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Duke, LifePoint leaders weigh in on hospital partnership
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Duke, LifePoint leaders weigh in on hospital partnership

Duke University Health System calls Durham home. LifePoint Hospitals is headquartered in Brentwood, Tenn.

If Duke LifePoint Healthcare’s proposed joint venture with Wilson Medical Center is finalized, the institution won’t try to govern the local hospital long distance, top officials with both companies said.

"One of the things we’ve been impressed with at Wilson Medical Center is the team,” said LifePoint Chairman and Chief Executive Officer William F. Carpenter III. "We’ll have a local CEO, CFO, department directors, all the types of physicians needed to run a medical center the caliber of Wilson Medical Center after the closing. We feel very strongly that governance of a hospital in a community like Wilson must be local.”

Carpenter and Dr. William J. Fulkerson Jr., executive vice president of Duke University Health System, recently spoke to The Wilson Times about the proposed joint venture with Wilson Medical Center, their two companies and the future.

Carpenter said they want people empowered to be leaders in Wilson just like they are today.

"You should expect to have all the administrative capacity you need to continue to run a hospital,” he said. "We won’t try to operate this hospital from Nashville, Tenn. or Durham, N.C. It must be operated by folks who are there. We provide resources to people who are there at the hospital. But nurses caring for patients and physicians caring for patients is the most personal and local relationship you can have. I hope as we add services there will be a lot more of that to come.”

Duke LifePoint is a joint venture of Duke Medical and LifePoint Hospitals formed to build a network of hospitals and health care providers.

The two said they are both excited and serious about this partnership formed in January 2011 and see it as combining Duke’s strength in medicine and LifePoint’s strength in operations.

"We worked with them a couple of years and it became clear to us at Duke that LifePoint leadership was committed to quality and safety in their hospitals,” Fulkerson said. "There was a sense we shared the same commitment to our patients and quality that made us start talking about combining LifePoint’s strengths, their operations, ability to raise capital along with commitment to quality, and our strengths in safety and quality programs and clinical program development.”

Fulkerson said the synergies were unique, especially as smaller hospitals in smaller communities began to anticipate struggles in an era of health-care reform and declining reimbursements.

"Duke Health System’s strength is not operating hospitals in small communities, LifePoint’s is,” Fulkerson said. "We felt that combination of strengths was something that would be attractive to smaller communities.”

Carpenter said the organizations worked together many years before the official joint venture formed in 2011.

"The relationship is really in its seventh year now,” Carpenter said. "Through that work together we have worked out the growing pains. Things you have to think about, we’ve already thought about. In the past couple of years we have been able to take it from beginnings to owning the four hospitals. There is a lot of momentum and potential. We do believe that working together we have the ability to focus on and strengthen community care in hospitals around the region and keep care local, which we believe means better care.”

LifePoint alone plans to be in 60 different communities in 20 states by the end of the year. The Duke LifePoint joint venture is in four hospitals.

"It is growing,” Carpenter said. "We see this as an important, innovative approach to care in the future.”

LifePoint is managing partner of the venture, according to Carpenter.

"Duke is a significant partner at the table. When Dr. Fulkerson and I sit down at the table to make any important decision for our partnership, it is one of complete trust and shared vision,” Carpenter said. "We have in Duke such a valuable partner ... our relationship is truly a partnership in every sense of the word.”

Fulkerson said they are very serious about this partnership.



"As I told the board at Wilson Medical, the most important thing to us is our reputation and our name,” Fulkerson said. "We are proud to put our name beside LifePoint in this venture. We are very confident we share common values in commitment in the hospitals we own together. Our commitment is all in this because we are not going to risk our name being in something that we are not totally committed to making a success. You will find in the other hospitals there is a lot of Duke inside. We are working on programs that may have been needed in the community but may not have been possible without this kind of partnership. We can strengthen the local community. We can strengthen the services provided to the local community. Duke and LifePoint can recruit physicians to that community.”

The two pointed to other ventures they termed successes.

Fulkerson said Duke LifePoint has never changed the name of any hospital in which they’ve affiliated with in the past.

"We are seeking to partner with a strong community partner with an established identity and wouldn’t come in with any intention of changing anyone’s name unless there was some reason the hospital thought a name change would be beneficial,” Fulkerson said. "That’s not the culture we bring to this.”

In looking at Wilson Medical Center, Duke LifePoint was drawn to the strength of the hospital and strength of community supporting the hospital, the two said. They said they were also impressed with the board, leadership and medical staff.

"Duke LifePoint wants to establish a network of hospitals, physicians and other health care providers that is focused on quality that is financially strong and that is well prepared to grow and succeed as the health care landscape continues to change and evolve,” Carpenter said. "It is changing and evolving at a very rapid pace today. We believe Wilson Medical Center is an ideal fit for what Duke LifePoint can offer. It is also located in a community that is committed to its hospital. This is critically important to us. We see an opportunity to expand and enhance services and improve health care throughout the entire region.”



Wilson Medical Center has stood as a largely independent hospital since its inception in 1964.

But national health care reform is spurring a trend toward consolidation, a marketplace where bigger isn’t simply considered better, but essential to survive, some industry experts believe.

A trend of hospital mergers and acquisitions has picked up momentum in health care markets across the country.

The implementation of the Affordable Care Act approved by Congress and signed by President Barack Obama on March 23, 2010, stands as the major driver here, Wilson Medical Center CEO Rick Hudson has said, as well as some of the fallout from budget deficit talks, particularly expected cutbacks in medical reimbursements.

Larger affiliations also result in cost savings in purchasing products for the hospital, which reduces overhead. It’s known as economies of scale.

Wilson Medical Center has already championed strategic partnerships with systems like WakeMed for cardiac procedures such as stents. This alone has trimmed some costs. But it doesn’t translate into assets.

Wilson Medical Center has current facility needs.

The hospital has filed an application to renovate the women’s and children’s unit. The proposed renovations include increasing the size of rooms and creating a better environment for women and children being cared for at the hospital. The project is expected to cost $12 million.

The hospital has already spent $6.2 million to upgrade its energy plant.

Wilson Medical Center officials said the women’s and children’s unit likely will be put on ice temporarily with a new partner coming into the picture.

Carpenter said it’s premature to talk about specifics, but they see potential and opportunities to invest capital and strengthen Wilson and ensure it has the resources it needs, from medical staff to technology to physical plant.

"We’ll do a process of strategic planning alongside community leaders, board members, medical staff and employees at the appropriate time,” Carpenter said. "I don’t think we should get ahead of the process.”

They said they are interested in looking at things to build up in Wilson’s health care.



Fulkerson said it would be up to the Wilson board to decide whether they wanted to pursue partnerships with Duke Medical Center.

"There is no requirements to have affiliations with Duke or refer patients to Duke,” Fulkerson said. "We’re interested in having programs in Wilson that strengthen care delivered in Wilson. We think we have some expertise to help with that. If the board agrees, we stand read to help .... We’ll work with the board and we have a common interest with the board to make the medical center the strongest it can be.”

Fulkerson and Carpenter said they are excited about this proposed joint venture with Wilson.

The specific deal on the table calls for an 80/20 joint venture with Duke LifePoint Healthcare with Duke LifePoint securing majority ownership interest, local hospital officials said. There would be a governance board composition of 50/50.

Even though a memorandum of understanding has been reached between Wilson and Duke, a lot of work remains, including a public process, 60 to 90 days of due diligence and a review by the N.C Attorney General’s Office.

Wilson County government ultimately has to convey its interest in the hospital and officials hope to complete the planned partnership effort by mid-November.

A public hearing will be held Sept. 9 during the regular commissioners meeting at the Miller Road building.

Wilson Medical Center officials announced their intention late last year to seek a partner for the future.

The county is required by statute to name known potential buyers or lessees. Known potential buyers or lessees, according to county information, included local and regional nonprofit and public health systems and for-profit national hospital chains such as Carolinas Healthcare System, Community Healthcare System, Duke/LifePoint, HCA, HMA, Iasis Healthcare, LHP Hospital Group, Novant Health, Pinnacle Health, RegionalCare, Sentara Healthcare, Tenet Healthcare, UNC Healthcare System, Vidant Health System, Wake Forest Baptist and WakeMed.

"We are excited about the opportunities that exist for us to collaborate with Wilson Medical Center and make your community and the entire region healthier,” Fulkerson said. "That’s an exciting thing to get to do together. We hope this process goes through smoothly and we have the chance to do that in the not too distant future.”

Duke LifePoint owns two other hospitals in North Carolina: Maria Parham Medical Center in Henderson and Person Memorial Hospital in Roxboro. It also owns Twin County Regional Healthcare in Galax, Va.; Marquette General Hospital in Marquette, Mich.; and DLP Cardiac Partners, which offers hospital-based catheterization labs and mobile catheterization services throughout North Carolina. | 265-7822
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Danny Long said...

There will be a rude awakening when patients learn just how their lives viewed by Duke as "frivolous". Patients are nothing more than an ATM machine, once the cash runs out, they simply bait another patient into their perverted profit trap.

Monday, September 09, 2013 at 9:47 AM
Yet Another Medical Scam said...

I stand by what I said.

Friday, August 30, 2013 at 7:42 PM
@ Yet Another Medical Scam said...

Really? Do you think $240,000 surgeries just walk in the door every day? While I agree that hospitals and insurance companies engage in their fair share of profiteering, your math seems a little off.

Friday, August 30, 2013 at 1:51 PM
Yet Another Medical Scam said...

Don't fall for the sob story of needing $12 million to renovate the women's and children's unit. That figure is roughly the equivalent of 50 surgeries. It's pocket change for these medical corporations. They make back that money in no time.

Friday, August 30, 2013 at 1:05 AM
Good shake-up said...

I think this will be a good shake-up. There is a lot of old employees, managers, and adminstrators who are stuck in their ways and have been doing things the same way for more than a decade. A lot of great employees but they have their habits set. It will be nice to get some fresh blood to shake it up a bit and improve its image and give it a chance to reinvent itself. In reality though, I give it two years. Lifepoint will come in, cut overhead by firing/cutting hours/HR tricks to alienate higher seniority nurses/staff thus lowering the average wages. They won't make a profit do to poor payor mix/high unemployment so they will cut unprofitable service lines and outsource and transfer all but the basic of services. Eventually 5-7 years later they will sell the hospital to Vidant (if not merged with UNC) who will promptly close it to funnel all patients to the main hospital where the profit margin is better.

Thursday, August 29, 2013 at 8:34 PM
Question said...

Whoever ends up in charge, lets hope they do something about the pathetic emergency room we have here. Its a disgrace, and is the biggest reason the hospital has the reputation it does. Unless you are facing a life threatening situation, you are much better off riding to Greenville or Raleigh for emergency service. Who wants to wait two hours or more to be seen?

Thursday, August 29, 2013 at 7:51 PM Duke? said...

I wonder how invested Duke is in this partnership. It appears that Duke is 3% of the partnership while LifePoint is 97% of Duke LifePoint.

Thursday, August 29, 2013 at 1:12 PM Employee said...

I hope that we can become competitive with Vidant and Wake when it comes to employee benefits and incentives. I am dedicated to working in the community that I live in, but in the past 5 years, Wilson Medical Center has cut the wages and benefits of every employee in some way. To have dedicated nursed in the Emergency Department which is responsible for a majority of the complaints is bring back wage incentive programs such as NAS and WAS. These programs give employees the reason to stay at the facility and venture off to Wake or Vidant. Come on Wilson, don't settle for second, lets take care of our own.

Thursday, August 29, 2013 at 9:02 AM Big Mistake said...

This choice of a "partner" is a mistake for the Wilson community! A bigger mistake would be to continue leadership as is...that's where the problems are...upper, middle and lower management!

Thursday, August 29, 2013 at 7:37 AM
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