At its meeting earlier this month, the Pender County Board of Commissioners shot down a proposal for a consultant to help guide officials to select a health care provider for the Novant Health Pender Medical Center. 

The county-owned facility (formerly called Pender Memorial Hospital) in Burgaw is currently operated by Novant Health, which took over operations following its February 2021 purchase of New Hanover Regional Medical Center -- also previously a locally owned system.

In recent years, Pender County commissioners have considered the possibility of shopping for a new health care provider – even before Novant entered the scene. The county’s 20-year operating agreement with NHRMC was set to expire in 2019, and commissioners have twice since extended the agreement, most recently doing so last year amid the major transaction. 

The $1 annual lease agreement will expire in July 2023. 

Novant Health New Hanover Regional Medical Center has invested more than $20 million in facilities and service upgrades at Pender Medical Center over a 23-year period, according to a Novant spokesperson.

This summer, the county issued a request for qualifications for a consultant to help guide officials through a request for proposals process to operate the 86-bed facility. “Such providers as Novant, Atrium Health, UNC Health, Duke Health, Vidant Health, WakeMed, Cone Health … among others, may be interested parties in the RFP,” the county’s RFQ document states. 

Just one firm responded to the RFQ, and multiple commissioners took issue with the potential price tag. 

On Sept. 6, commissioners voted 3-2 to decline to award a contract to Juniper Advisory, with Commissioners David Piepmeyer and Jackie Newton voting in favor. 

Commissioner Jimmy Tate (who recently replaced David Williams, a former commissioner with extensive health care leadership experience who resigned due to family reasons), said he’d rather rely on in-house resources than pay an out-of-town firm. “This cost could go up to $850,000,” he said at the Sept. 6 meeting. “Why can’t we use our talent that we have rather than paying an outside entity?”

In recent months, Novant Health representatives have engaged in a series of individual conversations with Pender County officials to present the system’s plan for the Burgaw facility. A Novant spokesperson confirmed staff has discussed with Pender County leaders “long-term future options for health care, including our recommended alternative to an operating agreement.”

The details of what Novant presented are intended to be confidential for competitive reasons, a spokesperson said. 

The recent conversations did not impress a majority of the board, Piepmeyer said at the meeting. “We were not pleased with what was presented,” he said. 

“Novant Health is currently considering how best to support the expansion of health care facilities and services in Pender County,” a spokesperson wrote in an email last week. “Any expansion would bring more jobs and positive economic impact for the county. Novant Health remains committed to Pender Medical Center team members and patients and ​will care for the community in the years to come.”

Piepmeyer said a consultant could help take the pressure off of county officials as they attempt to navigate the major decision ahead. The Burgaw facility could serve Duplin, Bladen, Sampson and Onslow counties, he said at the Sept. 6 meeting. “We have multiple places citizens may travel and utilize our new health care services … I feel we have the obligation to pursue somebody to help us through this.”

Newton also advocated for utilizing the consultant. “I think that we have a fiduciary obligation to determine the best health care scenario for our citizens rather than simply be passive in the process,” she said at the meeting. 

In an interview last week, Commissioner George Brown, who voted to decline the consultant's proposal, said his preference has always been to remain with the local provider. “My feeling all along has been … our best option is to work with Novant,” he said. “I'm not saying that Novant doesn't have its problems or issues, just like every other organization out there.” 

Novant officials presented a “fair” offer, Brown said, offering a good basis to begin further negotiations. “I got the sense that they were willing to work with us,” he said. “It gave us a basis to start from.”

Brown said he would prefer not to explore an RFP process or engage with an expensive consultant, but added, “I'm disappointed, for the group that wanted to go out and shop, that they didn't have more response.”

“I think we have an opportunity here that we could benefit from if we'd just take it,” Brown said. 

County manager David Andrews, who began the role earlier this month, said at this point, staff and the board are continuing to explore what options the county has. He said he anticipates more discussions with hospital officials in the next month or two. “Novant has expressed an interest in expanding their services in Pender County so I’m sure we’ll be having more conversations,” he said. 

The board did not take any action related to the issue at its meeting Monday. A move forward could come next month, Andrews said.

Issuing a second RFQ to attract other consultants’ bids is a possible option, but Andrews said that prospect could be premature. With 10 months until the lease ends, Andrews said, “We do realize there's a time consideration.”

“All options," he said, "are on the table."