch of this family. They have three sons, Raul, Andre and Sebastian, who jumpstarted the family’s WCU train.

Andre and Sebastian have both graduated from WCU with degrees in construction management and finance, respectively. Young Raul is getting a degree in marketing, his father is getting an accounting degree and his mother is getting one in psychology.

“The three of us were going, and they said ‘we have a lot of free time so we might as well go to school, too,’” young Raul said.

“And accounting is something you can use in any business,” his father added. “I can do my own accounting and taxes.”

Seventy-year-old Raul is an engineer by training.

“I’m doing my share of contributing to the social security working force,” Raul said, only partly in jest.

Mindy, 50, the mother, explained that both she and her husband were born in Cuba. She came to America on the first Freedom Flight from Cuba to Miami that brought exiles to this country. Her husband was already in America as a young student when Fidel Castro took over. His family joined him in the U.S. in flight from the ensuing oppression.

“He has a brother-in-law whose father was killed in his arms,” Mindy said. “We are a family that came to this country because we had to — it was either communism or freedom.”

That said, the family loves America and what it has given them in return, Mindy said. The Guillama family ended up in Western North Carolina about eight years ago following years of vacationing in this region.

These days, they live together, work together and go to school together.

Husband and wife are taking a psychology class together. Raul the older and Raul the younger are in calculus together. They both said that each is doing equally well, and they choose to sit side by side in the class.

Baking is in the family blood. Their daughter, Mindy, who lives in New York, is also a baker and worked with them in the past.

Mindy’s Bakery specializes in wedding and special occasion cakes, as well as tropical desserts such as flan, coconut cakes, and the Cuban “pastelito” pastries.

“I got the éclairs and took them to work one day and everybody just loved them,” said customer Diane Winstead who was at the bakery one morning this week picking up another order of éclairs for an office party. “It just all looks so fresh.”

There’s no clear winner in a complex and multifarious new system for ranking roads projects when it comes to the ongoing debate over Sylva’s main commercial drag.

In just-release road rankings, redesigning N.C. 107 out ranked the competing proposal to build a new highway bypass around it — but just barely.

The two dueling projects — redesigning N.C. 107 versus building a bypass to divert traffic from it — ranked second and third on a wish list of road building projects for the six western-most counties, with 45 and 44 points respectively.

The near tie means controversy is bound to continue over the best way to address perceived congestion on Sylva’s thoroughfare.

The two projects are neck and neck in the ranking process, despite a strong message by local leaders that they overwhelming prefer to rework N.C. 107. A regional transportation committee comprised of leaders from the six western counties got to weigh in on the road ranking — and in doing so awarded reworking N.C. 107 the maximum number of points it could.

By contrast, the regional leaders awarded zero points to the concept of a bypass around N.C. 107.

The bypass was catapulted forward anyway, however, thanks to heavily weighted points injected into the ranking process by the N.C. Department of Transportation.

Sarah Graham, a transportation planner and community liaison for the Southwestern Planning Commission, sees the ranking process as a success for public input, even though the preference of local leaders was nearly outstripped by DOT’s own rankings.

“The conversation we have going on now is of improvements to the current road, compared to a few years ago when the conversation going on was whether or not we wanted a (bypass),” Graham said. “The community said we want to see what it would take to improve 107 before you build a new 107.”

Indeed, community input got the idea of reworking N.C. 107 put on the list in the first place, and then advanced it forward.

But, some Jackson County leaders are discouraged that their input into the ranking process, which showed a clear preference for reworking N.C. 107 over a bypass, got watered down after the state DOT was done with the list.

“It is frustrating to see that a project the county planning board and the county commissioners ranked very low to score so highly on the statewide ranking,” said Gerald Green, Jackson County planner. “It made the time the county commissioners and planning board put into reviewing the projects and ranking them seem to be wasted and it felt as though our input was given much consideration.”

Point jockeying

The road rankings were done under a new system launched last year that is supposed to be objective and data-driven. The DOT awards its points based on several predefined variables. The old process was considered subjective, determined in part simply by the preferences of politically appointed DOT board members.

Gov. Beverly Perdue ushered in the new system, as one of many state government reforms aimed at transparency and ending political corruption.

“It is a scientific approach that would remove so much of the politics involved in funding transportation and try to infuse the process with more science and more local input,” Graham said.

The ranking process can be a bit daunting to the novice, however.

The final list is a mish-mash of rankings by local leaders, the local DOT office and state DOT planners. Each has its own system for awarding points. Points are also weighted, so the points awarded by the state DOT office count for a greater share of the total than those awarded by local leaders.

The system is still relatively new, but local leaders on the regional transportation committee have already figured out a way to game the system and try make their points count more.

Since the DOT’s block of points are weighted more heavily, input by local leaders can only carry a project so far. The regional committee is given a block of 1,300 point to divvy up among its favorite road projects, with the caveat that it can’t award more than 100 of the points to a single project.

Last year, the regional transportation committee carefully spread their allotted bank of points among a long list of road projects, splitting hairs over how many points each project should get out of the total 1,300 they had to work with.

Their balancing act ended up being for naught once the DOT added its points to the mix, however. The preferences of local leaders were watered down once the DOT plunked its more valuable points into the mix.

So this year, the local leaders on the regional transportation task force decided to game the system. Instead of spreading their allotted points around to lots of different projects, they dedicated all their points to a handful of top projects and gave zero to the rest.

In the end, they got more bang for their points.

“They realized you have to work together to get your projects moved up the ladder,” Graham said. “They said, ‘let’s give 100 points, the most we can give, to our top projects and start pushing them up faster.’ If we are going to be given some say, we want it to mean the most.”

Graham said the transportation planning committees across the state have caught on to the strategy as well.

Convoluted? Perhaps.

But, public input actually had an influence in the state’s road project rankings, so Graham sees it as a success.

“If we had not put improvements to 107 on the list and given it 100 points, it would not have been on there at all,” Graham said.

The rankings are all well and good, but the question ultimately is which ones will get money.

“We don’t really know how much money is going to be applied,” said Joel Setzer, head of the DOT for the 10 western counties. “What everybody wants to know is what is going to get worked on. We don’t know that yet.”

Technically, building a bypass is further along in the planning process than reworking N.C. 107. The alternative of reworking N.C. 107 emerged only a few years ago, while the idea of a bypass dates back two decades and has been inching ahead, albeit slowly.

“It is already in the development stage,” Setzer said.

But, “there is very little work being done on it,” he added.

Now, it is unclear whether that work should be halted, and the money put toward reworking N.C. 107 instead.

“We can’t hopscotch around the priority list,” Setzer said. “Because of the rankings, we can’t continue to work on the planning of the 107 (bypass) without addressing this potential project to widen existing 107 because widening existing 107 ranked higher.”

Devil in the details

While Setzer refers to the project as “widening” 107, that’s not what local leaders who requested the project would call it. They want traffic flow improved, but in their book, that doesn’t necessarily mean a carte blanche widening.

In fact, that highlights a source of contention between the community and DOT over what exactly a “reworked” N.C. 107 would look like.

DOT did a cursory plan for reworking N.C. 107 that calls for wider lanes, more lanes, bigger intersections and medians. The new footprint would be so wide it would take out nearly every business lining the commercial thoroughfare.

Local leaders and the business community believed there had to be another option for reworking 107, however.

“They didn’t like what the DOT suggested,” Graham said. “They said we don’t want the study defined for us. We don’t like the way it was defined for us.”

So a task force of town and county leaders, along with local business owners, hopes to come up with a more tenable solution. It has been meeting for a few months.

“There wasn’t really a clear vision of what had to be done with 107,” said Chris Matheson, a Sylva town board member and business owner. “There’s a lot more to consider than how to get from the light at 107 to the high school quicker. We are finding out just how complicated it is.”

Opinions on the committee vary on the extent of the congestion — which will ultimately frame out much of a “fix” the road needs.

Randy Hooper, owner of Bryson’s Farm Supply, doesn’t think traffic is that bad judging by his own commute.

“I can leave here in the afternoon and be home in 15 minutes. Twenty years ago, I could do the same thing,” said Hooper. “It takes no longer to get back and forth to work now as it did 20 years ago.”

The goal of the task force is to speak with one voice on what the community wants a “reworked” 107 to look like.

“We need our community leaders to be backing a single vision. We hope the corridor study will create the community consensus so as we move this project up the funding ladder we can say, ‘This is our vision. Help us fund it,’” Graham said.

Setzer agreed consensus is currently lacking.

“We are polarized right now on what we think we need to do, as a community,” Setzer said.

The $289,000 loan from Jackson County to the new owner of Sylva radio station WRGC has finally gotten the green light, meaning the popular local station could be back on the air early next week.

“I think everything is in place to move forward with this,” County Manager Chuck Wooten told commissioners earlier this week.

WRGC went dead last August, a victim of dwindling advertising dollars in a souring economy. Sylva resident Roy Burnette hoped to buy the station and get it back on the air, but lacked the money or financing to do so.

540 Broadcasting Co., the business formed by Burnette, sought an economic development loan of $289,000 from the county. The deal has been in the works for months. Although commissioners OK’d the economic development loan in theory, it got hung up on issues of collateral. It was unclear what assets Burnette would put on the table to guarantee the loan.

Proper collateral, allowing the county to recoup its money should Burnette fail to make payments, is a touchy issue. The county’s track record for economic development loans has not been great in the past — finding itself in possession of the questionable collateral from underground fiber optic lines to 500 sewing machines — and it is trying to be a tad more judicious these days, explaining the hold up on the loan.

The issue of collateralization has now been resolved, County Attorney Jay Coward assured commissioners. Burnette will put up personal real estate “worth in excess of $175,000.” Additionally, an inventory of the radio station’s equipment shows that it, too, is worth in excess of $175,000, Coward said.

Of the total $289,000 loan, Burnette needed $250,000 to purchase the actual radio license from Georgia-Carolina Radiocasting Co. Some $39,000 was designated for acquiring the equipment needed to install the 5,000-watt station. Burnette is providing $100,000 in his own dollars for working capital.

Burnette plans to expand the radio station’s reach, previously limited to Sylva, from Canton in Haywood County to Topton in Swain County, which in theory also would expand advertising-revenue possibilities and make the station financially feasible.

Prospects that Rover might one day find himself banned from attending events and festivals in traditionally pooch-friendly Sylva has left some dog owners here feeling like they are on the end of an increasingly short leash.

Town commissioners recently considered following Waynesville’s lead and prohibiting canines, even when controlled on leashes, from street festivals and town-sponsored functions.

Commissioner Harold Hensley emphasized on Tuesday “I am not a dog hater,” but said that he’s heard a rising tide of complaints from citizens and from law enforcement officers about dog-people interactions at town events and festivals.

“There was a man, he spread out on the ground for a picnic, and a big dog came up and helped himself to a piece of chicken off that man’s plate,” said Hensley, adding that more and more towns are moving to prevent those and more serious sorts of interactions.

Sylva leaders ultimately decided to postpone the discussion for now because one of the town’s most storied events, Greening Up the Mountains, is just around the corner, said Paige Roberson, head of the Downtown Sylva Association.

Greening Up, Sylva’s annual celebration of the arrival of spring when thousands converge on downtown for the biggest street festival of the year, takes place April 28.

The dog-ban issue hasn’t gone away, however, it simply has been postponed for additional debate until a later time. This frustrates dog owners in Sylva, who’ve been free to come and go with their animals as long as they abide by the town’s leash laws and clean up behind their animals when necessary.

“It kind of bugs me when people throw up blocks to bringing all God’s critters together,” said Annie Harlow, who is active in ARF, Jackson County’s humane society.

Harlow’s dog, P-Nut, is a rescue animal. Harlow said she hopes to bring P-Nut to Greening Up to help further socialize the terrier-mix dog.

Harlow emphasized that she’s in favor of some animal-oriented regulations, such as spay and neuter laws and animal-protection acts.

“But, we need to look at why we’re regulating and what it is accomplishing,” she said.

Eye-to-eye

Waynesville long has banned dogs, even when on leashes, from downtown street festivals. That town’s ordinance dates to 2002.

“We’ve had situations over time with dogs being eye to eye with babies and strollers, and situations when folks have almost tripped over dogs’ leashes,” said Buffy Phillips, executive director of the Downtown Waynesville Association.

Phillips said the ordinance seemed particularly critical because the sidewalks in Waynesville are narrower than in many other Western North Carolina towns. This placed dogs and people in uncomfortably close proximity, she said.

The decade-old ordinance places dog bans on Waynesville’s parades, four festivals, a block party and street dances. Signs are stuck in sidewalk flower planters on the approach to Main Street announcing the law to festival-goers.

An attempt to provide babysitting services for people’s puppies petered out almost as soon as it began. Haywood Animal Welfare Association offered dog sitting at a festival the first year the ordinance was passed, fearing owners would leave their pets in potentially lethal hot cars while partaking in the street festivities. But, finding volunteers proved difficult, and people just weren’t comfortable leaving their animals with strangers, Phillips said.

Dogs receive their dues and welcomes at Waynesville’s annual Dog Walk, she said, an event sponsored by Sarge’s Animal Rescue Foundation designed to highlight animal adoption efforts.

Dogs being brought to events and festivals in Franklin and posing hazards to others simply hasn’t been an issue to date in that town, said Franklin Planner Mike Grubbermann. For whatever reason, bringing dogs out into Franklin isn’t a particularly popular pastime, he said.

Pat Thomas, who lives in Sylva and is co-owner of City Lights Café on East Jackson Street, said that she’d be extremely disappointed and even shocked if dogs were banned at Sylva-based events and festivals.

The restaurant has a “pet friendly” patio so that people’s pets can be with there while their owners’ dine.

“In this day and age where pets are considered a part of the family, I cannot imagine not being able to bring my pet dog to an outdoor festival,” Thomas said. “Many visitors that come to this area vacation with their pets. I feel the demographic we are speaking of, in the majority, are responsible pet owners, whether they are visiting, or they reside here. I can definitely say that if I knew an area wasn’t pet friendly, I’d be reluctant to vacation there and would also not suggest the area to any friends.”