Talk about a great gig: Dan Winslow’s job is to help a $1.6 billion endowment eventually give away $80 million a year or more for worthy causes in an area totaling about 242,000 people.
Formed by the sale of the Wilmington area’s main hospital in 2021, the New Hanover Community Endowment instantly became among the state’s largest nonprofit charitable organizations. It’s larger than the Winston-Salem Foundation, which has $744 million in assets after operating for nearly 80 years. And it’s slightly larger than the Rocky Mount-based Golden LEAF Foundation, which taps its $1.4 billion portfolio to support dozens of North Carolina counties that formerly relied on the shrinking tobacco industry.“
“Our mission is to create transformational change for all citizens throughout New Hanover County, so that all can thrive,” says Shannon Winslow, an endowment board member who chaired the search committee that recommended hiring Dan Winslow. (The two aren’t related.)
As the endowment’s CEO since October, Winslow is now the quarterback for a community foundation that he says may have more money per capita than any other in the U.S.
The group expressly limits its giving to organizations in New Hanover County, which was the state’s most powerful county in the late 19th and early 20th century because of its port and railroad hub.
Groups across the bridges in Brunswick County and other nearby counties need not apply, based on the logic that only New Hanover taxpayers backed the debt that financed the hospital’s growth. Many question that logic because patients from outside New Hanover make up a majority of the hospital system’s revenue. But no one thinks the rules will change.
WIRED FOR THE JOB
Winslow’s key job is to ensure the group’s philanthropy creates long-term value, which is where things get interesting.
“Transformational change is bigger than funding routine, mom and pop 501(c)3s,” says endowment board member Woody White, who played a key role in its formation. “I never intended for the endowment to be a clearinghouse for local nonprofit grant writers.”
Winslow has his shot because the endowment’s first leader, Willam Buster, left the job in February, two years after his hiring. Reasons are unclear. Buster and board Chair Bill Cameron won’t say what happened. Buster was paid about $330,000 in 2022, according to the group’s last public filing. Winslow’s starting salary is $325,000.
The departure surprised the community because Buster had an impressive resume, with key previous roles at large charitable groups including Dogwood Health Trust in Asheville and the Mary Reynolds Babcock Foundation in Winston-Salem. But something didn’t click between him and the board, which is dominated by representatives of some of influential Wilmington families.
Other endowment officials also left this fall, including Lakesha McDay, who had been interim director after being among the group’s initial hires.
In response, the endowment hired Durham-based search firm Moss+Ross to lead a nationwide search. After looking at 164 candidates, the 13-member board hired Winslow. It was an unusual decision. The Massachusetts native, 66, has never worked in North Carolina or the South, nor has he worked at a large charitable organization.
But Winslow has had an unusually diverse career, working his way up to partner at a large Boston law firm, serving as an appointed district court judge and an elected Bay State lawmaker, helping build a publicly traded software company and running a statewide legal foundation, among other things.
“Dan’s leadership across multiple sectors really distinguished him among a deep, talented pool of candidates,” says Mary Moss, a partner and cofounder of Moss+Ross. “His passion for the work of community building combined with skills and experience to deliver results – that’s what got him the job.”
Director Shannon Winslow, who works for WebMD, says the new CEO is “wired” for the job. “Dan clearly appreciates the mission, and he will make sure that the people hired at the Endowment believe and live the mission,” she says.
Powerful jobs invariably draw skeptics. A vocal critic is Harper Peterson, a former mayor and state senator who wants elected officials to oversee the endowment, not community insiders. “Mr. Winslow’s credentials are impressive, but he has no reason to be the head of this group. He’s a libertarian ideologue who does not know the priorities of this community,” he says.
Sonya Taylor, leader of the county chapter of the National Black Leadership Caucus, says hiring a white male to replace Buster, who is Black, was disappointing. “William Buster’s credentials showed he had done some amazing things,” she says.
She questions leaders’ commitment to diversity, noting that New Hanover County’s first Black school superintendent was fired in July. Shannon Winslow says the endowment board is diverse, with two Black members and one Hispanic. Dan Dan Winslow says he will listen to all voices and focus on results.
BOSTON BACKGROUND
Holding a tension-filled role isn’t new for the CEO. The Wilmington job provides an opportunity “to become a social innovation laboratory to test and try new thinking to solve old problems,” he says. “There’s not a problem that exists in New Hanover County that doesn’t exist somewhere else in the United States.”
Solving challenging problems is a continuing thread throughout his career, he says, and that impressed the search committee, which included board members Cameron, Shannon Winslow, White, Cedric Dickerson and David Sprunt.
In his sole term as a Republican legislator in Massachusetts from 2011-13, Winslow sponsored a bill to make it easier for children with intellectual disabilities to qualify for benefits as adults. It passed with bipartisan support in a legislature dominated by Democratic members.
Earlier in his career, Winslow worked for two years as chief legal counsel to Massachusetts Gov. Mitt Romney, who is now retiring as a U.S. senator from Utah. He’d met Romney while working on voting-rights-related matters when the business executive ran for Senate against Ted Kennedy in 1994. He sums up lessons from his Romney days succinctly: “Show up for meetings on time and hire the best people.”
From 2013 to 2021, Winslow was the top lawyer at Las Vegas-based Rimini Street, a third-party software support company formed in Silicon Valley in 2005. He helped the company go public in 2017 and assembled a team of more than 60 lawyers to monitor contracts. Rimini Street has struggled financially in recent years, and its stock was trading in November for less than $2, down from its IPO price of $10.
For the past three years, Winslow led the New England Legal Foundation, which promotes free enterprise principles including traditional property rights and limited government. He helped the group raise more than $1 million in 2022, a record amount with backing from large corporations and law firms, among others.
A common thread in those stops was a desire to make the world a better place, Winslow says. His Wilmington job, “is the culmination of all of those jobs,” he says. “Each of these diverse jobs has given me an opportunity to make a difference in some small way.”
While new to the Port City, Winslow has visited often. Two brothers are cardiologists in New Hanover and Brunswick County, while another is a financial adviser in Wilmington. One of his brothers tipped him off about the endowment job.
Winslow emphasizes that the compounding of annual returns means that the endowment expects to make billions of dollars of investments over the decades.
Starting in 2028, the endowment is required to place at least 5% of its assets in the community. “It’s amazing if you think about it,” he notes. The portfolio is managed by New York-based BlackRock, the world’s largest asset manager.
The endowment has made about $100 million in grants and pledges for a wide variety of causes. Winslow points to an investment of 30 beds for unhoused residents as an example of an important initial impact. In December, the group announced more than $53 million of grants, highlighted by a three-year, $22 million commitment to boost the number of healthcare workers trained locally.
One of the larger grants is $6.8 million for a nonprofit food cooperative in north Wilmington, which local officials call a “food desert” for area residents. It’s about a mile northeast of the central business district.
As part of the group’s founding, New Hanover leaders set up the endowment as a private organization, so it doesn’t face the disclosure requirements of a public entity. Their hope was to make the group less political, though former Mayor Peterson calls it a “mindblogging, sophisticated political heist. This is a continuation of rich, white corporate insiders running the show and expecting everyone else to move with them.”
Winslow had no role in designing the endowment, but calls it an inspired, perhaps unique approach with board members holding very diverse views. “How often have you ever seen politicians willing to give up money and power,” he says. Novant Health appoints six directors, the county commission names five and two are picked by the board itself.
“That insulation gives us a bit more freedom to be bold, to be innovative,” he says. “We can go for the moonshot.”
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In many parts of the state and nation, county governments gained ownership of hospitals in the early and mid-20th century because of financial and regulatory pressures. A county referendum in 1961 approved creation of New Hanover Regional Memorial Hospital, which led to the merger of James Walker Memorial Hospital and Community Hospital. The latter mainly served Black residents after its formation in 1921.
Walker Hospital was named after a Scottish-born developer who moved to Wilmington in 1857. It opened in 1902, four years after white supremacists staged a coup that killed as many as 60 Black residents and drove hundreds of people away from New Hanover County. For much of its history, Black physicians were prohibited from practicing at Walker, which had a separate annex for patients who were not white.
The coup is considered the only successful overthrow of a domestic government in American history. It has attracted increasing attention to Wilmington because of journalist David Zucchino’s 2020 Pulitzer Prize-winning book, “Wilmington’s Lie: The Murderous Coup of 1898 and the Rise of White Supremacy.”
In November, PBS’s American Experience program debuted a two-hour documentary about the coup. An initial screening was held at Thalian Hall, the downtown Wilmington venue where white supremacist Alfred Waddell successfully pressed white residents to remove Black and sympathetic white officials about 126 years earlier.
In 1898, Blacks made up a majority of Wilmington’s population and held three of 10 Town Council seats. After the coup, the city didn’t elect a Black city leader until 1972. In November’s election, Jonathan Barfield, the only current Black county commissioner, was ousted after 16 years by 244 votes.
WELL PLAYED
New Hanover County built a new hospital in 1967, which grew along with Wilmington over the next 50 years. It employed more than 7,400 people and reported annual revenue topping $1 billion by 2019.
It is a key medical center for seven counties, benefiting from North Carolina’s Certificate of Need laws that protect hospitals from competition. While CON faces constant criticism from some lawmakers who favor free-market healthcare, the hospital industry argues that the regulations help the state avoid wasteful spending on facilities and equipment, holding down medical costs.
Geography also aids the Wilmington hospital, because the Atlantic Ocean borders the county. No competitors are nipping away from the east.
New Hanover, like many municipalities, periodically studies the financial status of its key assets, including the hospital. They received a report by Charlotte-based bond consultants First Tryon Advisors about the potential of creating a different corporate structure.
Still, the sale wasn’t a top-of-mind issue in 2018, when county commission Chair Woody White asked local leaders their thoughts about the idea. Many county boards across North Carolina either sold their hospitals or created not-for-profit authorities over the past 25 years. The theory is that hospitals operate better with stand-alone boards focused on healthcare, with less scrutiny from elected county officials whose work covers public schools, social services and other matters. Industry executives typically prefer more independence, which has enabled higher compensation.
White, who grew up in Bladen County, has practiced law in New Hanover County for more than 20 years. He was a New Hanover County commissioner from 2012-20, including two stints as board chair. He led the effort to lower the county’s property taxes for two straight years, a first in county history. He was appointed to the UNC System Board of Governors in 2023 after serving on UNC Wilmington’s board from 2018-21.
White says most people were initially opposed to a sale because the hospital was operating profitably and scored well on industry quality surveys. He was persistent, however, noting that it was increasingly hard to compete with larger rivals and that the county was facing a major debt burden to finance a list of $2 billion in needed capital projects.
In July 2019, the county board agreed to study the matter, and three months later voted 3-2 to explore a change in ownership. A 21-member Partnership Advisory Group, including influential leaders, was formed to study the hospital’s future. “I thought it was a 50-50 deal, that they would either recommend selling it or say, `Heck no, we can’t do that,’” White says.
After several months, the advisory group and county board set up a sales process that led to bids from six big hospital operators, including Atrium Health, Duke Health and HCA International. The public auction process helped drive the price higher, culminating in the February 2021 sale of New Hanover Regional to Novant Health.
The state’s second-largest hospital operator agreed to pay $1.25 billion to the new endowment; $300 million for a county revenue stabilization fund; $50 million for mental health services; and about $2 billion of hospital capital projects over 10 years.
Three and a half years later, Novant Health’s operation has sparked some community criticism about staffing levels and declining quality. The Center for Medicare and Medicaid Services now ranks New Hanover Regional Medical Center with a 2-star rating, putting it in the bottom 30% of U.S. hospitals. It had a three-star rating in 2019, the last year it was ranked before Novant Health’s purchase. By comparison, the WakeMed, Duke Health and UNC Health hospitals in the Triangle each have 4-star or 5-star rankings, the highest available.
But the concerns at the coast haven’t risen to anywhere near the controversy in Asheville following HCA Healthcare’s 2019 purchase of Mission Hospital. While some N.C. hospital officials contend Novant Health overpaid for New Hanover Regional, the healthcare system has continued its acquisitive ways. In February, it paid $2.4 billion for three South Carolina hospitals with combined revenue of $550 million, about half the amount of the New Hanover enterprise.
