The healing power of forgiveness is at the top of the list of things in which I believe strongly. It’s the best drug on earth, doing more good for more people than anything a doctor ever learned in medical school.

Anyone following the saga of Haywood Regional Medical Center has to feel like their head is spinning. So much has happened so fast that keeping it all straight is likely proving difficult, even for those with the most nimble minds.

By Julia Merchant • Staff Writer

Donning purple ribbons of support, members of the community came together Monday in a show of encouragement for the embattled Haywood Regional Medical Center, which is facing a financial crisis after losing its Medicare and Medicaid funding.

The future of Haywood Regional Medical Center could be in jeopardy following the termination of the hospital’s Medicare and Medicaid status due to violations uncovered by health care inspectors.

Doctors and officials at Haywood Regional Medical Center are accusing state inspectors of being heavy-handed, draconian, unprecedented, dangerous and unfair by pulling the hospital’s Medicare and Medicaid status.

Some are saying Regional Medical Center faces an uncertain future, but we believe it is vitally important for community leaders, the medical community and anyone else who cares to come together and do whatever it takes to help this hospital survive as an independent health care center.

June 9, 2006

Haywood Regional Medical Center receives a visit from the Department of Health and Human Services Division of Medicaid and Medicare Services, the state agency responsible for overseeing hospital compliance with standard of care requirements. Inspectors cite the hospital for its lack of adequate and qualified nursing staff after determining there was a failure to provide nursing treatment pursuant to doctors’ orders for six out of seven patients reviewed. Two of six nurses held out-of-date RN licenses, according to inspectors. In two cases, nurses restrained a patient without physician’s orders — one an unconscious victim of alcohol poisoning.

WestCare’s Harris Regional Hospital in Sylva will be filling a major void in the region’s health care in the wake of to the Medicare and Medicaid crisis at Haywood Regional Medical Center.

The resignation on Feb. 25 of Haywood Regional Medical Center CEO David Rice was preceded by a tense, hour-long public meeting where hospital trustees expressed surprise and irritation toward Rice’s lack of candor about ongoing, serious problems uncovered by inspectors.

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.”