The Haywood Regional Medical Center governing board met Tuesday evening to hear an update on MedWest from John Young, vice president for the western division of Carolinas HealthCare System and interim CEO of Medwest-Haywood.

Young started off by giving the board an overview on why the MedWest system was created in the first place, a system that affiliated HRMC with WestCare facilities in Jackson and Swain counties under the management of Carolinas Healthcare System.

He listed maintaining local control, recognizing competition from Mission for primary and secondary care patients, increasing primary and secondary care patients, increasing efficiency, retaining some level of semi-terchiary services, assuring a stable and quality safety net and creating ongoing local employment as the major goals for creating the health care system.

However, each part of the system has it’s own challenges, he said.

“Full merger was not the goal, and it’s not the case. Each board has it’s own responsibilities,” Young said.

In the past year, the MedWest board has acted for strategic growth at Haywood with a federally mandated medical records/computer system update, acquiring physician practices and several major capital project investments, all with an eye toward increasing market share in the future. But all that growth has come with heavy costs, and the hospital took out a $10 million line of credit to help cover them.

The loan is expected to be paid back within the year, but those investments have also taken a toll on the operational budget. MedWest has taken cost-cutting measures, trying to reduce costs my $10 to $12 million. So far, those cuts have included losing 52 staff positions through layoffs and leaving open positions vacant.

“It’s not fun finding cost savings,” Young said.

However, he said while the cuts are necessary right now, the focus is on seeing growth in the market share.

“In general, the thing we have to do right now is we have to be very, very cautious with how we spend capital,” Young said, but added he is on “the edge of optimism” when it comes to MedWest-Haywood.

The primary and secondary care market is back up to 63 percent, which is where it was before the hospital's decertification.

“The real problem isn’t that we have too many (staff) people, but that we have too few patients,” he said, pointing out that times are difficult with people paying hospitals less while costs continue to rise. “It’s not a difficult moment because we have difficult people. It’s because we have a difficult environment.”

The growth at MedWest-Haywood has also created a rift with the other hospital campuses over resource allocation and the unexpected costs at Haywood, Young admitted.

Although Haywood has begun to show a positive margin, Jackson and Swain operations have been losing money.

However, Young said with leadership now divided between MedWest-Haywood and MedWest-Harris/MedWest-Swain it will be easier to focus on issues within those counties and “the success of all three hospitals.”