Thursday, April 18, 2024

North Carolina’s best hospitals 2024

By Kevin Ellis and David Mildenberg

Duke University Hospital grabbed the top spot in Business North Carolina’s annual ranking of the state’s best hospitals, and it had company with two other Duke University Health System hospitals. Duke Regional Hospital in Durham and Duke Raleigh Hospital finished fourth and tied for eighth, respectively. The three Triangle-area hospitals had finished tied for third, ninth and 19th, respectively in the 2022 ranking.

While Duke Raleigh moved up from 19th in the rankings a year ago, it wasn’t the only hospital in the top 10 to make a significant jump. Asheville’s Mission Hospital, which is drawing lots of criticism, is tied for sixth, up from 12th a year ago. Charlotte’s Novant Health Presbyterian Medical Center went from 16th to tied for sixth.

The list uses calculations of more than 25 health care metrics, with a significant weighting based on data from the U.S. Centers for Medicare & Medicaid Services. The report includes patient-satisfaction surveys, infections, readmissions and mortality rates for common procedures. Other data includes findings from safety report cards by the Washington, D.C.-based nonprofit The Leapfrog Group, distinction awards from insurer Blue Cross and Blue Shield of North Carolina and national performance ratings from U.S. News & World Report.

Seven hospitals appear in the top 25 after being unranked the previous year. Newcomers to this year’s top 25 are Raleigh’s WakeMed Health & Hospitals; Novant Health Mint Hill Medical Center; Hendersonville’s AdventHealth; Northern Regional Hospital in Mount Airy; Atrium Health Wake Forest Baptist Health in Winston-Salem; Hickory’s Catawba Valley Medical Center; and Novant Health Matthews Medical Center.

The methodology to create this list tends to favor large institutions because they gain
more points based on national awards and performance rankings. Smaller hospitals perform fewer procedures, which eliminates those institutions from select categories
used for calculations.

Dr. Gregory Pauly took over as president of the 11,000-employee Duke University Hospital on
Jan. 31, also overseeing the Durham and Raleigh campuses. He was previously chief operating officer at Massachusetts General Hospital in Boston. Duke Health, which oversees the entire organization and includes 23,000 employees, named Dr. Craig Albanese as president and CEO. Dr. Mary Klotman became the first executive vice president for health affairs in July, and will remain dean of the School of Medicine. Dr. Thomas Owens, the former president of Duke University Hospital, was promoted to executive vice president and chief operating officer for Duke Health. The Albanese and Klotman appointments reflect a restructuring of the leadership model for Duke Health’s academic and clinical missions, which were previously consolidated under Dr. Eugene Washington, who stepped down in June.

The National Institutes of Health awarded Duke University School of Medicine more than $527 million in federal funding in 2022, ranking ninth nationally among academic medical centers. Duke has ranked in the top 10 in NIH research funding for seven consecutive years. Duke Health reported a $295 million operating loss in the 2023 fiscal year, according to Fitch Credit Ratings. Enactment of the Healthcare Access and Stabilization Program and Medicaid expansion should spark improved financial results, according to Fitch.

After more than 110 years in Greensboro, Cone Health opened its first urgent care center in Winston-Salem in January, and second in Forsyth County. Cone faces larger Triad rivals Atrium Health Wake Forest Baptist and Novant Health in a more competitive environment. Atrium overcame Cone’s opposition to win regulatory approval last year for a $246 million, 36-bed hospital in north Greensboro, two miles north of a Cone Health medical center. Cone Health is appealing the decision, which CEO Mary Jo Cable says will boost medical costs and serve as a “way station” for patients needing more intense care to go to Atrium’s big hospital in Winston-Salem.

Meanwhile, Moses Cone Hospital broke ground last fall on a five-story, $160 million heart and vascular tower, with an opening expected in fall 2025. A smaller heart and vascular center at Alamance Regional Medical Center in Burlington will open this summer. The not-for-profit authority expects to invest $500 million on capital projects over the next decade. It also kicked off an innovative program last year aimed at boosting the life expectancy of residents of several specific ZIP codes by at least five years. The “Catch 5 in 5” program followed research showing areas where people live 15 years less on average than those in an adjacent ZIP code.

In May, UNC Hospitals will open the $425 million N.C. Surgical Hospital. The seven-story, 377,000 square-foot facility will feature 26 operating room suites that will be twice the size of current surgical rooms. It follows last year’s opening of the $116 million Roper Hall, the new home of UNC’s medical school, as it expands class sizes from 190 to 230. A mix of donations and $68 million in state bond money paid for the building. The school received about $359 million in National Institutes of Health funding in fiscal year 2022, ranking sixth among peer public universities. 

Also in 2023, UNC Health and the N.C. Department of Health and Human Services opened a 54-bed Youth Behavioral Health hospital in
Butner. Officials expect the 200 employees, including psychiatrists, pediatricians, art and occupational therapists, to treat more than
800 children per year.

UNC announced plans for a $2 billion children’s hospital, expected to open around 2030. It will include a 100-bed psychiatric hospital. The state has awarded $320 million to kick off the project. Overall, UNC Health’s network includes 14 hospitals and employs about 40,000 people.

In April 2023, Duke University Health System removed the chief financial officer,  chief nursing officer and chief operating officer after a “thorough assessment” of performance. The shakeup came about two months after Devdutta Sangvai became president.

Duke Regional has more than 3,500 employees, including 500-plus physicians, and mainly serves Durham, Orange, Person, Granville and Alamance counties. The hospital, originally called Durham County General, opened in 1976 and has been part of Duke Health since 1998. In fiscal year 2023, Duke Regional admitted 15,866 patients and had 236,000 outpatient visits.

Duke Regional was named the most socially responsible U.S. hospital last year by Boston-based Lown Institute. The think-tank’s criteria included health equity, value and patient outcomes, racial inclusivity, community investment and pay equity. Leapfrog gave an A rating to the hospitals for its safety record.

Kirsten Riggs is interim president after Ernie Bovio left in January to become president of Novant Health New Hanover Regional Medical Center and Coastal Region in Wilmington. Riggs joined Rex in 1998 and has held prior leadership roles in cardiology, surgical services and ambulatory administration. She has a bachelor’s degree in nursing from East Carolina University and a master’s degree in health administration from Pfeiffer University.

In late 2023, Rex opened the North Carolina Neuroscience and Spine Center, which offers
specialized care for brain and back issues. The center repurposed the space that previously held the UNC Rex Cancer Center, which moved into a freestanding, three-story building that opened in March 2022. The $65 million, 145,000-square-feet Cancer Center tripled Rex’s space for oncology care.

The $170 million UNC Health Rex Holly Springs hospital marked its second anniversary, reporting higher-than-expected volumes of emergency visits, surgeries and more. The institution has 50 beds. Rex is looking at ways to expand the services available in that fast-growing region.

UNC Rex Healthcare is the sole hospital in North Carolina, and among only 18 nationwide, to receive 22 consecutive “A” grades every year since 2012, when the Washington, D.C.-based Leapfrong Group started rating hospitals twice per year for patient quality and safety.

In July, Mission opened the $65 million, 120-bed Sweeten Creek Mental Health and Wellness Center, followed a month later by the new Burn, Wound and Hyperbaric Center. It is the first burn center in western North Carolina. Mission Health also partnered with another HCA Healthcare division to open Head and Neck Specialists of Western North Carolina, which specializes in complex head and neck cancers.

Mission Hospital received its fifth consecutive A rating from Leapfrog for quality and safety. Healthgrades named Mission Health one of the nation’s 50 Best Hospitals, the only North Carolina facility on the list.

Despite its positive recognitions, HCA Healthcare continues to face intense criticism for how it operates Mission Health. N.C. Attorney General Josh Stein filed a lawsuit in December against HCA, asking the court to order the for-profit company to restore emergency and trauma services and oncology services to the level Mission Hospital provided before HCA’s $1.5 billion acquisition in 2019.

In a separate action, investigators with the N.C. Department of Health and Human Services listed Mission as being in “immediate jeopardy” of losing its Medicare and Medicaid funding over delayed responses and other shortcomings in its emergency department. On Feb. 1, the federal Centers for Medicare and Medicaid Services issued a similar “immediate jeopardy” report.

Mission said it is addressing the shortcomings. “This is not the standard of care we expect, nor that our patients deserve, and we will work diligently to improve,” according to a statement. HCA is the largest U.S. healthcare system, with more than 180 hospitals.

Novant Health’s year was marked by lots of dealmaking and executive turnover. In early February, Novant completed its $2.4 billion acquisition for three coastal South Carolina hospitals owned by Tenet Healthcare. But its $320 million bid for two Iredell County hospitals in March 2023 prompted a Federal Trade Commission lawsuit in January, seeking to block the deal on antitrust grounds. In Charlotte, Novant parted ways with executive vice presidents Jesse Cureton and Angela Yochem, while CFO Fred Hargett and former Chief Operating Officer Jeff Lindsay left for other hospital systems. Meanwhile, the authority’s two flagship hospitals in North Carolina scored well in various industry ratings.

In August, the hospital submitted an application to the N.C. Department of Health and Human Services to add as many as 41 beds at a cost of $14 million. UNC Rex and WakeMed North hospitals also are seeking expansions as part of an annual bid process. State regulators agree Wake County needs 44 more hospital beds.

The Raleigh hospital employs more than 2,000 people, admitted 10,204 patients and had 397,299 outpatient visits in fiscal year 2023. It has served Wake County for more than 35 years and been a part of Duke Health since 1998. Leapfrog awarded its top A grade to the hospital for its safety record.

In January, the hospital’s maintenance employees voted 14–11 in favor of unionization, which will enable the International Union of Operating Engineers Local 465 to seek a collective bargaining contract.

The Sandhills hospital, which serves 15 counties in the mid-Carolinas, opened its $68 million cancer center last March, upgrading its services for patients at the 120,000-square-foot, four-story outpatient center. Research and clinical trials are also part of the center. A $5 million expansion of Women & Children’s Services last year increased the number of triage rooms from six to 10 and labor and delivery rooms from six to nine. Long-term plans call for a new tower to serve women and children at the Moore Regional campus. Moore Regional Hospital was recognized as one of the nation’s top 100 hospitals, according to analysis provided by PINC AI  and reported by Fortune. It was the third consecutive year that the hospital had received the designation.

The 1.8 million-square-foot center opened in 1964 and serves a footprint of more than
20 counties, with 921 licensed beds making it the second-biggest hospital in the Triad. It is adding a $444 million, five-story tower that is the biggest investment at the campus since 2007. It will house 59 critical-care rooms and 36 medical-surgical rooms, with completion expected in 2025. Vannoy Construction is the contractor. The latest project follows a $180 million investment to enhance services for women and children, renovated the center’s cafeteria, added a new energy plant and modernized patient rooms.

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