Protecting the Future of Healthcare in Martin County
Below are updates from Ascendient and Martin County regarding the lease of Martin General Hospital and the provision of healthcare in the county.
Updates as of May 2025
Updates
Martin County Receives Qualified Proposal to Reopen Healthcare Services
Community to have opportunity to review proposal and provide comments at upcoming public hearing.
WILLIAMSTON, NC – At their regular meeting on Wednesday, May 14, the Martin County Board of Commissioners announced that it has received a qualified proposal from ECU Health to establish essential healthcare services at the former Martin General Hospital facility. The proposal came in response to the county’s Request for Proposals (RFP) issued on February 13, 2025.
Martin General Hospital, which served the county for more than 50 years, closed abruptly in August 2023 when Williamston Hospital Corporation filed for Chapter 7 bankruptcy. Since that time, county officials have been actively working to restore healthcare services to the community.
“We are pleased to have received a strong proposal from ECU Health, an organization that understands the unique challenges and opportunities of rural healthcare delivery,” said Joe Ayers, Chair of the Martin County Board of Commissioners. “ECU Health has demonstrated experience in revitalizing healthcare facilities and shares our vision for implementing a Rural Emergency Hospital model to establish essential services to our community.”
The County’s search for a healthcare partner has been extensive. County representatives have been in contact with nearly 20 organizations including health systems in North Carolina and Virginia, local healthcare entities in Eastern North Carolina, and hospital companies from across the United States.
While initial proposals were submitted in April, the County’s advisors have been engaged in a thorough review process with both organizations to strengthen and refine their proposals. This collaborative refinement period is a standard practice for complex healthcare partnerships to ensure the final proposals address all critical components required for successful, sustainable healthcare delivery in Martin County. Following this extended review process, a second party that submitted a proposal did not provide sufficient documentation to demonstrate the financial capability required to meet the minimum qualifications outlined in the RFP.
ECU Health, a private, not-for-profit academic health system serving 29 counties in eastern North Carolina, was selected to move forward in part because of their long history of partnering with rural communities through strategic collaborations and hospital acquisitions. Their proposal supports implementing the Rural Emergency Hospital model while creating an integrated, regional system of care for Martin County residents.
As the next steps in the process, ECU Health’s proposal will be made available for public review beginning Friday, May 23, 2025, here at https://martincohealth.com/ or in person at the Office of the County Manager, Martin County Governmental Center. A public hearing has been scheduled for Wednesday, June 4, 2025, at 7:00 PM at the Martin County Governmental Center, Commissioners Boardroom, 305 East Main Street, Williamston, NC 27892, where ECU Health will have an opportunity to present its proposal, followed by public comments.
The county has been following a statutory timeline for the hospital operator search process since January 2025, beginning with the adoption of an Intent Resolution on January 8, followed by the required public hearing on February 12. The RFP was issued the following day, with initial proposals received on April 4, 2025. Following the public hearing, the Board of Commissioners will continue to proceed with the process required by N.C. Gen. Stat. § 131E-13(d).
Contact:
Dawn Carter
Advisor to Martin County
Senior Partner
Ascendient Healthcare Advisors
dawncarter@ascendient.com
919.226.1701
Previous Updates
- The three essential questions that Ascendient and the County have been pursuing have been substantially answered.
- As we have stated previously, the Centers for Medicare and Medicaid Services has indicated that we are able to reopen the now closed facility as an REH.
- While we continue to work with the North Carolina Department of Health and Human Services finalizing the building updates required prior to reopening, we have narrowed down the items under discussion sufficiently to be confident in moving forward.
- Fortunately, the building updates that are required are fairly minimal in nature and will not require significant capital.
- A number of those building updates and maintenance items are underway.
- We have started the RFP process to find a new operator. The County is following the North Carolina laws that that govern the process required when planning to lease or sell hospitals owned by local government. The County has or is undertaking the following steps required by those laws:
- On January 8, 2025, the Martin County Board of Commissioners adopted a resolution of intent to lease or sell Martin General Hospital.
- On February 12, 2025, the Martin County Board of Commissioners held a public hearing on the resolution of intent to lease or sell Martin General Hospital, giving the public the opportunity to provide input.
- As discussed during the January 8, 2025, Commissioners meeting, the process has and will continue as follows after the February 12, 2025, public hearing:
- RFPs were distributed on February 13, 2025, to multiple parties who had previously expressed interest in operating the facility
- Proposals will be received/processed in the next few weeks
- Proposals will be made available to the public for their review
- A public hearing on the proposals will be held
- The successful proposal will be selected by the Commissioners
- A negotiated agreement with the successful proponent will be made available to the public for their review
- A resolution to approve the final agreement will be adopted by the Commissioners
- Distribute RFPs
- Receive Proposals
- Make Proposals Available
- Hold Public Hearing on Proposals
- Select Successful Proposal
- Make Available Successful Agreement
- Adopt Resolution to Approve Final Agreement
- Ascendient and the County are still working diligently to find a solution to sustainable healthcare in Martin County. This process has taken much longer than anyone had hoped, but please know that we care deeply about this community and are doing everything possible to find a long-term solution for care in the County.
- Earlier this year, Ascendient and the County identified three essential questions that must be answered before beginning the search for a new operator for Martin General Hospital and issuing an RFP:
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- How—within both state and federal regulations—can we reopen a closed hospital as a rural emergency hospital (REH)?
- What, if anything, needs to be done to the existing hospital building before it can reopen?
- What, if any, kind of capital does the hospital need to reopen and what potential funding options are there for Martin General Hospital?
- We were pleased to share in our last update that The Centers for Medicare & Medicaid Services has indicated that we are able to reopen the now closed facility as an REH.
- Since we received that decision, we have been working with the North Carolina Department of Health and Human Services (NC DHHS) who must determine whether the building meets the REH facility requirements, which are different from a general hospital, and to identify any other updates the building would need before reopening.
- In order to make an official determination, NC DHHS must have accurate architectural and engineering drawings of the existing facility to compare with the REH requirements. The County has engaged Criterion Healthcare, who assisted Ascendient with the initial assessment, to develop these drawings and submit to NC DHHS.
- Based on our preliminary discussions with NC DHHS, we are cautiously optimistic that the facility updates will be limited in nature and feasible to complete. We continue to work with officials at the federal, state, and local level to finalize facility requirements.
- Once we have sufficient information regarding the extent of the facility updates, we will move forward with the process of issuing an RFP to all interested parties and anyone else who wants to submit a proposal to provide healthcare in Martin County.
- Ascendient and the County have met with the NC Department of Health and Human Services Division of Health Service Regulation (DHSR), Centers for Medicare and Medicaid Services (CMS) and others to discuss options for providing sustainable healthcare in the county.
- Over the past few months, there has been interest from more than a dozen potential partners in operating healthcare services in Martin County.
- Down the line, Ascendient and the County plan to facilitate an RFP and state-required public bid process, where interested parties will submit their proposals for providing sustainable healthcare in Martin County.
- Each party is currently under a non-disclosure/confidentiality agreement (NDA), as is the County, to protect the County’s interests ahead of releasing requests for proposals.
- The following questions need to be answered before the RFP/public bid process can begin:
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- How—within both state and federal regulations—can we reopen a closed hospital as a rural emergency hospital(REH)?
- What, if anything, needs to be done to the existing hospital building before it can reopen?
- What, if any, kind of capital does the hospital need to reopen and what potential funding options are there for Martin General Hospital?
- As previously noted, Ascendient and the County believe an REH is one viable model that could ensure access to healthcare services in Martin County. Many of the interested parties are open to operating Martin General as an REH.
- The rural emergency hospital model is brand new, and no other hospital in North Carolina has converted to an REH yet—certainly not one that has previously closed. Therefore, the state and federal governments are still figuring out how this can and should be done.
About Rural Emergency Hospitals
- A Rural Emergency Hospital (REH) is a new designation designed to support rural communities by providing emergency and outpatient services without maintaining inpatient facilities. Existing rural hospitals can convert to REH status to receive enhanced Medicare reimbursements, ensuring financial viability.
- As you may recall, REH legislation was passed as part of the state budget in early fall last year. Without the work of the Martin County Board of Commissioners, this model would not be possible in NC today.
- Many of the interested parties we’ve talked to are interested in operating Martin General as an REH.
- We believe an REH is a viable, sustainable model that will ensure access to healthcare services in Martin County. Making this come to life requires intense collaboration with the NC state government and federal government and interface with the Williamston Hospital Corporation bankruptcy process.
- However, this is a brand-new model and NO OTHER hospital in NC has converted to an REH yet.
- In addition to the fact that there are no other REHs in the state of NC, no one else has been in the situation that we are in – trying to reopen a closed hospital as an REH.
- That means that all the questions about how it can and needs to be done, what regulations apply and what regulations don’t in our unique situation, are being explored and answered for the very first time with the help of state and federal government officials.
- As we continue to work with state and federal officials to resolve these questions, we also need to be mindful of the interface that will be necessary with the bankruptcy trustee during the process.