(Note: This is the third article in a series regarding the decision by UNC Health Caldwell to discontinue maternity services. Read the first two articles here and here).

LENOIR, N.C. – As I’ve reported the last two days, in November 2021, UNC Health Caldwell  discontinued maternity services. While that decision was one that I believe required a thorough explanation because of its public health implications, an equally concerning issue about the hospital arose through my attempt to learn the full story behind the decision – the refusal by its leadership to be transparent.

As a result, I am recommending that patients and donors avoid UNC Health Caldwell until its leadership agrees to be transparent about the discontinuation of Maternity Service and other decisions to be made moving forward, in particular those that impact patients directly and complicate the work of Caldwell County Public Health and EMS employees.

This is not an unreasonable recommendation. Caldwell County Commissioner Donnie Potter, in an interview published yesterday, said, “I would ask how the people who donated to build our L&D department feel about this.”

That is just one of many valid questions remaining unanswered by hospital leadership. In fact, there are several others than can be asked (many of which were published in the first article). I know this because for seven years, from 1999 to 2006, I served as the Managing Director of Education and Communication at Wall Watchers, an independent donor advocacy organization based in Matthews, N.C.

There, we analyzed and investigated more than 500 Christian nonprofits across the United States. Many of the questions we asked them are certainly relevant to any institution providing community services, receiving government funding and soliciting funds from the public for projects, such as UNC Health Caldwell is doing.

We looked at chartering documents, by-laws, mission statements, board makeup, executive compensation, adherence to mission purpose, required governmental reporting and other criteria, the most important of which was transparency.

“But North Carolina State Treasurer Dale Folwell isn’t backing down when it comes to challenging the executives in charge of the state’s largest hospital systems. He has called the hospitals ‘cartels…disguising themselves as nonprofits’ while their CEOs rake in millions of dollars a year.”

WECT Wilmington, Sept. 22, 2022

In fact, in time, an organization’s transparency became the most important measure, for without it, all of the other criteria cannot be analyzed. In response, we elevated transparency to the level that it could lead to the highest level of positive assessment, which we called “Shining Lights,” or to the most dire of warnings, which we called “Donor Alerts.”

Applying the same criteria to UNC Health Caldwell, it is clear that its lack of transparency requires a Donor Alert. For a hospital, it is best described as Patient Alert, since it is for the sick and injured the hospital exists.

However, in Lenoir, we do not know if that is the case. Indeed, in a bit of irony, three days after I first sent questions to UNC Health Caldwell CEO Laura Easton – Sept. 19, 2022 – a state official was slamming the state’s largest hospital systems. According to WECT Wilmington, “But North Carolina State Treasurer Dale Folwell isn’t backing down when it comes to challenging the executives in charge of the state’s largest hospital systems. He has called the hospitals ‘cartels…disguising themselves as nonprofits’ while their CEOs rake in millions of dollars a year.”

Folwell’s comments are relevant in light of UNC Health Caldwell’s Capstone Campaign. It’s a plea for donations for Phase 2 of a $33 million dollar expansion. The hospital is asking for $3 million in assistance from the public.

Until the hospital leadership agrees to be completely transparent on the decision regarding Maternity Services – and other matters, such as executive compensation – donors should beware.

The same is true for patients. According to the hospital’s website, a patient’s ability to pay is irrelevant. There is a quote from an anonymous patient. The patient is quoted as saying, “I was brought to tears when I thought I would be sent home because I did not have insurance. The doctor told me ‘We do not treat insurances but we do treat patients’ This is a great hospital.”

This claim about insurance is clearly disputable. Again, an interview could easily clear it up, as the hospital could simply offer evidence to counter a claim by two employees – one former, one current – that they were told maternity services were being ended because hospital supervisors had told them, “There were too many Medicaid patients.”

Since the hospital administration has refused to be interviewed, those statements remain unchallenged. It is believable because it is a national trend to end maternity services because of the number of babies on Medicaid. Hence, if it is a factor, the hospital leadership should acknowledge it and work with community leaders to find a way to mitigate that challenge rather than compromise the health and safety of a large number of vulnerable county residents.

A serious claim that remains unanswered is based on the accounts of two people. Last summer, a visitor who was with a patient in the Emergency Room learned of a pregnant mom arriving in the ER only to be told the hospital didn’t deliver babies. They had to anyway. A nurse afterwards said, “It’s a good thing we have an old L&D nurse working today or that baby would have died.” In fact, there is at least one report of Caldwell County EMS refusing to transport an expectant mother from the hospital, asserting that there was not enough time to transport the patient safely.

These reports require answers.

While I await the opportunity to provide those, I share, for your consideration, the musings of Alan Eddington, a retired 79-year-old priest that served some of the most vulnerable populations in Appalachia in the Diocese of Wheeling-Charleston (West Virginia). Responding to the hospital leadership’s lack of transparency, Eddington wrote via email, “As with most everything that comes my way these days, I began thinking back to the days when ‘health care’ was a godly profession. I remember, for example, during my brief time at Sacred Heart in Huntington of hearing so many stories of how the Pallottine nuns at St. Mary’s Hospital DEMANDED that patient care be the first and only priority at their hospital. I was there in 1986-87, and just about everyone, Catholics and non-Catholics alike, had stories of how they or their families had been helped by the nuns. Perhaps the most poignant story to emerge for me was how the nuns during the Depression in the 30’s would sacrifice their own food, in order for the patients to have something to eat. When the food for the nuns ran out, they would go out onto the lawn, pick grass, and make ‘grass soup’ for their meal! Wouldn’t it be revolutionary if just one hospital CEO was so dedicated to patient care that they would resort to eating ‘grass soup,’ if that’s what it would take to provide patient care?!!”

While Eddington is alluding to a different time, it is fair to ask, even today, of the leaders at UNC Health Caldwell, “Can you provide tangible proof that patient care is the hospital’s first – and ultimately – only priority?”

Until such proof is offered, it is best to beware! The hospital has already made it inconvenient – to say the least – for moms-to-be and their babies. If you’re a potential patient or donor, follow their lead. Take yourself and your money elsewhere.

© Michael M. Barrick, 2023. Newborn photo by Christian Bowen on Unsplash