Email from Mission Health employee slams CEO, calls planned job and pay cuts ‘morally corrupt’


An email sent out to all Mission Health employees, and then deleted, caused some commotion on Thursday. The missive came in response to Mission CEO Ron Paulus‘ recent announcement that he was cutting the jobs of 68 employees (Mission employs some 9,000) and cutting the pay of another 150 or so employees.

Paulus said he would take a 26 percent pay cut, or a $270,000 to his $1 million pay. Meantime, Mission is moving ahead aggressively with property acquisition, plans to build a new health clinic near Biltmore Park and plans for a massive new tower on its main campus.

Bottom line: there are a lot of disgruntled Mission employees out there. Yesterday’s letter captures some of their sentiment. Here’s the letter, from Mission RN Brett Robertson. (I don’t know if he’s one of the employees losing their jobs):

To Whom It May Concern:

It’s appropriate to find myself writing this on Labor Day. This commentary is in response to the letter we recently received from Mission’s CEO, citing new fiscal adjustments coming our way in the near future. I will begin by saying that this proclamation is disrespectful, and potentially morally corrupt. So begins the vampiric siphoning of our basic benefits back into the Mission vault in a systematic fashion. These cuts stem from unsubstantiated financial losses that the corporation has projected it will incur beginning in 2014. Despite it’s designation as a Not for Profit Organization, Mission Health is a corporation like any other. And as with most corporations, the wealth of the few is forged on the backs of the many.

Now Dr. Paulus mentions that it is his duty as the leader, to fall first on his proverbial sword, in reference to these cutbacks. He cites arbitrarily cutting 26% of his salary for the coming year. Firstly, this plays as a gesture of solidarity, when he knows that his head would be bitten off if he didn’t take such preemptive action. Secondly, I would bet that he will make back at very least his reported loss over the next few years through incentivized bonuses alone. And thirdly, losing 26% of around $1,000,000 for a single year’s compensation is laughable. Hopefully he can still support his kids, and pay the bills while earning such a pittance. These changes do significantly affect the majority of us. I’ve placed an empty coffee can at the Bean Shop for donations toward the Executive Discretionary Fund for anyone who feels differently.

So what other options does Mission have? You might believe that a Top 15 Health System with all its accolades, may want to take better care of the employees who helped in that achievement. We are the engine which drives this hospital. Despite this, Mission has pledged to continue with all nonessential building projects, real estate acquisitions, and the assimilation of area medical and surgical practices under its banner. You can’t throw a stone anywhere near Asheville without hitting a Mission Health sign. Their directive is to effectively monopolize health care in this region. And it is so easy for them to justify this decision by simply citing their altruism to the community. Paulus says that we can’t “retreat into a shell” in this situation. In the military there exists the concept of a strategic withdrawal. It allows for time to regroup, take care of each other, assess the situation, and find a more viable route toward achieving an objective. Perhaps this alternative shouldn’t be discounted so readily.

Fear can be a very powerful tool. Senior administration is using the instillation of fear to quell any real reaction to our discontentment regarding these policies. The comment that “at least we still have jobs” is too pervasive. Granted, Western North Carolina is an economically depressed region of the country. We are generally under-compensated for our labor at this facility and elsewhere locally. I call for truly competitive wages. I urge you to voice your thoughts, feelings, and ideas openly. By doing this, we can begin the restore some balance to the situation. If things continue to deteriorate, you can start weighing your options. You aren’t forced to work for an institution which doesn’t support you. There are better alternatives out there, where your contribution is more aptly recognized and appreciated. Asheville is a beautiful place, but if you aren’t socially fettered to Mission, consider experiencing the beauty of other locales.

Some will disregard all this, believing me jaded or cynical. There is truth in what I say. We don’t have unions to help protect us from exploitation, so we must advocate for ourselves. Tolerance of the situation only makes it easier for them to continue with similar actions in the future. I’ve had the pleasure of experiencing goodness in many people here. Don’t let them mistake goodness for weakness! Take care and good luck!

For those of you willing to endure the enevitible shafting if we do not foment change, we stock plenty of lube in the O.R..
Brett Robertson, RN


Bud Wolf May 21, 2015 - 7:29 pm

I fell & hit my head while landing on the floor. Took the paramedics advice & went to hospital trauma center hospital. Just paid my bill for overnight stay in hospital. Thank G-d I have Medicare & secondary insurance or I would have had to sell my home.
The C.E.O. of that hospital group makes over 1 million dollars a year in salary and bonuses yet they have to fire many of the Nurses and nurses aids.
Seems these non profit hospitals are money hungry corporations!

MeMawof8 November 13, 2014 - 8:40 pm

I hear that a ton of nurses have joined Brett in leaving Mission’s OR. Seems they don’t cotton to the new Kool-Aid being served up by the new managers there-come heres from someplace else as usual. Stirring the pot and wreckin things for good people who have been there for more years than those folks have been alive. What a shame.

what'shappening? February 19, 2015 - 10:56 pm

What has happened to this blog? No comments for months and Mission has a record number of nursing vacancies, is increasing costs to patients which collides with patient’s deductible increases due to the ACA, and we still have 40 something VPs . At least NPR is looking at some issues, if not Ashvegas, ACT or WLOS. But I understand not wanting to lose advertising funding. Rp’s lack of transparency to NPR and the obvious lack of actually kmowing what goes on at the front line rings true for other issues besides nursing injuries. Not that a CEO can know everything but how about being open to setting up a tour to show the reporter the lifting equipment and less of the disingenuious blab about nursing’s importance.

Marshall Mama November 12, 2014 - 7:05 pm

Word on the street is that over TWENTY FOUR (and counting) Mission OR employees have quit and joined their friend Brett in seeking employment elsewhere- Apparently they don’t like the Kool-Aid the new management is serving to all the employees… I reckon that bit of news is on the cutting room floor of Paulus’ latest video…

Sara January 22, 2016 - 9:25 pm

FYI – The numbers are now up to 50%. Over 50% of the operating room staff has left to seek employment elsewhere. Things continue to get worse.

cat April 17, 2014 - 7:49 pm

careful now, be sparing with the lube, I believe it comes from nursing cost budget.

just a lowly RN April 19, 2014 - 11:26 am

A letter from our CEO. Another NEW position created, while the staff have had their PTO suspended, and another year ahead of no raises.

“To better serve the population of western North Carolina and respond to the need for significant health care transformation, Mission Health has appointed Marc Malloy, a seasoned health insurance and managed care executive, to the newly created position of Senior Vice President, Health Plan Solutions.

This role will focus on creating the infrastructure and associated product offerings for Mission Health’s at-risk offerings, which have been under development for some time. Reporting directly to me, the role will provide strategic direction and implementation of key goals for risk-bearing provider operations, including collaborative physician- and provider-network development, administration, health and wellness, and sales and marketing. This position will also be critical in preparing Mission to participate in the major overhaul of Medicaid services in North Carolina, federal health insurance exchanges and other key health care reform elements.

We know that the best way to add value to our community is to deliver improved population health at lower cost with an exceptional patient and family experience. By adding a seasoned executive who has successfully managed multiple insurance and at-risk products together with existing team members who have helped develop value-based provider organizations including Intermountain Healthcare, Cleveland Clinic, the Mayo Clinic and Geisinger Health System, Mission Health is positioning itself to lead the nation in managing health, wellness and total population cost during a time of dramatic health care transformation. Mission’s first concern is always the quality and safety of care that we provide our patients, but doing that alone does not define success; achieving success requires the simultaneous improvement of individual patient care, population health and total cost.

Marc has more than 20 years of senior leadership experience with several nation-leading companies that provide health care business and insurance solutions. For the last two years, he has been an executive with Healthways, the leader in well-being products and services, leaving that organization as President, Health Plan Markets.

He began his career at insurance giant Aetna, Inc. in 1994, and ascended through various leadership positions, including Vice President, Georgia Network Operations, and Vice President, Southeast Region Medical Economics. From 2004 to 2009, Marc served in two consecutive C-level positions for Coventry Health Care, a leading managed care organization. After leaving Coventry Health Care, he became President and CEO of Renaissance Medical Management Company, a clinically integrated group of 230 primary care physicians located in suburban Philadelphia.

Marc holds a bachelor’s degree in business administration in economics and an MBA, both from Kennesaw State University. He will join Mission Health on April 21.”

Sunshine List April 20, 2014 - 8:00 pm

Can anyone provide a link to Mission Hospital’s IRS Form 990 for 2013? I believe we need to shed some light on Executive Compensation given the current climate of no wage increases, and reduced PTO and 403b Matching. Guidestar provides forms for public inspection but at considerable cost. Can anyone help us out?

happytobealiveinWNC April 24, 2014 - 9:40 pm

So this new VP position was budgeted for, right? And posted appropriately, right? There should be an expectation of this VP to provide a better than break even ROI, more so than the other VPs. But if the VP expense wasn’t budgeted , nor the decrease in expense this VP could theoretically effect…. more cut backs and lay offs. Was this VP part of a major strategic plan or is Paulus acting “off the cuff”? Perhaps this is a former acquaintance?

Your Compensation March 19, 2014 - 11:01 pm

Dr Paulus has announced today that PTO will not be paid in April. June is still up for grabs. Perhaps if each and every employee were to take a Sick Day in April, it would make a statement.

Fred March 22, 2014 - 9:35 am

MAY 1 would be a statement !

feduptohere March 24, 2014 - 6:03 pm

congratulations Dr. Paulus on your new TRUCK!!!!

Dogbyte March 25, 2014 - 10:34 am

Maybe he was thinking about a Lexus, but due to his own self imposed bonus cut he settled for a Toyota.

happytobealiveinWNC March 24, 2014 - 9:45 pm

There is something wrong when the CEO makes over a mil and $12/ hr staff don’t earn their time off. In addition, is Mission getting ROI on its VPs? Many had little or no experience at the position they have been placed. Some magically became VPs, with no posting of their positions or searches for the best qualifications. Instead of cutting the few perks for the frontline, how about lopping off some top dogs due to poor ROI?

left out April 3, 2014 - 6:49 pm

lay offs are widespread all the while they are keeping it secret by making laid off workers sign legal agreements to keep it secret. no end in adding more & more VPs but firing directors, managers & frontline staff.
the worst employer i have ever worked for. the feds need to investigate!

get your healthcare elsewhere. Mission can’t take care of you.

leadership are cowards.!!!!

Suzi April 23, 2014 - 5:50 pm

We need a union at Mission hospital!!!! And everyone needs to stand together…….how can they get away with all they are doing to their employees that have always made MSJ what it is today.? We, the employees, are the backbone of the hospital. How can they be allowed to treat us like they do. The latest is that they are sending RNs and Aides all over the hospital to work…..and most have never been trained for the units they are sent to!!

Sunshine List April 28, 2014 - 8:39 am

Suzi, is there support for a nursing union in your area? I finally believe there is sufficient interest in mine. Wish we could meet…

happytobealiveinWNC July 29, 2014 - 10:48 pm

So, now the ACT will come out with info to the community about their hospital and its financial challenges this year, (read near future lay offs). Don’t expect real information as the employees are afraid to speak. We have no where to go . Even corporate compliance is ineffective now. Information from whistleblowers is not acted upon. Paulus has again insulted us by his statement of “anyone who is not now or can’t get on board is frankly standing in the way of everyone else….” Then asks for us to submit questions, ideas and barriers. When in the past, we have shared ideas, or critically questioned issues, we have been labeled resistant ( not considered on board). It appears there is no place for creative, critical thinking, just following marching orders. Get ready for layoffs. And by the way what is the new emphasis on charitable giving? Anyone know?

What exactly is causing the half billion dollar deficit? Anyone know? All we hear is generalitites about decreased reimbursement, no expansion of Medicaid, increased supply costs, etc. Every year the deficit gets bigger even though the estimates are for the “next 10 years”. Did the lay offs from last year not improve the deficit? It is worse!

It could be that there is a strategy to look very bad, cut a lot of costs, then when reviewed by the ACO reviewers, improvements look better, voila more reimbursement, at the expense of valued employees.

Or cutting more looks good for negotiating the buyout of the hospital and subsequently Paulus’ big package after that is done, again at the expense of employees.

ghostnurse1 September 29, 2014 - 5:23 pm

North Carolina employees have the legal right to perform a poll concerning interests in seeking unionization. Mission Hospital Systems policy forbids the employees to seek unionization.
I once considered performing a nurses union poll, to be conducted on the sidewalk in front of the ER parking deck, on Biltmore Avenue. This sidewalk is NOT Mission Hospital property.

happytobealiveinWNC October 6, 2014 - 2:51 pm

Hospitals are going through “trying times”, to say the least. Employees (we) are treated as dispensable. However, Mission seems to be at the extreme, and the excuses are the non-expansion of NC Medicaid, the high percentages of Medicare/Medicaid, etc. There is some validity in those excuses and in the fact that Mission was behind in aligning health care in WNC. But to have laid off 10% of all of the health care workers in NC (NC Hospital Association reports that 2000 health care workers have been laid off in NC; Mission laid off 70 last year and 130 this year), seems out of range. In addition, not just employees should be alarmed, but local employers and individuals should be alarmed at the increase in outpatient charges that are on the way. Mission will be able to charge more as they open new outpatient facilities. This may decrease access to care to many patients in this area. If there were to be protests, it should be about this and if there is to be accurate and informative reporting by WLOS and the ACT, it should be about this. This is a travesty, although a good business opportunity for competitors:)
And as an aside, last year Paulus repeatedly stated that the executives had taken deep salary cuts. This was disingenuious as they only agreed to forgo some of their bonuses. That does not qualify as a definition for a salary cut. This year, he is claiming that they won’t get PTO in one report, but another stated they just won’t get to carry it over to next year. Which is it? If it is that they can’t carry it over, that just means they will take more vacation because if they don’t, they lose it.

fred March 19, 2014 - 10:11 pm

Take action by celebrating May Day in America.Are we want different or is something wrong with celebrating our daily labor to support our families like the rest of the world.It is our day to honor our efforts and sacrifices.We Are the job creators. We make the country.We the people

fred March 19, 2014 - 10:15 pm

Correction “are we different?”

MD November 23, 2013 - 10:54 pm

No easy solutions ahead for MMH, this disaster has been years in the making. While its is true , the health care environment has contributed to our current sad state of affairs. It is not the major cause.

The blame lies clearly with the board and the hospital administration. The current leadership has created a nightmare. The board has obviously enriched themselves at the patients , staff and communities expense. Properties and practices are being bought by the hospital at a rapid rate, all in the name of a bigger picture. ” MONOPOLY”

HR has a powerful weapon called fear, if your the only game in the town any perceived noncompliance is harshly dealt with. I know many former and current employees that have been intimidated and have had no ear or path to justice.

The current administration has bet everything on the “Bigger Picture” Thier view of the future has major flaws. It was never founded on good business principals. In essence they have bankrupted MMH on the altar of pride and greed. I truly think that most of them don’t see the train wreck that is coming. In the end they will move on with thier golden parachutes, the board will have made millions .

Hopefully we will be able to pick up the pieces by FOCUSING on caring for patients and each other. I do believe we need over site by Buncombe County and NC State .Contributing to our tax base would be a good idea ,an just maybe ….the monopoly needs to be broke up by the Federal Government.


just ask the questions November 26, 2013 - 11:58 pm

Your ONLY chance at getting these issues addressed is to take the monopoly/community issue to the Federal Trade Commission or the Department of Justice.

The main issue here is the increased cost to the community caused by the substantial increases in charges to Mission’s payers. Where do you think these increases in employer premiums are coming from if not from Mission and its employed monopoly practices?

The local media will not investigate due to their fear of Mission’s board and leadership, and so the only way to make this right is to pursue justice outside of the community.

not as brave as Brett November 28, 2013 - 7:50 am

This link was just emailed to the Department of Justice asking if they will research these concerns.

NativeSon January 22, 2014 - 10:35 am

you can bet higher ups will get those coveted bonuses!

happytobealiveinWNC January 31, 2014 - 10:42 am

This could be considered a type of crisis management, meaning that management, unethically, uses potential crises as a reason to rally the troops to make change. Using a potential budget crisis could be a reason to reduce staff who are older, and cost more in salary , are matched higher in the retirement program and most importantly are not bullied easily. If these staff were to stay, VP incompetence might be revealed to the detriment of the administrative team illusion. The downside is that wisdom and experience is lost, along with trust; front line staff trusted many of the elders. These staff also brought important perspectives from their experiences that combined with new initiatives due to ACA and other health care changes, would many times foster better solutions and strategies than those presented without the perspectives. Too bad. Now, magically, the budget will turn around (really, in 2-4 months in a billion dollar company?), so that bonuses can be presented. And why not be transparent about senior administration cutting their salaries? They decided to forgo their bonuses only. Why not state this? That action alone, my friends, illustrates the fortitude and integrity of the senior management team.

WFBH November 16, 2013 - 12:00 am

So this is really interesting to me as someone being recruited by Mission. While I oonly know what I’ve heard and read, I can assure you none of this is unique to Mission. The big difference, from what I can tell, is Mission’s place in the community. I work at Baptist in administration now, and I can promise you the feelings are the same. We just laid off almost a thousand folks over the last year. Hardworking caregivers. Critical staff. And our patient care has suffered greatly. Our management makes decisions in a vacuum and is equally as popular as Paulus and the like. I have been to many hospitals and heard the same story. It’s the nature of healthcare today. Under the ACA and Medicare/medicaid changes, it has become almost impossible to operate a hospital while focusing on what matters. Our CEO, MacDonnell, made more than Paulus, including a 10k allowance for country club dues. We’ve faced cuts in raises, benefits, etc every year for like 3 years. The numberpof VPs and size of the executive team is alarming indeed at Mission. And Paulus certainly sounds suspect. But I would encourage you to read about other similar sized health systems around the country, and I suspect you’ll find a lot of layoffs, a lot of employees being asked to do more, and a lot of what you’re feeling. I promise you are not alone, but take pride in doing what yyou can in your role to provide safe, quality patient care. That’s why I got into and stay in health care. You can make a difference in patient lives every day. Don’t let that suffer because Paulus is a tool and the system is feeling pains. Eyes on the prize. And if nothing else, reading this discussion has helped me as I consider potential opportunities at Mission and given me some hard to find context (the thoughtful responses at least; I’m naturally suspect of petty personal attacks). So thanks and best of luck to those in the trenches.

WFBH November 16, 2013 - 12:01 am

Excuse the spelling mistakes… McConnell, etc.

NativeSon January 22, 2014 - 10:39 am

How was his golf game?

so sad November 9, 2013 - 7:21 pm

You want a new view Jason? Come to Missions Child development Center. Now there is a dog and pony show. We are supposed to be a 5 star center. We (the teachers don’t see it) We buy must of our supplies and have no support from our supervisor for out of control children AND parents. Teachers are pulled from classrooms so our director doesn’t have to answer phones. She does not like to deal with problems. (The last 2 supervisors answered their phones).
Director leaves on open house night, ( not comfortable with parents) And we were not even allowed to tell the parents if we were going to be their child’s teachers.
I am planning on starting a family, and they absolutely will not attend Missions Child Development while the current supervisor is in place, even if I am still there. Which I pray I will not be. The turnover there has become incredible.

not as brave as Brett November 3, 2013 - 10:39 am

In response to the question asking why the hospital continues to purchase physician practices, look no further than the compensation hospitals receive for provider based care. this compensations often two or three times more than that charged by the physician practice (check out you charges for testing now done by ACA since they have been purchased by the hospital. You may also want to take the time to research this on the web; both the NY times and Wall Street Journal have excellent articles.

It is understandable that in this time of decreasing reimbursements hospitals seek to find ways to increase revenue. What is intolerable is the way Mission is wasting money. Take for example the Surgical service line. Not so long ago that service line functioned (as Bad Mistakes concisely states above) efficiently and effectively. They had ONE Vice President and One Director. Surgical Services now have TWO VPs and THREE Directors. Compensation for one of those “consulting VPs is as follows; $190.00 PER HOUR (compare that to physicians who make a difference in patient quality are paid at $130 per hour), Mission is paying for this VP’s housing at Weirbridge, a VERY expensive apartment complex, a rental car AND for the VP to make two trips a month back to Washington State, because you see, the VP does not live here ( much like many new Mission leadership) how vested can they be in a community they can’t even call home or claim to be a part of? How can they live with themselves knowing other long term staff are being let go and those remaining are having their benefits cut?

Please Mission Board, take the advice of above of following the money, else the “blood sucking” outside infiltrators will successfully finish the job started by Joe Damore. Mission will be left in financial tatters and sold to the highest bidder.

just ask the questions November 4, 2013 - 9:44 pm

In addition to the issues of waste and substantially overcharging the community and payers for provider-based billing (split-billing), the real smoking gun here is the anti-competitive, antitrust activity by Mission’s senior leadership regarding Mission’s practice of purchasing monopoly physician practices and leveraging their predatory position. This is the issue that, once exposed, will force a change in how business in done at Mission. If you have information that you believe shows Mission’s intention to eliminate its competition, contact the Department of Justice or the Federal Trade Commission — their telephone numbers and email addresses are on their website. The Federal Government must assure your confidentiality by law. Do it before the organization is entirely compromised with its greedy, exploitative senior leadership and its board. Could this situation get any worse?

The Truth About Mission November 1, 2013 - 5:06 pm

Seems this is the end, folks. The 7% participation rate for the Mission United Way campaign is about the only statement we’re willing to make. Thanks for playing…

Bad Mistakes October 28, 2013 - 8:33 pm

Dr. Paulus and Dr. Maples were huge hiring mistakes. A BIG gamble on them vs real business people to run our hospital Well, those real business people of the the previous 10 years did rather well and put us in great financial and quality position. These newcomers with no business experience (only great theory) are destroying the place.

I am gone now, but as a former scrub tech, I can tell you surgery went from excellent to a nightmare. Kathy Guyette privately told a lot of people that Dr. Paulus and Dr. Maples were huge mistakes and they are out of control. Only problem with her saying it to us back then is we thought she was a bad hire too, and she always talked about everyone behind their backs! She has no idea what she is doing. Oh, and just try to find her after 4:30pm everyday. Oh, you can’t because she doesn’t after 4:30. She told a lot of us that. She needs to come on surgery and work for a day and learn what hard work is. She couldn’t handle it!

I know, it sounds like a lot of petty complaining about people, but these are the leaders of a huge hospital in our town, and it is the only place for people here to go for healthcare. If it continues to get ruined (look at the number of significant negative quality cases arising in the last 2 years for evidence) then we are all in big trouble, and we will look back and say it wasn’t petty at all! We all should have done something sooner!!!!!!!

RN October 28, 2013 - 10:13 am

Seems like a great plan.

RN October 28, 2013 - 10:11 am

The size of Mission’s executive team is an abomination. Research the leadership structures of similarly sized hospitals and you will find Mission’s leadership structure is a testament to inneficiency. Now leadership is telling directors and managers to start preparing your nursing staff for increases in nurse to patient ratios. The Dr. Maples’s quality crusade is a fine philosophy but with inadequate resources and accountability it has become an expensive excercise in futility in spite of the cadre of expensive process guru consultants Mission flew weekly back and forth from Texas for years). Why do you think Mission has had such consistent accolades in patient care? Because staffing has been adequate. Now Mission is going to balance the books on the backs of the clinical staff while contiuing the expansion of an already bloated executive team. After more than 20 years at Mission I moved on to greener pastures (of my own free will) along with many experienced nurses. As our benefits and compensation continue to be slashed and morale continues to plunge there will be a whole lot of green and inexperienced staff to serve the acute care needs of WNC as more experienced staff leave Mission (and leave they will). The board and the leadership team needs to take care of buisness where the clinical rubber hits the road for the sake of us all. Build new building, buy up real estate, raise staffing ratios, expand executive team, reduce benefits and compensation.

Never Forger October 25, 2013 - 6:05 pm

Carolina Public Press would be a great start. I would also love to see someone send this link to the NYT or Wall Street Journal. The COPA, Mission’s “predatory” practices, the urban/rural consumer, the payer mix, the “all-star” executive team that has grown as large as many health systems 3x Mission’s size….all these factors would make a great story about the disfunction that is health care today.

The Truth About Mission October 25, 2013 - 5:43 pm

Nursing must take the lead. We have the numbers and we have the incentive. National Nurses United (NNU)for improved staffing ratios and competitive wages and benefits. I KNOW we would have the support to organize in my area. Please, I want to hear from you…Our futures depend on us taking action.

Media Watcher October 25, 2013 - 12:34 pm

If those who have inside information and insight into the Mission situation could contact the following, some investigative journalism might take place:

Angie Newsome, Director and Editor

Jon Elliston, Investigations and Open Government Editor

As professional journalists, they will not violate your confidentiality, if they believe you have accurate information. If they can get the same information from several independent sources, they may decide it warrants investigation. Their policy may not be to quote anonymous sources, but that sure didn’t stop “Deep Throat” and Woodward and Bernstein when the matter was serious enough. Is this matter serious enough to the people of Asheville? Jason Sandford is correct; bitching and moaning here won’t do the job. Insiders do not have to speak publicly and risk their jobs. Speak to some responsible journalists. Jason Sandford no longer has a platform for investigative reporting.

In the “old days,” Cecil Bothwell as a reporter might have leaped on this story. Have any of his supporters spoken to him about this? Ask him at the next candidate’s forum if he’s seen any of the comments on Ashvegas.

Jason Sandford October 25, 2013 - 1:00 pm

you’re funny, Media Watcher.

smytty October 25, 2013 - 2:13 pm

Just in the interest of fairness, I want full credit for saying that bitching and moaning here will do nothing, not Jason.



Not going away October 24, 2013 - 5:19 pm

Folks-don’t worry. This is not going away. All that has been written and spoken to is important because Mission is the largest employer in town and the community is so dependent on Mission for healthcare, jobs, and economic development. The things written about and being discussed every day in the community and inside Mission are real and not petty. This will continue well beyond Ashvegas – It is being talked about everywhere! I know there are execs at Mission monitoring this, and I also know some Board members are aware and are concerned. Some execs are cheering it on, because they know something needs to happen, but they fear they cannot talk about it until a proper forum exists.

Ron Paulus will continue to make decisions not in the best interest of our community. He was ill-prepared for the role, and that is the Board’s fault for hiring him. He has mis-managed this community asset so badly that it will require a huge turnaround effort or we will have to sell to someone to fix it. These are not allegations – these are facts. Facts- if you care to dive into them include the spiraling operating income trend, the spending down (and more planned future spending down) of savings, the downward trend in employee satisfaction, the high profile quality mistakes in patient care, the poor treatment of long term employees, the increase in cost (especially the dramatic increase in administrative costs). Anyone paying attention to the national healthcare landscape would tell you Mission is a real outlier in how they growing costs.

The next sets of issues are we now have union talk, we have over-spent on purchasing some physicians, we have over-spent on buying community hospitals, we have a CEO having to deny in management team he is having an affair with the VP Marketing (I am not saying he did or did not, only saying it is bad when the CEO has to explain himself to management abut something like that). Then ofcourse we have all these Board questions about why they are allowing this to happen, and their potential conflicts of interest.

In the end, the community will have to live with what ultimately develops from Mission. Our hope in bringing light to these issues, is that someone will look out for the best interest of the most important asset in our community before it gets so bad that we have an impact that becomes irreversible. Regardless of what you think, and understanding there will always be dis-gruntled employees, there is too much downward movement on the facts for something not to be done!

Media Watcher October 24, 2013 - 2:31 pm

Thanks! That helps your loyal readers.

Jason Sandford October 24, 2013 - 2:51 pm

just being honest about priorities. food, clothing and a roof over my head trump a crying Paulus at this point in time. #avljobless

Understand October 24, 2013 - 5:25 pm

I completely appreciate what you are saying. I understand the need to find a job and pay for food, shelter, etc. I have to find a new job myself. I am one of the long-term employees (after 26 years at Mission) that was let go without any communication as to why.

While I would like to tell people more about what bad things are occurring at Mission, I can’t spend my time doing it (other than this single response). I have to find a job – which is hard in this town when you are in healthcare and not working for the Paulus run Mafia.

Bring it to Light October 23, 2013 - 1:45 pm

This topic and others like it about Mission, the current leadership team, and what is happening at the hospital need to stay on the front page! These are very serious issues and serious times!

There are all kinds of things happening at Mission – some of which have been discussed here, and some of which have not yet been brought to light. Lots of concerns about what is happening. This is the tip of the iceberg. Lots of potentially very bad press to come. The minions as you say have no direction, and are lost.

Quality has become a real issue!!!!!!!!!!!

More Light - Interesting October 23, 2013 - 4:22 pm

Everyone should know that I recently learned that Rowena Timms, the VP of PR, Marketing, and Public Policy for Mission (yes the same department that everyone keeps turning over/leaving) does not even live here. In fact she does not even live in NC. She lives somewhere in South Carolina, and she doesn’t even come to work everyday like the rest of us. Must be nice to be the CEO’s right hand, make lots of money, and not have to even come to work, and not even live in the area or State she represents! Something smells!

RN for Unions October 23, 2013 - 10:50 pm

Seeing so many of our best nurses (our long term nurses) being given their walking papers by these despicable executives forces us to come together to form a union to protect us against these people. We are starting to organize and hope we can get it together before they let more of us go.

Quality is an issue, and it will get worse as there will not be anyone there to train these young nurses. Our hospital is not clean anymore, our hours are reduced, they are letting higher cost – long term employees go everyday, our benefits keep getting reduced, we now treat the computer and not the patient. Employee morale is the pits. Our executives are really bad, and they don’t listen to anyone.

We are pleading for folks to help us. Please listen to us and ask for investigations to be done.

Jason- Put this on Front page October 23, 2013 - 11:07 pm

Jason- while we appreciate the movie reviews, etc, on this site, this story about Mission and a few others are key stories affecting our community, the people here, the economy, the quality of patient care. This needs to get top billing. I am surprised you are letting this continue to slide to the back pages. What other stories are you receiving over 100 comments on? This is a key story that needs to be put front and center a little more. Lots of folks are concerned about what is happening at Mission.

Jason Sandford October 24, 2013 - 8:34 am

To respond: This story had its run on the “front page” of the website, and I think the conversation it has generated is a good one. I’m exploring ways to follow up. But I must say that many of the comments in recent weeks are simply repetitive, verge on petty personal attacks and are not advancing the discussion. It’s getting old.

Media Watcher October 24, 2013 - 11:30 am

Are you ready/able to share some of the ways you’re following up? Or a timetable of when to expect some more substantial reporting? People are continuing to post because they don’t want this story to slip into obscurity. It’s too important, if the accusations have any validity. If you’ve determined that there is just a small group of disgruntled employees, and there is no evidence of mismanagement and inappropriate dealings by trustees, please share that with us. You’ve built up a lot of trust in the community. The community is looking to you. John Boyle, the only other journalist willing to stick his neck out (or his employer’s neck out), is not likely to look into this, as Gannett seems only willing to tackle Mark Meadows and the Chief of Police.
MountainX is off clubbing and dining.

Jason Sandford October 24, 2013 - 2:28 pm

Media Watcher, no, not ready to commit to anything right now beyond getting a job – either one that I create or one that I find – that pays the bills and allows me to stay in Asheville. That’s job # 1 for me right now.

WNC October 25, 2013 - 11:11 am

Your comment of “it’s getting old” may be your personal opinion, but professionally you should recognize that the comments are repetitive because so many are having the same experience at Mission. People want to be heard!

When the public gets together to rally around an issue, typically that is seen as unity, not repetitiveness.

Sorry this is “getting old” to you. Your site states this blog is intended to serve the city and people of Asheville – clearly the people care about this issue. Even if you don’t.

Jason Sandford October 25, 2013 - 11:15 am

WNC, please re-read what I wrote. i never said the issue is getting old. the bitching and moaning and personal attacks is what is getting old.

Smytty October 25, 2013 - 12:09 pm

I’d also say that some of these folks who are so insistent about trying to get the article bumped back to the front might ought to pursue other avenues with their grievances. This isn’t really the proper avenue for rehashing stories and personal attacks. It would be very easy for one or two people to use this as a forum to press their own agendas.

Jason did his part in bringing attention to the situation at Mission, and I can’t see any reason that he’s obligated to do as you ask and continue to re-promote his own article.

If you have significant personal issues with Mission, perhaps they ought to either be taken to HR at Mission, or through legal channels – not complained about on a local blogger’s website.

Jason Sandford October 25, 2013 - 12:22 pm

story won’t get re-posted to the front page unless there’s a new development here.

Disgusted October 25, 2013 - 8:14 pm

HR at Mission? The slash and burn department? They are part of the problem, not the solution.
If you go to them in confidence with an issue, you will find yourself targeted then termed.
Unless you are ready to quit, stay away from HR. Far, far away.

Keep the momentum going October 21, 2013 - 2:12 pm

I wish this article/topic would get bumped up on Ashvegas…these issues are huge & should not be allowed to die down once again. More employees will lose their jobs but the leaders keep lining their pockets. Paulus & his minions need to go & the only way to make it happen is enough people putting pressure on the board.

Bump the Article October 21, 2013 - 8:46 pm

I agree- the article should be moved to the front page. The story needs to remain front and center. The employees are suffering, and eventually patient care will suffer. In fact, it is already happening! The docs are not happy with Mission leadership. Ron Paulus has been a big disappointment to a lot of us – we had high hopes, but turns out he is not what we thought he was. He has made some bad hiring decisions, and some bad financial decisions that has put us in a bad spot. His hire of his COO (Jill) and his Quality Leader (the infamous Dr. Maples) are really poor decisions and they seem to be causing more problems than they are fixing.

This talk of these execs getting bonuses surely needs to be exposed given the situation they have put us all in. Not much fun to be a doc around here anymore.

Seriously October 23, 2013 - 9:06 am

Is the CEO at Mission really making over $1million/year? That is a lot of money for all this talk about how bad things are in heath care, not to mention all the talk about how bad things are at Mission under his leadership.

Disgusted October 17, 2013 - 8:34 pm

I wonder how all of the laid off employees and remaining employees whose merit, PTO, benefits and retirement match were cut feel knowing that management are getting bonuses this year.

Not as Brave as Brett October 18, 2013 - 11:21 am

They are probably disgusted. If half of the Senior Management team were “cut” instead (along with their benefits, retirement, etc.,) no doubt Mission could afford to keep staff (the ones giving patient care!) benefits the way they were. At an average of $300,000 per year plus benefits, that would add another $10M to Mission’s bottom line…..

WHY October 19, 2013 - 9:15 am

Why would Mission management be getting bonuses this year? I heard the financials were distressed, and that they are making significantly less money than in previous years. Heard the CEO say that tougher times are ahead too. And add the fact that we keep hearing employee satisfaction is low, why would management be getting rewarded with bonuses?

That does just not make sense that they would be getting bonuses, and having to lay people off too.. sounds crazy!

Soul-sucking October 15, 2013 - 11:37 am

Dr Paulus and his ilk continuously prioritize buildings and technology over compassionate employee relations. The caregiver experience at Mission has become a soul-sucking endeavor. Paulus’s shortsighted neglect of Labor and his failure to secure a positive work environment and fair compensation for hospital staff have resulted in a distracted and resentful work force.

The constant devaluation of employee health insurance benefits results in a “secret” claw back of already low wages. What percentage of employees are in debt for their own health care? Is staff aware that thanks to unregulated cost-shifting, charges to the insured are exponentially higher than those billed to Medicare? US hospitals would have you believe that there are no profits in the delivery of Medicare services when, in actuality, Medicare reimbursements are reflective of true costs of care. Compare this to the inflated charges on your own hospital bills. When the privately insured are no longer willing or able to subsidize the unparalleled growth of the Medical-Industrial Complex that is Mission, there won’t be anyone left to care for those with Medicare and Medicaid.

just a lowly RN October 16, 2013 - 10:18 pm

Another couple of long term employees bite the dust. Hmmm. Guess when nurses reach a certain age, they will be fired! This is becoming the normal. just can’t believe they spend 30 years devoted to patient care, to be fired and disgraced in the end. Oh. and of course, they did nothing wrong except make too much. Bring on the young nurses whom make less is the new motto here.

Media Watcher October 8, 2013 - 6:49 pm

Thanks. You may be the only journalist in town positioned to tackle this story! Your loyal readers will be eagerly awaiting further developments.

Jason October 8, 2013 - 9:44 pm

Jason, we do appreciate the forum. Several of us wish we could share more, but we just cannot share openly or be too specific because the environment would only get worse for a lot of us. We are scared we would lose of jobs without a doubt. It is not a good environment for any of us. The Board supports Dr. Paulus, but they are not well informed. We actually have good people on the Board, but they have been “duped” by Dr. Paulus and his ability to sell them a bag of goods. He and Jill have really hi-jacked the place like nothing I have ever seen before. Most of us do not attend Board meetings anymore like we used to do – part of the hi-jacking that is taking place.

We are hopeful someone will start asking the right questions, but it cannot be one of us.

just ask the questions October 9, 2013 - 9:04 pm

As an executive, I would encourage that either a community ombudsman or journalist ask the questions posed by Follow the Money and Insightful Questions, particularly about board purchases and the financial impact to the community regarding the large-scale acquisition of monopoly physician practices.

Who will pursue on behalf of the community that Mission serves? Who will standup?

follow the money October 8, 2013 - 10:06 am

Always follow the money. Ask the board for an accounting of their individual member’s contracts with Mission over the last 5 years and whether proposals were considered from other vendors for these contracts/purchases/deals.

Ask the board about how much money has been spent on purchasing physician practices in the past 3 years, and the financial impact to patients and community before and after the purchases. How much more money is Mission making now based than if they had remained independent practices? What types of practices were purchased and what changes were made in billing methods after the purchase?

Ask the board and management to provide information about the total number of executives hired in the last few years as a percent of budget as compared to the previous 3 years.

This is the only healthcare system in western North Carolina,and a not for profit one. Shouldn’t it be accountable to its community? Ask the questions, evaluate in the information, and ask more questions.

Media Watcher October 8, 2013 - 1:40 pm

Follow the Money, your questions would be an excellent place for an enterprising investigative reporter to start. Ashvegas, if you’re not willing to take this on, perhaps you can toss it to Carolina Public Press. Citizen-Times, alas, doesn’t seem able to do this kind of in-depth reporting and probably doesn’t have the staff or the stomach for it. MountainX is bleeding staff and seems to have totally lost focus on anything other than Clubland and Best of.
Ashvegas, can you get back to your loyal readers on this?

Jason Sandford October 8, 2013 - 2:55 pm

Media Watcher, I’ll think about this one. I’ve got a lot on my plate currently, as you might imagine…

Media Watcher October 8, 2013 - 4:56 pm

Thanks, Ashvegas. The last time this blog unleashed a torrent of unrest and possible wrong doing at Mission, the culpable administration collapsed of the weight of its transgressions. That was, in its way, a coup for this blog and established its importance in this community. Is that likely to happen again? Probably not. The medical community may have had something at stake then, but doesn’t most of the medical community now work for MIssion? Carolina Public Press had one story, on September 20, which has zero comments. Are Newsome and Elliston following the comment thread here? Is any responsible journalist paying attention? Is this just a case of just whiny, disgruntled staff complaining?

Jason Sandford October 8, 2013 - 5:26 pm

Media Watcher, thanks for your insightful comments, as usual. And please don’t mistake my short answers for disinterest. I’m very interested, and I’m watching. I also recently had an off-the-record conversation during a face-to-face meeting with a high-ranking Mission executive who offered their own insight. Yes, I’m paying attention.

Insightful Questions October 8, 2013 - 9:21 pm

Here are some key questions folks may want to ask…

1. Why has the Mission marketing department had almost 100% turnover 3 times in 3 years? Is this quality control?
2. How many new VP/Execs have been hired in the past 3 years? Does Mission now really have 50 VP level and above execs compared to having 21 across the entire system just a few years ago? Has Mission really gone from having 1 VP of surgery to 3 VP’s of surgery with the same volume? Why is all this necessary? Are we seeing this similar cost growth across other systems across the country? Do all of our VP’s know what their job is anymore?

3. Who owned the land that is on Long Shoals that Mission is now building an outpatient center? Was it a Board member? Is it really needed? What price was paid for the land?
4. Did Mission really need to rent the entire Biltmore Park ex-Volvo building? Who are they renting it from? Was the owner at a loss of who could use the property?
5. Who lives next to Jack Cecil in the Ramble? Is it the current Mission CEO?
6. Who owned the Pisgah Bank property and adjacent land that Mission purchased? Was it several board members? Was it really needed by Mission? What price was paid? Were the owners in financial trouble when Mission purchased the land?
7. Did Mission all of the sudden buy all this land in the past 3 years since Ron Paulus has been in power? Why did Mission all of the sudden need all this land?

8. Is Bob Roberts (the Chair of the Board and a banker) bank lending more these days to Mission than in past years? Have Mission banking accounts and investments been switched to his banks in the past several years? Does Bob Roberts get paid more if things go well for his bank (i.e., increased assets/cash)?
9. Did Ron Paulus really take a decrease in actual base pay or was he being untruthful, as he really just was not going to hit his bonus payment, so he said he would not accept that bonus this year- money he would not be getting anyway, but quite the sales approach?
10. Is Dr. Paulus really making $1 million/year? Did he really go from a $300,000 salary at Geisinger to a $1 million salary at Mission? Did Joe Damore only make around $500,000? Did David Spiller (who would have been a better choice than Ron or Joe) only make around $300,000? Why was this astronomical increase in CEO pay necessary in our community?

11. What price is Mission paying for all these physician practices? How much are they losing on these practices? Is this a good thing for Mission, our fellow physicians, and the community? Is it really necessary to employee physicians in Asheville?
12. Have the financial operating incomes really dropped dramatically in the past 3 years under Dr.Paulus leadership? What are the facts? Shouldn’t they be shared with the public, the medical staff, etc. What does the Board think about that and what is being done?
13. Is Jill (our COO the builder) and Ron really going to build a $350 million facility during these economic conditions and healthcare downturn, including the new low financial ebb at Mission?
14. What do people really think about Ron Paulus at Geisinger? Were they truthful with us or were they glad to be getting rid of Ron Paulus?

15. What are the results of the employee satisfaction surveys over the last several years? Is it getting worse? Shouldn’t these be made available for everyone to see? Dr. Paulus talks a lot about transparency, but we have not seen these kinds of results or information. As I listen to employees all across the hospital, I hear more negativity than ever before, which is concerning.
16. Have any of the executive level hires at Mission Hospital in the past 4 years been from the southeast? Or all they all from far away places that don’t know our culture?
17. How long have the same Board members been on the Board? Who has been on the Board the longest or the most times?

Whew.. I am tired.. but very concerned! Too many issues for a place I will need to get my healthcare from as I continue to get older and more frail. Hope I can hold up.

Little Bird October 9, 2013 - 5:08 pm

Whew! I’m tired just reading that, but every single question is right on the money. Yep, where there’s smoke, there’s fire!

Compare Hospitals October 22, 2013 - 8:47 pm

Has anyone compared the number of executives at Mission to other similar sized systems? I heard Mission has 50 executives in the system. Mission has $1.5 billion in net revenues as I understand it.

Huntsville Hospital has $1.1 billion in net revenues and has 17 executives. That is a big difference.

I also understand that Mission used to only have about 18 executives about 8 years ago. There is nothing that can explain why Ron Paulus and the Board needed to grow that kind of cost these days in healthcare.

Someone needs to call that into question. Where is the responsibility to the community for this not-for-profit?
Board- what are you doing?

The Truth About Mission October 5, 2013 - 10:15 am

“Observer” has it exactly right. The Board is in complete agreement with Ron Paulus’ directive at Mission. Individual Board members have reaped enormous personal gains, and will continue to do so, under his leadership. Their profits are realized due to the tremendous efforts of Mission Staff and Physicians, all under the guise of assisting the community.

As a long term RN, I do not completely agree with Brett’s method of delivery. However, his principle position is frighteningly accurate. And I do understand his considerable disgust and exasperation. For Ron Paulus to compare HIS compensation cuts to OURS displays a particular sense of tone deafness peculiar to the one percent. His losses, assuming they are real, may require limited restructuring of his financial portfolio and estate plans. Ours, in contrast, require us to make choices which dramatically impact our daily lives. Food and energy costs, childcare and education expenses, medical costs, vacations and sick time are all up for consideration. As a direct result of our low and declining compensation, we will continue to spend less. The impact of our loss will be extended to the community at large. And, yes, I will be “working sick”. As I care for your children, your spouse, your aged parents, I will work with pain, malaise, and fever because I have no other choice.

My hope for myself, and my colleagues, is that we join with other healthcare professionals across the country to fight for improvements in both work environment and compensation. Our unionized counterparts have lower patient ratios and better pay and benefits; including affordable access to the very health care that we provide and the ability to retire with security. Even hospital employed physicians are realizing the need for collective bargaining. Individually, we have no voice with Mission’s Board. Together, we will. Thanks, Brett. We are ready.

Media Watcher October 5, 2013 - 7:34 pm

Truth About Mission, could you please give us some concrete details about how “individual Board members have reaped enormous personal gains” from their affiliation with Mission and Dr. Paulus. You probably are not willing to give names, but it would be helpful to the community and to any reporter who cares to “follow the money” to know what you’re talking about. Are you talking about land purchases? Contracts for equipment or services? If financial improprieties have occurred, the community needs to know.
Charles Ayscue, Mission’s vice president of finance and chief financial officer, recently received the Order of the Long Leaf Pine from the the governor. Accusations of financial improprieties should be taken seriously.

follow the money October 7, 2013 - 9:41 pm

Dear Media Watcher,

A few questions that might be posed to Mission’s current board:

1. What financial transactions over the past five years have transpired between Mission Health System (including its subsidiaries) and its board members? What was the financial benefit, short and long-term, to any board member, and were formal requests offered to other potential vendors that would indicate fair award practices for a non-profit hospital?

2. What was the total number of staff before Dr. Paulus’ tenure and now? How many of these staff were hired in executive positions during the last 3 years? What is the average current executive salary expense now as a percentage of budget compared to 4 years ago?

3. How much money was spent in buying physician practices in 2012-13 as compared to the previous three years, and what was the type of practice? Were they the only practice of their type in WNC?

The Truth About Mission October 8, 2013 - 8:49 pm

Follow the money, its seems you are the perfect person to formally address the Hospital Board. Indeed, I find it inconceivable that the Board has not had to respond to these questions, and more, prior to this point in time. Media Watcher, unfortunately, I have neither the resources nor the safety net necessary to pursue an investigation. But someone-or some group- in the community does. Keep talking.

Board Meetings October 8, 2013 - 9:28 pm

Can anyone attend the Board meetings- like can the media attend? How often does the Board meet? Do they meet enough to know what is really happening? What Execs are in the Board meeting? Are any physicians allowed in the meetings to talk to the Board? How abut staff to express their concerns?

Based on what I am reading and hearing, it sounds like maybe the Board may be receiving filtered information from the CEO and not the real truth. Kind of scary!

observer October 5, 2013 - 1:02 am

This is a sad turn of events for Mission Health System, a once-outstanding healthcare organization. Unfortunately, its board has made consistently poor decisions on their choice of leadership over the past decade. An argument could be made that these decisions have effectively covered up the fact that several of the most influential board members have realized substantial profits on the backs of its local healthcare community as well as Mission’s employees. Personal gains have twisted the board’s perspective in carrying out their responsibilities to the community, a shameful thing.

Ron Paulus’ tenure is the just the worst in a long line of arrogant, ineffective leadership. Mission and the community it serves deserves much, much better.

Iworkexec October 4, 2013 - 9:31 pm

THESE COMMENTS ARE JUST THE TIP OF THE ICEBERG. Get what they want when they want it.

Mission copycat October 2, 2013 - 12:38 am

Tell me more

Harry in AVL October 3, 2013 - 10:22 pm

Who is currently on the Board at Mission? Is it just 3-4 people? That is not good if only a few are running such a big place. Are they appointed by the community?

Politics Watcher October 4, 2013 - 9:21 am

The Mission Board of Directors are listed below. Boards of our public institutions are often not well informed about how the internal operations of their organizations are running, as the recent rubber stamping by the UNCA Board of Trustees of Anne Ponder to be renewed as chancellor shows, despite plentiful evidence that the university faculty and staff are deeply dissatisfied with her; the same seems to be true of Mission, if the comments on this site are to be believed.

Robert C. Roberts, Chair; Wyatt S. Stevens, Vice Chair; Darryl J. Hart, Secretary; Janice W. Brumit, Immediate Past Chair; Ronald A. Paulus, MD, President & Chief Executive Officer; John R. Ball, MD; George M. Bilbrey, Jr., MD; Richard W. Bock, MD; John F. A. V. Cecil; Suzanne S. DeFerie; Hank Dunn; Brian K. England, MD; John W. Garrett, MD; William S. Hickman; William E. Lee; Robert M. Moore, Jr.; Charles D Owen, III; Robby L. Russell; Anna S. Shivers; Pamela M. Turner; John D. Kimberly

Matter of Time September 30, 2013 - 8:00 pm

It is just a matter of time before more problems are surfaced.

In the meantime, financially we have gone backwards, and we are continuing to go backwards faster. Jill and Ron are spending all the money we have in savings. Quality is not improving and will go backwards. Employee satisfaction is going backwards. The affiliate hospitals we are buying are not helping us, in fact, they are dragging us down faster.

Just a matter of time before Ron and Jill leave, are asked to leave, or we sell to the highest bidder.

Shameful October 3, 2013 - 10:14 pm

This administration is shameful! Mission is so mis-managed right now and so many people know it, but so many are scared to death to say anything. Now that is a great environment for us to work in!

Dr. Paulus is so arrogant! He is the most shameful of them all! He recently said we are going to spend $350 million on the a new tower no matter what else is happening because it is the right thing to do. That kind of decision-maiking is what gets organizations in trouble. It is what gets governments in trouble. We have to consider what else is happening, not just what you want to do with our money. You did not help put any of the money we have saved for years, you have only spent it unwisely.

I am embaressed how far we have fallen under his leadership!

just sad September 28, 2013 - 1:35 pm

it hurts me to see such a fine hospital like mission sell it soul for greed. Paulus is just a pawn of Cecil and his objectives. When mission needs land it is from Cecil, when Paulus needed a home guess what it was from Cecil. I think the board of mission needs to be removed and let the common man have a say.

not as brave as Brett September 29, 2013 - 8:28 pm

I agree or at least let the common interest be fairly represented! After their selfish selection of Joe Damore and now the back scratching with Paulus, Cecil and Owen need to go!! Joe was selected without even a reference check because he promised an insurance plan that would line some pretty prominent pockets.

David Spillers was the much favored successor after Bob retired. Physicians, staff, ALL the regional CEOs, and community leaders favored David. All the regional CEOs and most community leaders as well as many physicians wrote letters of support. Why wasn’t David selected? Because Cecil and Owen said it was their decision and it did not matter what anyone else wanted. And they are still on the Board.

It has been suggested before to have someone on the Board who would represent regular staff and who would look out for the community not their own bank accounts. Want to guess why that did not fly? Brett would you be interested? At the very least 1/2 the Board need to be those who have the best interest of the patients and community as a priority.

Media Watcher October 4, 2013 - 9:35 am

” Paulus is just a pawn of Cecil and his objectives. When mission needs land it is from Cecil, when Paulus needed a home guess what it was from, Cecil.”

Paulus’s over-a-million-dollar home was indeed bought from Mr. Cecil’s Biltmore Farms. A good investigative reporter could trace the real estate transactions of Mission Health and see what the connection with the holdings of Mr. Cecil and his company. Ashvegas, are you the one to do it?

Who is the Board Chair? September 28, 2013 - 11:24 am

Who is the Board Chair at Mission? They should be protecting our community hospital. All this is very concerning. It is the only place we have to go for healthcare. Mission also employees a lot of people and we need jobs protected in Asheville for our economy. If these people are hurting our hospital something should be done. I heard a big group of people recently at a restaurant in Asheville talking about the same things. It must be pretty wide-spread knowledge.

Bystander September 28, 2013 - 6:49 am

Dr. Paulus and his internal marketing campaign have tried to convince us all in management not to be “bystanders” and not let people talk negative about Mission or administration. Well, I understand that, and under normal circumstances, that would be a good approach. However, when management is bad, and treat people badly, trying to convince others to not talk is only serving the ineptitude of leadership. That would not be good in this case for us at Mission. I am afraid that in current times at Mission, we have to speak up, and encourage others to as well. The bystander impact in this case is well served. In fact, if these current leaders are allowed to go much longer in power, and everyone is educated to stay quiet and support these bad leaders and their decision-making, then we will go the way of a lot of history- from businesses to entire countries that have followed poor leaders down a path to total destruction.

just a lowly RN September 28, 2013 - 1:19 pm

This is just craziness. The management at this place has really gone too far. Many “seasoned” RN’s are being fired for stupid things, and really it’s because of the amount they earn. The management really doesn’t care about patient safety anymore. “Do more with Less” is the logo now and really should read “kill more with less”. There was a day I was proud to work at Mission, now, well, I try to not say. Yes, we fear for our jobs daily because of management. More so, we fear for the safety of our patients. Management doesn’t share this fear at all. We voice our fears, but it doesn’t matter, it gets worse. We work 13 hour days, no bathroom breaks, no lunch breaks. We are given impossible assignments. We simply keep the patients alive. (most of the time).
This week I said goodbye to 2 more whom were “fired”. HR is a joke. They are there only for management.
I hate to say it, but a union is so badly need in this place

not as brave as Brett September 28, 2013 - 8:43 pm

How do we remove this inept leadership? How do we get the Board to act (it took way too long for them to finally act on Joe Damore. The last time many powerful physician practices united against Mission’s toxic leadership. I am not sure they can do that again in part because many of those powerful practices are now “owned” by Mission. A massive walk out by everyone but this “leadership team” would show who the real key personnel are but it would be the patients that would suffer through this. I also know that dedicated caregivers would not be able to turn their backs on their patients. So again it begs the question “how do we get Mission the type of leadership the community and the hospital need?”

Never Forget September 24, 2013 - 4:51 pm

Many true words posted here. This is not your average “be mean and spiteful because you can hide behind the veil of the internet.” Many of these people are afraid for very good reason.
People who speak the truth, question the waste, question where the money is going (much of it outside WNC)lose their job. It’s that simple.
Rather than investigate any claims of waste, corruption, or just plain ole ineptitude,leadership goes on a witchhunt to find out who is “not a team player.”
Dr. Paulus’s way of assuring people that his motives are pure is by telling the leadership team, “I wouldn’t have to work another day in my life if I did’t want to.” That would maybe mean something if money was his guiding light, but spend 5 minutes in a room with him and you’ll quickly discover that it is not $$ that drives this little man, it’s his enormous ego.
That’s what keeps him from getting rid of a key exec who has brought shame onto the management team. He doesn’t want to admit he made an error in judgment and so the whole commmunity must suffer.
I have read recently of Metropolitan New York Council on Jewish Poverty CEO who lost his job because there was waste and fraud on his watch. Would not be surprised if that story gets played out here in WNC.

Shame on the Management Team September 26, 2013 - 5:27 pm

Which exec are you referring to that has brought shame on the management team? It is hard fro me to choose just one. I could pick from several – Rowena, Dr. Paulus, Jill, Taylor, Dr. Maples, Kathy Guyette, Jon Yeatman just take your pick. They are all shameful representatives of our organization. It is shameful that they are allowed to continue treating people they way they do, continue making bad decisions for the organization, and in some cases not even sure what they do at all for the organization.

This is no secret to those of us in management that have to endure working with them on a regular basis. Dr.Paulus hired them all so he will not take responsibility for them and will not do anything about them. In fact, he endorses their bad decisions and praises them constantly- which none of us can understand.

By the way, more cuts on the way.

JanCardiology September 26, 2013 - 9:02 pm

I can tell you people are afraid, and rightfully so. I am afraid too.

Brett spoke up for a lot of us. I wish the physicians would speak up more publicly about it, as much as they do talk to us about it privately. I know they think Dr. Pawles is a phony, and they tell us he will not be around long because he is not from here. So they say stay quiet for now because they don’t want the heart program to get hurt. Well, we are all hurting right now already.

Never Forget (right on target) September 27, 2013 - 10:31 am

The President/CEO of Orlando Health was just forced to resign by the BOD for mismanagement and poor leadership like Dr. Paulus is showing.

Interesting that Orlando Health is more than double the size of Mission, yet the CEOs compensation is less than Paulus. Why is his salary, perks and bonus package so large when he’s stated more than once that he doesn’t need the money? Why wouldn’t he put it back into the caregivers paychecks, PTO freeze, retirement plan match…?

The caregivers are all afraid to speak up because of the reign of terror, and it’s up to the Board to take action.

Mission Needs Help September 24, 2013 - 12:45 pm

As a long term employee of Mission/St. Joseph I can tell you we are at rock bottom. My VP says she doesn’t want to talk about it with us because she doesn’t want to lose her job. We trust her, but we do not trust the people above her, and neither does she. She agrees it is real bad.

This is not related to the government changes, although those are disturbing too, but this is related to the administration of our hospital. Why does it have to be so hard to be nice and honest to employees. We are the ones doing the work for patients. It seems as if the administration thinks we are all stupid. Brett tried to voice his opinion and he got told to leave immediately. That is not right. They say they want our opinion, but they really do not.

I have seen a lot of changes through the years, and this I must say is the worst group of people I have seen running our hospital. I don’t think they care at all who we are or how we feel.

Good VP's Leaving October 9, 2013 - 7:09 am

A lot of us wish we had options to leave! It has to get better, because it sure feels like it can’t get any worse.

Media Watcher September 24, 2013 - 9:10 am

Have any others received telephone surveys asking extensive, probing questions about Mission Health? Who is behind the surveys?

Real Estate Watcher September 24, 2013 - 1:52 pm

Are they asking why Mission is buying all the real estate around town? A lot of us in town are talking about that. All of the sudden they seem to be buying everything around us. Not sure why or how they can afford it while they are talking about financial woes and government cutbacks.

I am in real estate and can tell you that the community is not growing fast enough to justify that kind of investment. Tells me something is wrong, and after reading more and listening to folks around town and friends at the hospital, I am concerned about what is happening up there.

Media Watcher October 7, 2013 - 6:47 pm

Real Estate Watcher, from your position in the business of real estate, can you tell us if any on the Mission board are benefiting from the real estate Mission is purchasing, as soon have alleged here?

Business Person Needed as CEO at Mission September 24, 2013 - 8:31 am

Mission needs a business-minded person running our hospital. The “experiment” of Ron Paulus -the doctor with no operations experience running a hospital needs to end! Just cause he is a physician does not mean he is a smart business person. Things have not gone well since he has been at Mission, and it is directly related to his leadership and lack of understanding the business.

We had businessmen running our hospital in the past, and like it or not, the results were better. Our hospital was never in this kind of financial crisis, and we have never spent this kind of money on land and buildings before, and I can’t understand why we need this many VP’s. We have done just fine in the past (actually better) without all these new VP’s. They are spending all our savings that smart people before have saved. Also, do we have a CFO at Mission Health? That might help!

MD Friends of Spillers September 24, 2013 - 1:23 pm

Bring back David Spillers. Hear he is doing excellent things at Huntsville Hospital as CEO. He is from here and knows the culture better than the current yahoos running the place. The physicians like him, he is a businessman (which I agree we need now), and he is good with employees.

The Board should have hired him a long time ago. He can fix it, but need to hurry up before it gets to be unfixable and we get sold to UNC or Carolinas. I have heard Paulus say that may need to happen anyway, but a lot of us disagree with him.
Not sure he (Paulus) has our (Mission Hospital and Physicians) best interest in mind. I do believe he will do what is the best interest of Ron Paulus.

In the meantime, we will keep on pedaling.

Intolerant MD September 24, 2013 - 4:35 pm

Why must we endure all this pain from these higher ups in administration. Just sell us out to UNC why don’t you, and take your golden parachutes and leave us please!

Now I am just a good old country doc, but seems to me the Board should learn that when you bring people in from Pennsylvania, Oregon, Michigan, and the likes, well those folks just aren’t our kind and just look at the mess we have now to clean up.

We don’t want to be Mayo, we want to be Mission, and that will work just fine for us!

Sad Times at Mission September 24, 2013 - 6:41 am

These are indeed sad times at Mission. I am not sure what has happened, but things are not good. I am constantly hearing negative talk about administration from my co-workers. I have tried to ignore it and just do my job, because I need a job. I cannot afford to lose my job. But I too am scared of the current environment and what they might do, especially to the long term employees now. May peace be with us all.

OrthoRN September 24, 2013 - 12:55 pm

What happened to Brett is sad!

The dictator said “he who speaks against me must go immediately!” Now HR VP, you go do your job and get him out of here.

Brett we will keep fighting for you and what is right for all of us. We will not stop Dr. Paulus. We are very disappointed to meet the real Dr. Paulus. Who are you really?

We will fight for our hospital!

whattabunchawhiners November 13, 2013 - 1:32 pm

Actually, I would think that he was fired because he sent a mass email and that is probably against some media use policy that he signed as an employee… that’s just my opinion and it doesn’t play into your conspiracy theories that are rampant on here so I am sure that it will be discounted so carry on.

Need A Meeting Place November 14, 2013 - 10:19 am

That really is the bottom line. What he said may very well be true, but HOW he said it was stupid, no matter how “brave”.

But this is typically Asheville, where public protest is like crack, they just gotta have it. “One, Two, Three, Four, We don’t wanna go to…work today!”

Mission Board Members - Action Needed! September 23, 2013 - 9:47 am

George Renfro, Jack Cecil, Bob Roberts when will you act? This administration has “highjacked” Mission Health, and we are being dragged down the river with them. Please look at the facts and take action. Don’t “buy” the acting from Ron Paulus anymore! Don’t let him keep deflecting the reasons for the financial downturn on the government. The government did not hire 25 new VP’s for the system in the past 3 years, and they have not been good hires!

It is going to only get worse!!! Please listen, and do something Board. It is your responsibility. Some of us are trying to give you clues, but it is too dangerous of an environment for us to speak to you directly. In fact, we have been told not to!

Why is the Board not acting? Is it because Mission is getting big loans these days from Bob Roberts bank? Is it because Mission is buying up all of Jack Cecil’s property? Is it because George Renfro went too far last time he was the Chairman?

Get Hezzy Miller back on the Board, he is not afraid to stand up to them!

We need you now! Please help us! It has never been this bad. Just ask the folks in the finance department, nursing, surgery, etc. Even the admin secretaries know it!

Also, We cannot afford $350M in new building right now! Stop it!

Too Much September 24, 2013 - 6:56 am

Ron Paulus makes 1 million dollars? Wow, now that is criminal.

So let me get this right, ‘Dr. Paulus” (who I understand never practiced medicine really) makes 1 million while he cuts the jobs of people making less than 40,000 dollars. Dr. Paulus makes 1 million while the hospitals financials continue to drop because of his leadership. As Bret said, That is corrupt!

Our CEO Is Not Being Truthful With Us September 24, 2013 - 5:34 pm

I heard that Dr. Paulus is not really “reducing” his salary at all as he told everyone. Instead, he is not “accepting” a bonus payout this year. The truth is that he would not have received that bonus anyway because we are not meeting our financial, quality, and other targets is what our VP said. So he is not giving up anything. Just another non-truthful statement to try to make us feel like he is dong something for us or sharing our pain. He is not sharing our pain. He should really reduce his million dollar salary and give it to folks that need it (the caregivers) and not cut our staffing anymore. Why should he make that kind of money here if we are not doing very well and some of our friends are getting laid off or not getting their hours?

Oh Boy September 24, 2013 - 8:54 am

I get the feeling we are about to have another emergency called management team meeting where Dr. “Payless” is going to tell us how we are supposed to act!

I am sure it will come with tears too, oh and maybe if we are really lucky, we can hear about how he went for years without milk and bread to eat again. He knows how to pull at the heartstrings – oops or is it deflecting?

Time for More Training September 24, 2013 - 1:05 pm

Oh yeh, you can bet we will have another management team meeting after all of this. There may not be a place big enough to hold us all.

Anyone wanna guess at the next slogan or the next management training session?
Pull the Rope
Hold on Tightly
I Got This
No Worries, Be Happy
Just Beat them down until they stop talking
They will Never Understand, so Just Proceed as Ordered
CEO says – You Must Obey – someone said that earlier

Let’s take a vote!

not as brave as Brett September 24, 2013 - 9:28 pm

Really?! Dr. Paulus tells sob stories – that is not leadership. Joe Damore used threats and fear tactics; not leadership either. Bob Burgin we need you to come back as interim CEO. Mission (the community and patients) need you to demonstrate leadership.

Not as Brave as Brett September 26, 2013 - 11:37 am

Don’t look for help from Cecil and Renfro – they, along with Charlie Owen are the reason Mission was almost destroyed by Joe Damore – they forced him in without any kind of due diligence for their own gain.

Paulus Must Go September 20, 2013 - 10:18 pm

Ron Paulus Must Go!

He is a fraud. He is an actor. Ask the Directors and VP’s- they know. We have had enough of his fake crying episodes in management meetings. Get real! The community is the one crying because you have destroyed our hospital. You have no idea what you are doing. You have no clue how to manage the finances of an organization.. You only know how to spend money and talk about quality. Well, quality was good before you got here, and financials were much better! You are a complete fraud. Please leave and take your 30 new bad VP hires with you!

Give us back our hospital! Don’t fall for his act anymore!!!!

JY September 20, 2013 - 5:17 pm

Jon (no “h”) Yeatman here.

I was born at mission hospital (memorial mission actually). My wife, children, sister, niece, nephew, father, and step family all still live here (my mother has moved to Greenville, SC).

I am also just barely over six feet three inches.

So, I am sorry to tell you that I qualify as neither “northern” or “little.”

I can’t speak to your other points since they are your opinions. Nevertheless, I hope you feel good about yourself for having made them here, in this way. My phone number and email are both on the mission intranet…which you will know as an employee of 10 years. You can call or email any time you’d like to talk.

Exec Anonymous - Because we have to September 23, 2013 - 9:31 am

Jon- you have no idea what people think of you, and it is your arrogance that is in you way! Once Ron leaves, and he will, you will be gone immediately because no one wants you around. John, you are duplicating costs all over this hospital, wanting to build a kingdom for yourself. It is a joke and everyone knows it. You do not know how to manage people, and we cannot afford you. You bring zero value!

This will all cost Ron his job and more importantly to Ron his reputation in time!

Facts: Since Ron, Jill, Rowena, and you have arrived include:
1. Worst financials in history of MIssion
2 Worst employee engagement scores, especially in nursing
3. The largest increase in cost, and number of VP’s hired ever in a 2 year period
4. Worst executive environment/relationships ever.. everybody is scared, paralyzed, threatened, and hoping to ride it out until Ron and others named above leave.
5. The most self-promotion (Ron, Jon, Jill, Maples, Rowena) we have ever witnessed.
6. The most internal investigations of an exec (Rowena, Ron) we have ever seen. Understand Ron was brought the findings of the internal investigation of Rowena and refused to look at them. Wow- now that is leadership.
7. First times in a while the organization did not hit its goals consistently.
8. Board asked to not be so involved as they have in the past- and they took the bait. So we have a Board that is uninformed now!

Now that is leadership. That is why you and others need to leave town. You will have to find another place to learn and experiment – not at Mission, not for long.

Oh, and yes, I am an exec team member, and yes, I know I am sending this anonymously, and frankly it is because we have shared these thoughts with others in the past and nothing happens! Secondly, the environment has become threatening, and not an environment condusive to straight talk or reality. It is either “drink the cool-aid or leave” and I do not wish to do either!

It is sad, but true! I am afraid all this will get worse before it gets better. I know we are talking about another round of layoffs, and it will need to happen. A lot more will need to happen. Hopefully the Board will get back in the game!

Marketing Dept in Disarray! September 23, 2013 - 6:21 pm

What is going on at Mission? The marketing department has had complete turnover of staff 3 times in 3 years. We have lost a lot of good long term people. These new hires around here are scary!

Staff morale is at an all time low throughout the entire hospital! It is ashame! We have lost everyone that really cared about people, we have lost good administrators and replaced them with bad ones. We have no one who understands business around here anymore.

It is sad, very sad. I think they know they are the only option in ton for many of us, so they just treat us like crap. the new VP of human Resources is a joke. She doesn’t care about any of the staff, she only follows Ron’s orders, as he hides behind everyone. I agree with the people who are saying he is a fraud. Maybe I can wait them out, but it is not fun to work there. Hopefully I will not be one that has to “re-apply for my job” because I make too much or to make room for another VP!

Cut Execs, not staff! September 23, 2013 - 6:28 pm

I understand cutting costs is necessary in healthcare these days, however, this Mission administration – “the executive team they like to be called” has grown so much that we are having to pay for their fat salaries by cutting clinical and non-clinical staff. We do not need all these execs. We actually performed better when we had fewer execs than we do now. Now that speaks volumes!

Dr. Maples is also one scary man. He has never seen a cost he did not want to increase, and if you ever cross him, you will put on his list! He has a real problem with women! Trust me, I have seen it and witnessed it firsthand!

Consider Unionizing September 24, 2013 - 7:19 am

I came from a unionized hospital up north, and it did help employees. We had a similar environment at my former hospital one time – administration scare tactics, high exec salaries, and bad upper management decisions.

We unionized and it got better. We were protected, and we had a voice! Actually new management was asked to come in then and it did get better. I have only been an employee at Mission fro 2 years, but it is similar to what we had at my previous employer before we unionized. I don’t even know who these administrators are, but the environment is not good here. I know a lot of folks are talking about leaving to seek other options. Some have said that Park Ridge is a nice environment with caring administrators. I don’t know I have not been there, but may need to try it.

yankeetransplant October 8, 2013 - 9:27 pm

Having come from up north almost 28 years ago from a union hospital, I can say it would be so much better if Mission would unionize. I say Brett should get the ball rolling on that one! Its called having protection and representation against this nonsense. Just the fact that we have to pay so much for our insurance and then the copays and deductibles are horrible, out of pocket expenses etc is enough to want to unionize. Not to mention the other crap that goes on up there. It has been needed ever since I started at MMH in 1985 and it is getting worse. Unionize people!

Charles Evans September 20, 2013 - 10:04 am

The Plain Truth

As an employee of 10 years now I can tell you this is the most dysfunctional leadership team I have ever worked for at Mission. The letter Brett wrote is only the tip of the iceberg! Dr. Paulus is a salesman and a fraud. He is taking us to financial ruin and then he will leave for greener pastures, and blame it on something other than himself! He is constantly marketing himself and it is disgusting. He has hired 24 new VP’s in 2 years – nobody in the country is doing that! He has no experience as a CEO and it shows! The Board has been duped! Oh and I found out that this so-called “taking a 26% reduction in salary” is not true, in fact he is not “receiving” his bonus this year, which he would not have anyway because Mission did not meet any of its goals. So he is not really giving back anything. Another example of his great “salesmanship”. Well not all of us are stupid Mr. Paulus. Take yourself back to the north and take your little northern buddy John Yeatman with you- he is absolutely useless and arrogant!

Jill, or COO, is a fake, phony, unorganized, and a poor fiscal administrator. She only knows how to build buildings. Ron has had to remove her from some operations because she is not good at it. No one respects her. Facts are facts, and since she has been there, the financials have been worse every year and going down faster every day! The paper should investigate that. This is an important community asset that is being destroyed by outsiders who will leave soon!

A handful of other real jokes – Kathy Guyette (what does she do these days? oh yeh, I know, she cuddles up to Ron.. guess that has worked for her. She sure has not done anything with nursing!

Where is the Board? There heads are buried!!!!

Brett continue to lead on!

Right ON Target/Where is the Board? September 21, 2013 - 6:22 am

This person knows what he us talking about. Ron Paulus, Jill Green, Rowena Timms, Kathy Guyette, John Yeatman, and Dr. Maples. This is the bunch of crazies that the Board has allowed to highjack the hospital. They are big spenders, have no fiscal constraint, are big talkers with no results, and all are outsiders. Just look at the financial results of the hospital sincethey arrived- straight down every year, and now we are at crisis levels! This was not the case in the previous 10 years before they got there!!!!! Alos, look at employee satisfaction since they arrived- worst in the history of Mission now!!!!
They have hired an army of VP’s- Can’t believe the Board has allowed this spending. I thought they were there to protect our hospital.

These are all facts. Just ask forthe information and you will see the disturbing trends. Dont let Paulus “sell” you on its the Fed governments fault. It is his fault. The Federal Govt didnt hire all these people at Mission!

Ron Paulus is the worst administrator in the country, but he is the biggest promoter of himself. Management was asked to vote for him as a top administrator in the country – what a joke. Just another part of the marketing plan of deception!

Board of Trustees- where are you now?????

Big Al September 22, 2013 - 10:33 am

“…but he is the biggest promoter of himself.”

This is very true. Joe Demore was no better, trying to hide his pasty, unhealthy appearance with quaint Walt Disney quotes.

Having said this, does it make sense for any Mission employee to fall on their sword and lose their job in a vain attempt to get rid of an incompetent CEO? Just wait em’ out. A failing system cannot and will not retain failing leadership forever.

THIS is the forum Brett should have chosen to vent his spleen, not interdepartmental email.

not as brave as Brett September 19, 2013 - 9:17 pm

All of this with Mission is heartrending. It began with the Board not selecting the best CEO, the candidate the physicians, all regional CEOs wanted, the STAFF and most of the community leaders, David Spillers. Instead Joe Damore was hired because he had an insurance plan that could line some prominent pockets. Those of us who watched that fiasco are still trying to recover from the loss of talented staff while Mission and more importantly the community (our families,friends and neighbors) are impacted by the the demise of this once caring medical facility. I use to be proud to say I work at Mission, not now’ though There are still many reasons to be proud of the clinicians and other support staff.

Can anyone tell me why there are over 40 VPs and Senior Leaders when clinicians are being let go? I had hopes when they hired Paulus-not so now. Back to David (sorry for those of you who did not know Mission under the leadership of Bob Burgin and David
Spillers). Currently David is running a 900 bed hospital with as many affiliations and
complexities as Mission with 19 (not 40+) administrators. Why the difference in leadership? Are Mission leaders so inept it takes two of them to do what it only takes one to do at other comparable hospitals?

There are other atrocities occurring at Mission things like staff with excellent records and years of experience being told they have to reapply for their positions “and by the way, Mission will also be accepting applicants for the position from outside the organization.” Experience is once again being sacrificed to hire the less experienced.

By the way it eventually came out that due diligence was an issue with Joe Damore’s hire – in other words, his references were NEVER checked. Again due to the self interests of a couple of prominent Mission Board members. Their greed nearly destroyed OUR hospital – is it going to still happen?

Brett, I applaud you.

You should be as brave as Brett September 24, 2013 - 5:58 pm

I have worked in the pharmacy and in surgery for over 15 years and will say we need more people like Brett. I am now getting worried because I guess I will start being considered “long term” employee.

You are right about people having to re-apply for positions, and you are right about way too many administrators around here now. I don’t even know what most of them do, and certainly would not recognize most of them.

Are you saying they didn’t do due diligence when they hired Dr. Paulus similarly in how they didn’t for Joe Damore? How can this keep happening? Someone said I think that Dr. Paulus never was a CEO of a hospital before he came to Mission. We are too big of a place for someone to learn on the job and not have that CEO experience in that position.

Not as Brave as Brett September 26, 2013 - 10:32 am

Dear You Should Be as Brave as Brett

I will hope that you are not asked to re-apply for your position- Mission needs all the experience it can get right now.

I apologize if it was implied that the Board did not due their due diligence on Dr. Paulus – I only know for a fact it was NOT done on Joe Damore. It is true; however, that Dr. Paulus was never a CEO and never practiced medicine.

I also agree with you that Mission is complex and needs experience AND as someone else said, we also need people who are familiar with the culture of the community and the surrounding area. Current leadership does not get that at ALL. It does not necessarily need to be someone “from” WNC – just someone respectful of the area and its rich history. David Spillers was not “from” Alabama nor was he “from NC”, but he is doing a tremendous job at Huntsville because he listens and learns before he makes changes – he is respectful of physicians, staff and culture; just as he was during his 18 year tenure with Mission. I wish he would come back, but he won’t because as he said when asked before, the Huntsville Community has been kind to us and they have a lot of faith in me (unlike the previous Board who did not allow him to be Mission CEO but chose Joe), to leave them now would be poor re-payment of their faith. Honor, integrity and respect – David has always had it and always will.

I should be as brave... September 28, 2013 - 10:24 am

thank you ‘Not as Brave’

I have worked at Mission for over 25 years and agree with your summary.

What I hate is that is there is little respect for the excellence that has been Mission Hospital. Joe Damore dismantled as much as he could and Paulus is on his way to finishing the job.

I understand that there are significant challenges ahead for all healthcare systems. Hard decisions will need to be made. Unfortunately, many of the present administrators are disrespectful of what is working well. They want to reinvent the wheel (thus the many employees being asked to ‘reapply’) rather than tweak.

Paulus and Jill Hoggard-Green say they want to set up Mission so that it’s ready for the Accountable Care Organization model of healthcare. Perhaps. It’s looking to me like they want to control everything and are using ACOs as an excuse. Time will tell if this is the right gamble.

In the meantime, has anyone checked to see if Mission board members are personally benefitting from the no holds bar expansion program? For example, have any MH board members sold property to the hospital?

Little Bird October 7, 2013 - 5:06 pm

Sadly, so sadly, you are right. My question is, does Brett still have a job, because Mission says they don’t have a policy of retaliation, but don’t you believe it for a second.

Another former employee September 14, 2013 - 8:32 am

My impression when I worked at Mission was that Ron Paulus chooses to lead with mottoes and snappy phrases. During a “town hall meeting” we were told that there is such a thing as a free lunch: Just work harder with less and the result will continue to be high patient care at less cost. What he seemed to overlook was, while the monetary savings may be there, there was a cost in employee morale.

Nurses are being asked to assume the duties of nurses’ aids at the expense of patient care. Managers who care about employee welfare are being replaced by sycophants. Money is being spent on hardware and not on the direct, hands-on care.

Patients want a positive outcome for their physical problems, but human interaction is an important component of healthcare. If staff is unable to devote as much time as is needed to treat the whole person, then Mission is neglecting its duty.

I understand that with so many thousand employees it is impossible for management to know everyone, but it should be important to do more than just nod in passing in the corridor. The town hall meetings I attended were too large and time-constrained for us to convey our real concerns.

Over It September 13, 2013 - 2:00 pm

As a Mission nurse, I have to publicly agree with my new hero Brett Robertson. Things are worse for staff under Dr. Paulus than I’ve ever seen, and he’s the 4th administrator I’ve worked under, so I speak from a long perspective. When he was only on board for a couple of months, Dr. Paulus spoke to us about how ‘we’ in this community felt about the future of health care, without any interest in what the culture of this region was, or how “outsiders” needed to prove themselves here before they’d gain respect. I knew at that moment this was an insincere, ambitious man, snd that we were in trouble. He proceeded, arrogantly, to impose his view of what was “best” for the patients of the region, pissing off nearly everyone in WNC with his expansionist policies. In collusion with the board of directors, he continues to mask the profit margin imposed by the COPA by acquiring useless expensive real estate under the guise of necessary capital expenditures.

Dr. Paulus sends out endless whiny emails to staff directing us to write to Raleigh as individuals in support of his agenda. Dissent is not tolerated, or is dismissed as unprofessional and destructive to the hospital administration’s omnipotent goals. He’s even told the nurses that they’re whiny. If you really want to piss off overworked, underpaid, secretion-covered nurses, tell them they are whiny. At one point, we were even supposed to vote for him in some “best administrator” national contest – seriously? I know several people who specifically went online to vote for an unknown nominee just to vote against him.

Dr.Paulus came to us from an excellent hospital system and he is trying to impose its model onto our region, but it’s not a good fit for this community. He doesn’t seem to realize that. He’s in trouble, with deserved resistance from many quarters. I think he may be surprised by the blow-back he’s getting and is clueless about why his arrogance is resented. I don’t think he even sees himself as arrogant. Now it feels like he is falling back to a position that many paternalistic doctors have done over the years – he’s blaming the nurses, as well as other staff he sees as too juvenile to understand the big picture.

So what will happen now as a result of Brett’s public stand is that some other PR nonsense will be generated and staff will have to sit through perky HR people talking about how to portray the positives of Mission at every opportunity. Pleae don’t criticize Brett for speaking out – no one is listening when we do it internally. This sort of thing shakes Mission administration to its core. They HATE this sort of publicity. Brett speaks the truth about who built Mission’s quality, and I’ve already seen it start to deteriorate at a bedside level. Their patient satisfaction rates will slowly go down as good, passionate staff like Brett say “enough” and leave.

If Dr. Paulus was smart, he would ask Brett to stay and serve as a staff rep on the Board of Directors. Brett would likely enhance his perspective on the problems that the board and CEO deal with, but would also be a voice for the passive-agressive among us (and I include myself here) who complain from a place of perceived powerlessness. Passionate nurses like Brett force change when an institution becomes mired in self-defeating whack-a-mole patterns. If Mission were to value someone with Brett’s passion, it would really be a kickin’ organic and vital place to work.

Ashley September 12, 2013 - 10:26 pm

Brett, you are brave, intelligent, and you have a great sense of humor. I hope the next corporation you work for appreciates you. I have seen several years of zero raises and reduced benefits. There are many people employed at Mission who struggle to just get their heating bill paid, and their car full of gas. It makes me sad that Paulos had to take a 26% cut from his million dollar a year paycheck. Perhaps the collection jars placed around the hospital will help him buy clothes for his children.

BallsyRn September 12, 2013 - 3:12 pm

Brett I salute thee for standing up for us! I need to let you know that what goes around comes around. Your skills will absolutely land you a better job—not in a nursing home either. Like it or not Mission , our good reputation is not because of YOU It is because of stellar seasoned docs, nurses and techs. Your good ones are tired of being treated like crap. The sad state of affairs is you will fail as an institution not because of your stellar employees but because you are greedy. You are doomed to fail. Enjoy your cocktail parties and trips while you can…afterall you’ve outgrown your britches. You are no better than the goodwills of the world and all those other so called not for profit places that devote 10 cents out of a dollar which actually goes to the cause and 80 cents goes to upper management salaries for “overhead”

former employee September 11, 2013 - 9:30 pm

Way to go Brett. This is the reason I left. Mission cares nothing about its employees, only the name and status. Sorry to hear a fine nurse has had to leave. Think of what it is going to cost to retrain someone to replace him. As far as outsourcing goes, they will soon find out what it is like to not have any RN’s to fill positions. Then where will you be Mr. Powlus…

Brett is awesome September 9, 2013 - 9:55 pm

I know Brett personally and he is AWESOME! Just someone that was NOT a coward and voiced his opinion! He did not recall his message! The mERIT values are often not upheld by leadership, so much for leading by example!! I give MAJOR props to Brett for voicing
His opinion. Maybe more people should and it would make a
Difference! Way to go BRETT!!!!

standinginthesidelines September 11, 2013 - 12:11 am

Thank you for standing up for him!!! I salute you! He was actually cutting Mission & their board a LOT of slack, I thought! What he said was true, true, true!! AND THEN SOME! I don’t work there, but am VERY closely related to someone who does, and he’s been getting the shaft…for YEARS now! All while Mission tells lies & has lied to all the employees who DID/DO make the hospital what it is! NOT THE BOARD who make all the money, benefits, etc… The ones who make the difference in how the PATIENTS lives!!! I say BRAVO Brett, I thought you were VERY politically correct & stopped short of being rude… Not that he deserved how polite you were!

hauntedheadnc September 9, 2013 - 8:15 pm

Mission is no different from any other major employer in this city, demanding salt mine work for burger-flipper wages. The ugly truth is that you will make more money doing the same work in most any nearby city like Greenville, and pay less for housing while doing so. Mission uses Asheville’s beauty as an excuse to abuse its workers just like all the rest of them. Asheville: low wages, high prices, harder work — always and forever.

mission ceo September 9, 2013 - 7:54 pm

U must obey!

innocent bystander September 9, 2013 - 6:59 pm

as a teenager and growing want a bee medical professional~ i agree with someone with so muchballs!! its time to take our rights back and voice our opinions/which by the way most of us “thought” but would not ever–rock the boat mentality– put into words. FEAR is a powerful thing!!! we are labeled as mental for having and veiwing our ” crazy ideation ” just as the suits want us to be…….. thanks brett… i second guess my choice to go into the medical profession. lolo

confused September 9, 2013 - 2:14 pm

Proud RN–please explain how sending an inhouse email is COWARDLY? Mr Robertson raises valid questions…why cuts when Mission is spending millions of property and continues to build, build, build?
I also find your mental illness suggestion a bit strange since it would seem to this reader that you have never met Mr Robertson…really suggestion of treatment before an exam? ODD…

Big Al September 7, 2013 - 8:42 am

Mr. Robertson’s choice of venting his spleen was inappropriate, not to mention stupid. Mission has a set of values known as MERIT (Mercy, Excellence, Respect, Integrity, Trust/Teamwork) of which all employees sign a statement of understanding to be held accountable for upholding. Clearly an angry email riddled with sarcasm an thinly veiled insults does not uphold the values of Excellence, Respect or Teamwork.

If not for the seriousness of the issues discussed, it would be hilarious that Mr. Robertson chose to distribute this message to all Mission employees through their email system with his name attached, only to recall it, a process which does not remove the message or the identifier. The cat is out of the bag and there is no turning back. If Mr. Robertson was not already on a layoff list before, he probably is now. Doom On You, Brett!

Not So Fast September 9, 2013 - 4:25 pm

Big Al,

Brett did not recall the message, Mission’s IT department did.

So employees are expected to uphold the MERIT values even when senior leadership does not? Sounds like the bystander effect to me, which is something Paulus is working so hard to fight.

Paulus should give Brett a medal for standing up to the 500 lb gorilla that is Mission.

Big Al September 9, 2013 - 5:01 pm

Yeah, keep holding your breath. Management really gets off on being insulted.

There are smarter ways to protest unfairness than bashing your boss in public, but if you think expressing your opinion is worth losing your job, then go for it. There are plenty of folks out there that are smarter than you just waiting to fill it.

RealDeal September 9, 2013 - 4:36 pm

You sir, are an idiot.

Obviously this cost “throat cutting” did not affect you or your wallet.

Many people were thinking the same words, he was just the only one with the balls to say it. Your idea that Brett retracted his letter on his own free will is “laughable”. Do you really think that administration didn’t force or make a deal with him, in order to have him take it down? They were just back pedaling. He was already on his way out, why not make a point that the “suits” are trying to sweep under the rug.

Big Al September 9, 2013 - 4:56 pm

WHAT he said is not in contention. HOW he said it, distribution through mass-email, is the issue, and there is no doubt that, courageous or not, he was just plain stupid. Unless he MEANT to lose his job anyway, (he did resign the next day, according to Mission scuttlebutt) in which case “You who must die today, I salute you!” I hope his big balls are warm and fuzzy in their new job at a nursing home.

Over It October 1, 2013 - 11:38 pm

Big Al, Do you hold those who care for elders in nursing homes in contempt? I wish I knew who you were so I could remind you one day in the future as I was feeding you pureed food in long-term care, just how lucky you are to have someone change your diapers who doesn’t have such contempt for other human beings. Shame on you for insulting those who care for the old and infirm. Shame on you.

Big Al October 3, 2013 - 2:30 pm

Not contempt, but the pay is clearly lower, as is the opportunity to advance. I worked in nursing homes, and while I respect the staff for what they do, the environment, pay and opportunities are far inferior to what is available in a the surgical service of a large regional hospital. And to lose such a job cuz you couldn’t keep yer trap shut (or at least pick a less public forum is just tragic. And a little funny.

Proud RN September 6, 2013 - 9:55 pm

As a RN with 33 years of experience, I strongly disagree with this disgruntled nurse’s methodology and overall comments. I personally believe that all healthcare systems are trying to strategically place their systems into a very competitive field in order to survive in the new US health care model. Other US and NC hospitals have laided off much larger numbers of employees. No system can survive without significant changes. You took a pathway of bringing forth your concerns, however valid, in the most unprofessional manner which was very cowardly. As I began to read your note, your words were full of spite along with malicious intent. Shame on you! The only rationale reason is mental illness. Good luck finding treatment, even though you need it. I quickly hit the delete button because you do not represent the any of my colleagues within Mission’s team.

BabyRN September 7, 2013 - 8:58 am

I have been an RN at Mission for 15 years. I believe Mr. Robertson’s remarks represents the sentiments of many of my colleagues in the Women’s and Children’s service areas.

Nate September 8, 2013 - 9:11 am

You have a strange definition of cowardly … he clearly stated his contrary opinion and signed his name to it. You may think his opinions are *wrong*, but if you think the way he presented them was cowardly, you are simply mistaken. And it’s just sad that your sensibilities are so delicate that you can’t even read an opinion different from your own without shutting down.

BallsyRn September 12, 2013 - 2:03 pm

Roger that bro!

JPStineman September 8, 2013 - 4:43 pm

He is right and you know it. Mission is greedy. There is a deficiency in its’ treatment of employees despite having a reputation for medical proficiency. Are you a bedside RN or in management?

RealDeal September 9, 2013 - 4:48 pm

You are obviously a payed employee at missions health system. You are probably a member of human resources, trying to deflect the real issues that he brought up.

“Mentally Ill?” You think that is the answer? You are “Delusional,” there is nothing wrong with him, besides the fact that he cares about rational equality for his coworkers. There are many rational cost saving techniques that could be implemented, they should just pull ideas from the workers, not the hundreds of expensive committees.

TiredofMission October 12, 2013 - 11:31 am

You are probably someone planted to deflect people speaking out. Mission is a monopoly. They treat employees and doctors poorly and you know it. When you are the only game in town you can do what you want and justify it with all sorts of statistics. Look at who is on the Mission board and who is profiting from the purchase of all this property especially in Biltmore and Arden. Property that once belonged to the Biltmore Estate. The problem goes higher than just the Paulus. Don’t get me wrong he is still large part of the problem. People need to look at all the top people and how they are profiting on the backs of hard working nurses and doctors.

Southern September 6, 2013 - 9:03 pm

If you don’t like your job then quit. This town is full of the biggest bunch of cry babies, fact lacking morons. Maybe he has been using the lube too much for him self. Go somewhere else and see if its better. If mission doesn’t control this area, another large out of area medical system will. Take your pick.

Giatros Theopolis September 11, 2013 - 12:09 pm

Or, they could unionize. It’s not like they can outsource an RN. Other cities also have more than one hospital to work at. As a result when people quit mission they have to move away. So when You get sick or hurt, realize that it is the one’s left behind after the talent and experience are gone who will be treating you.

hauntedheadnc September 11, 2013 - 6:15 pm

That’s insulting. Just because they can navigate Mission’s yes-man bullshit, that does not mean the nurses who have held on to their jobs there are the dregs.

nativeson September 11, 2013 - 9:35 pm

Because of morons like you who lay down and let the big wheel run over you because of your weakness is why many of our institutions and government are bankrupt. Brett is merely expressing his opinion just as you are. However his speaks of the obvious (corporate coruption and big spending) while yours is of total disregard of those who actually finance this corporate crap! The consumer. So maybe you should go find some place where spineless morons like you are more than welcome. I’ll buy your ticket!

BallsyRn September 12, 2013 - 1:58 pm

Brett standing up for us all does not denote a cry baby mr or ms upper management! At least he stands with us including at least two thrids of the mission populace

Santa September 6, 2013 - 12:20 pm

Brett Robertson has balls of steel! That is an excellent response to the ridiculous situation developing at Mission.

Nancy Robinson September 6, 2013 - 11:07 am

Bravo!! I am not a Mission employee but I was thinking the same things Mr. Robertson pointed out. The Mission machine is buying up million dollar properties all over the county to put in non essential offices. Parking lots are practically empty at some of these offices. They didn’t like Park Ridge building near Biltmore Park so they just had to buy more property and build something to compete with Park Ridge. They put up billboards everywhere, television commercials, ads in newspapers in every surrounding county. Do you know how much advertising costs? We are talking hundreds of thousands of dollars advertising budget. They could do away with a few billboards and save some jobs. Forego buying another million dollar property so they don’t have to lower wages. They will blame it on Healthcare reform but it looks to me like they need to blame it on management. Why do they need to keep expanding in all the other counties but cut pay for those close to home? If I were an employee at Mission I would be outraged.

Murphy September 6, 2013 - 4:20 pm

“They” did not blame it on healthcare reform … “they” blamed it on the refusal by the Guv’ner to accept Federal monies to expand Medicaid … as well as the reduced reimbursement from current Medicaid payouts …

Proud RN September 6, 2013 - 10:18 pm

And your point is??

Excuses September 23, 2013 - 6:38 pm

Dont believe all their excuses. What other health system in the US is adding 25 VP’s and building a $350 million hospital in this economy? It is Mission under Paulus and Jill H Green leadership. That is the reason the ship is sinking. You can bet there are more announced job cuts to come, but it will not be from the executive group. It will be from us the staff.

I know my department manager has suggested we all send emails and submit info to ashvegas and the newspaper. We are doing anything we can to hopefully get someone to listen to us. It is scary what is happening here. I respect my manager for being honest with us, although I know she puts her job in jeopardy by talking to us about it. She also said her VP agrees but she cannot do anything about it either..

Thank you Ashvegas for giving us a forum to talk and inform people to be careful around here. Our cardiologists are great and our CV surgeons are great. They don’t like this administration either, and they say just wait them out! Hopefully we all can.

Professional September 28, 2013 - 10:38 pm

You asked where else, look over at Huntsville Hospital in Huntsville AL

Not as Brave as Brett October 3, 2013 - 11:28 am

Dear Professional,

If I understand correctly, you indicate that Huntsville has hired an additional 25 members to their leadership team – not so. All you need to do is “google” Huntsville Hospital Leadership Team and you will see that their TOTAL number of leadership at 18 – Again 18 – not 40+.

Yes, they are experiencing some of the same issues that hospitals throughout the nation are trying to deal with, but they are NOT cutting jobs, and they are freezing ALL salaries. They are also reducing PTO (ETO) and the hospital’s match to the profit sharing plan. In speaking with some folks at Huntsville, this is being handled as compassionately as possible. Don’t think Ron Paulus and his cohorts compare favorably to David Spillers and his team comprised of Jeff Samz and Lonnie Younger (all former Mission VPs before Joe Damore)

Lexingtonian September 6, 2013 - 10:35 am

This is why medicine needs to be not for profit.

Imagine…making money off someone’s suffering!

weavervilleman September 6, 2013 - 5:24 pm

actually Mission Health is a NON-Profit organization

Persephone September 6, 2013 - 9:36 pm

Mission is a not-for-profit hospital.

Icenine September 7, 2013 - 6:38 pm

Not for profit….with a CEO making $1,000,000 per year. BullS**T.

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