2020 North Carolina's BEST HOSPITALS.

• Author: Miller, Harrison

Our annual list of North Carolina's best hospitals examines data compiled from several sources to determine which medical centers provide the best care for their patients. We start by developing a comprehensive list of the state's top-performing general acute care, adult hospitals with 50 or more beds.

The rankings are calculated using more than 25 metrics, including information provided by the U.S. Centers for Medicare & Medicaid Services. We look at patient-satisfaction surveys, as well as infection, readmission and death rates for common procedures. Other factors include safety report cards by the Washington, D.C.-based nonprofit The Leapfrog Group, distinction awards from insurer Blue Cross and Blue Shield and national performance ratings from U.S. News ft World Report.

Taking so much data into consideration makes the rankings particularly tight. This year, the overall winner and the medical center coming in at No. 10 are separated by just five points; the separation between No. 1 and No. 20 was just 16 points.

Despite attempts to be as thorough as possible, our methodology can skew in favor of larger institutions, which earn more points based on national awards and performance rankings. Smaller hospitals tend to come up short, largely because some procedures aren't performed often enough during the year to be considered, resulting in insufficient data.

Other factors such as health care system consolidation had an impact on this year's rankings.

The federal data and Blue Cross and Blue Shield of North Carolina insurance distinctions were compiled in December 2019. Leapfrog safety scores and U.S. News ft World Report rankings were updated in January.

01

MISSION HOSPITAL ASHEVILLE

BEDS: 730

2018 RANK: 3

CEO: CHAD PATRICK

A perennial top performer led the way during its first year owned by Nashville, Tenn.-based HCA HealthCare, the biggest U.S. hospital operator. Management turnover followed the $1.5 billion sale that dosed in February 2019 with Greg Lowe moving from HCA's Richmond, Va., market to become president of a new N.C. division and Chad Patrick becoming CEO for the flagship. Mission was one of four N.C. hospitals named to IBM Watson Health's list of the 50 top cardiovascular hospitals.

Under terms of Mission's sale, the Nashville-based Gibbins Advisors consulting firm was hired to monitor HCA's compliance with agreements it made in the transaction. Those commitments include replacing the hospital in Franklin, adding a 120-bed behavioral health center in Asheville and investing $232 million in existing sites. Gibbins reports to Dogwood Health Trust, a nonprofit foundation created by the Mission Health sale.

02 (TIE)

MOSES CONE HOSPITAL (1) GREENSBORO

BEDS: 529

2018 RANK: 1

PRESIDENT: TERRY AKIN

Greensboro's dominant hospital opened its $100 million Women & Children's Center in late February, replacing the nearly 30-year-old Women's Hospital. Nurses and patients helped design the space, which has its own entrance and 45 private rooms for neonatal babies. Industry groups again recognized Cone for various innovations, including programs to serve recent immigrants: partnering with Guilford County on a mental health crisis center; and starting a unit to support new health care ventures.

Parent Cone Health reached a new shared-services agreement with Atrium Health that loosens ties between the two systems, including moving CEO Akin off the Charlottebased group's payroll. The system posts annual revenue topping $2 billion and employs about 12,000.

02 (TIE)

UNC REX HEALTHCARE RALEIGH

BEDS: 660

2018 RANK: 1

PRESIDENT: STEVE BURRISS

The division of Chapel Hill-based UNC Health plans to open five urgent-care centers in Wake County this year after renaming its nine UNC Rex locations as UNC Urgent Care. Last March, UNC Rex broke ground on a seven-story, 50-bed hospital in Holly Springs scheduled to be completed in 2021. It will offer an emergency department, labor and delivery services, and operating rooms for various surgeries. Next year, UNC Rex will open a four-story, $65 million cancer center on its west Raleigh campus. Demand is expected to continue to increase as the region's population grows and ages.

UNC Rex Healthcare faces strong rivals in WakeMed and Duke University Health to expand and lure new customers in the Raleigh metro area, which grew by 20% between 2010-18 with more than 225,000 new residents, according to U.S. Census Bureau estimates.

04 (TIE)

CAROLINAEAST MEDICAL CENTER NEW BERN

BEDS: 350

2018 RANK: 5

PRESIDENT/CEO: RAYMOND LEGGETT III

In January, the Craven County hospital opened the $38 million State Employees Credit Union Comprehensive Cancer Center, an 80,000-square-foot site. An adjacent $22 million diagnostic center is opening in March, a partnership with UNC Health Care to offer expanded cancer care services. The not-for-profit hospital's cardiovascular care center was the state's first to achieve an excellence accreditation from the American Heart Association.

The locally controlled hospital system had net operating revenue of $427 million in the 2019 fiscal year. That makes it the smallest hospital among the 10 highest-ranking on this list. Leggett has worked for the system for 30 years, including 12 as CEO.

04 (TIE)

DUKE UNIVERSITY HOSPITAL DURHAM

BEDS: 957

2018 RANK: 7

PRESIDENT: THOMAS OWENS

Ranked among the top U.S. research hospitals, its affiliated medical school was awarded $385 million in grants from the National Institutes of Health in 2018 --the ninth most of any university. Duke University Hospital surgeons made history by completing the nation's first "donation after circulatory death" adult heart transplant, a procedure performed after the heart stops beating. It's one of five centers in the U.S. approved for the surgery. An 11 -story tower in Durham is expected to open next year with adaptable beds to serve neurosciences, and solid organ and bone marrow transplants, with four floors dedicated to children's inpatient services.

The Durham hospital has the most beds of the Triangle-area hospitals and leads in outpatient visits with 1.08 million, while UNC Hospitals has the most admissions. UNC Rex Healthcare ranks second in outpatient visits. While dominant in Durham County, it's making a push into western Wake to complement its north Raleigh hospital.

04 (TIE)

FIRSTHEALTH MOORE REGIONAL HOSPITAL (2) PINEHURST

BEDS: 390

2018 RANK: 11

CEO: MICKEY FOSTER

In December, FirstHealth launched FirstHealth On the Go, a virtual care app that lets patients connect digitally with board-certified doctors 24 hours a day. FirstHealth says On the Go will help fill coverage gaps via virtual visits and online prescription refills. Next year, the not-for-profit authority will break ground on a four-story, $60 million cancer center on its main campus with completion expected in November 2022. In February, FirstHealth opened a Heart Failure Clinic in Pinehurst.

In July, Mickey Foster replaced retiring CEO David Kilarski, who had headed parent FirstHealth of the Carolinas since 2011. Foster, 47, had been senior vice president at Greensboro-based Cone Health. The system has nearly 5,000 employees and is licensed for four hospitals with 610 beds.

07 (TIE)

ATRIUM HEALTH CAROLINAS MEDICAL CENTER (3) CHARLOTTE

BEDS: 907

2018 RANK: 8

PRESIDENT, CENTRAL DIVISION: VICKI BLOCK

The flagship hospital of the state's biggest health care system could add a medical school to its offerings, pending regulatory approval of a partnership agreement with Winston-Salem-based Wake Forest Baptist Health and Wake Forest University. Later this year, Atrium expects to open a nearby building for its Sanger Heart & Vascular Institute and another one for neurology and digestive health specialists. It's part of a $1...