Hospital hopes to heal itself by hooking up.

• Position: Western

The straw that brake Haywood Regional Medical Center's back--February's Medicare and Medicaid decertification after the death of a 37-year-old woman was linked to a medication error--might be the one that gets it up and around again. The crisis nudged the hospital, which gets more than 60% of its $128 million top line from federal insurance programs, to look for a bigger, richer partner. Choices? Charlotte-based Carolinas HealthCare System, Winston-Salem-based Novant Health and Asheville-based Mission Health System. "It--decertification--was the impetus," CEO Mike Poore says. "It got us going."

Problems began after the death and an inspection in January that found the level of medication errors unacceptable. Loss of patients forced the hospital, whose roughly 900 employees made it Haywood County's third-largest employer, to cut hours for all staffers and order two-week layoffs for more than 100.

Certification was restored in May, but not before the 170-bed hospital in Clyde had drained its reserves, been abandoned by major private insurers--most are now back--and undergone an upheaval that saw several top executives and its board chairwoman resign. Poore succeeded interim CEO Al Byers in October. He says Haywood Regional and WestCare Health System, which covers neighboring Graham, Swain, Jackson and Macon counties, have asked the three larger health systems to submit proposals by mid-January.

Like most small...