Standing firm: HCA's top N.C. executive defends the company's Tar Heel expansion.

• Author: Mildenberg, David

Greg Lowe was one of two HCA Healthcare employees who started working at Mission Health on Feb. 1,2019, when the biggest U.S. hospital company completed its $1.5 billion acquisition of the Asheville-based hospital system. Four years later, he is president of HCA's North Carolina division, the state's sixth-largest health system. The graduate of the University of Utah had previously been CEO at HCA's Richmond, Virginia, and Fort Pierce, Florida, hospitals and, earlier in his career, led Lake Norman Regional Medical Center in Iredell County.

It's been a tumultuous four years for HCA in Asheville, with continued criticism from community leaders and employees and a barrage of media reports contending that the quality of care has diminished under the publicly traded company's ownership. The frustration was evident when Mission's nurses voted to join a union in 2020, resulting in a three-year contract through 2024.

In an interview, Lowe discusses the controversies and HCA's experience.

WHAT ARE EXAMPLES OF HCA'S COMMITMENT TO ITS LARGE N.C. REGION?

We've made what I consider amazing capital investments in our region since 2019. We've approved more than $660 million in projects. We've not spent all of that, but we've committed those dollars. We're finishing a new 120-bed behavioral-health hospital in Asheville that will cost $140 million. We've opened a new hospital in Franklin that is incredibly positive with much better access for people of that region.

We're also expanding McDowell Hospital in Marion by adding 11 beds. That's a $20 million project.

At many of our facilities, we're also going floor by floor and completely renovating each room and nursing stations. That's costing $2 million to $5 million for each floor.

We've also added a helicopter, which is very important in a mountainous area where folks might have heart attacks in some inaccessible areas and need to be picked up quickly. A helicopter costs more than $8 million.

Another example is that four years ago, we had one robot to do surgeries. Since then, we have purchased six da Vinci [Surgical System] robots to provide super high-end surgical care that didn't exist until HCA came here. We are adopters of technology that helps our physicians deliver care that leads to better outcomes and shorter lengths of stay.

WHAT WAS YOUR VIEW WHEN REGULATORS ALLOCATED NEW HOSPITAL SERVICE IN ASHEVILLE TO ADVENT HEALTH?

We went through a process that showed there was a need for 67 more beds. We...