The future of employee housing on the Highlands Cashiers Hospital campus may hang in the balance of some Highlands Commissioners’ lack of trust in HCA.
During its Thursday, Oct. 1 Health Committee meeting, commissioner Amy Patterson laid it out in the simplest of terms for attending HCH CEO Tom Neal and Board Chairman Jimmy Maurin.
“I don’t trust HCA,” she said.
The lack of trust stems from a potential future decision HCA might make regarding a tract of hospital land off Buck Creek Road earmarked for hospital employee housing, if the Highlands Board of Commissioners approves a vote to run water and sewer lines to the property located outside of the Highlands town limits.
Only once before has the town agreed to run water and sewer to the hospital, and when the previous parent company of HCH experienced difficult financial times during the early 2000s, they decided to sell the property that is now the Chestnut Hill Assisted Living Center.
Commissioners tabled the vote during the board’s September meeting.
Patterson, and fellow commissioner John “Buz” Dotson listened to Neal and Maurin present the hospital’s case reassuring the board of commissioners the HCA will be here for the long run.
“I’m not sure my mind’s made up, but I’m here to be convinced one way or the other,” Dotson said.
Patterson’s and the commissioners’ concern stems from a 10-year working contract HCA signed when it purchased the Highlands Cashiers Hospital from Mission Health in 2019, and the long-expressed concerns of Town Hall that the healthcare giant might abandon the hospital at the conclusion of the contract, or sell off its employee housing facility for profit.
“We only have you under contract for eight and a half more years,” Patterson said during the 90 minute in-person meeting. “I feel like you would be building an asset – HCA’s asset.”
An asset they could one day sell at their whim.
Neal said Patterson’s concern was a fair statement and offered to draft measures to ensure it didn’t happen.
“What we propose, would be the assurance it will be used for healthcare, affordable housing,” he said of the hospital’s plan. “We would enter into a long-term lease, a 50-year lease with future leases being in five-year increments.”
Secondly, Neal said the town and the hospital could agree, the town could put restrictions on how the water and sewer would be used into any amendment the hospital and town would enter into that it could only be used for healthcare workforce.
“Therefore if it were ever sold, that it would be part of that transaction, that would limit that sale… a covenant restriction entered into by the hospital and the town on what it could be used for,” Neal said. “That was kind of the solution we were looking at as how we can assure that housing is used for healthcare workforce.”
Patterson said, if the property were ever sold, the town would never decide to cut off anyone’s water.
“We won’t cut off their water,” she said.
The “Fool me twice shame on me” sense of distrust was born several years ago when the current Chestnut Hill Assisted Living Center, also located off Buck Creek Road, was a part of Highlands Cashiers Hospital. The Town of Highlands supplied the hospital with water and sewer services after it moved to its current location off US 64 from the Peggy Crosby Center on North Fifth Street. Chestnut Hill was eventually sold for a profit.
“Been there, done that,” Patterson said.
That sentiment carried over into the Oct. 1 Health Committee meeting.
Is workforce housing necessary?
Dotson posed the question, wondering why this was necessary now since back when HCH was fully staffed, workforce housing wasn’t considered then?
“When HCH running at full staff, numerous doctors, numerous employees, why was there ever a request for employee housing at that point?” Dotson said.
According to Maurin, part of the master plan included the development of workforce housing.
“Why it was never built, I don’t know,” he said.
Maurin said the Highlands area has the least affordable housing of anywhere in the entire Mission Health/HCA system.
“Because of the nature of this plateau, housing is not affordable up here,” he said. “Asheville has more affordable housing than Highlands. Our little hospital is at a competitive disadvantage to other Mission hospitals as well as to other healthcare providers that are not a part of the Mission system. It’s all about driving.”
Maurin said the lack of water and sewer services to the proposed site would threaten the feasibility of the development.
“It’s not just a healthcare problem it’s a staffing problem,” Maurin said. “If we don’t provide the housing we are always going to have issues about sustaining a workforce.”
Maurin cited several private country clubs in the area that have built workforce housing dormitories for its employees. Mountaintop Country Club, where Maurin is a member, has 160 employees with housing capacity for 90 of them.
“Mountaintop had to build 80 living units to maintain its 80 employees and we’re adding 10 more units this year,” he said. “It’s not just a healthcare problem, it’s a staffing problem.”
Patterson said, she’s afraid there won’t be enough demand to satisfy the supply.
“I’m afraid there’s not going to be enough employees to support employee housing,” she said.
Neal conceded recruiting healthcare professionals to move to the plateau has been challenging, but he is not deterred in his efforts, with or without the housing plan in place.
We’re looking at growing,” he said. “We’re looking at wanting to bring services back. If this doesn’t happen, we’re still going to try and attract staff. We’re still going to try and recruit staff.”
Trust, but verify
Mayor Patrick Taylor said he is waiting to be briefed by Health Committee members before the next commissioners meeting. The mayor agreed, trust may be an issue between the hospital and the community.
“Given the history of Mission with the hospital and so forth, there may some folks in the community that are skeptical with them,” Taylor said on Monday. “Commissioners are willing to work with the hospital, but want to verify everything. Like President Reagan said, ‘trust, but verify.’ Our commissioners are cautious.”
Commissioners could potentially vote on the HCH water and sewer proposal during the board’s Oct. 15 meeting.