TRANSYLVANIA COUNTY, N.C. (WLOS) — Concern is growing in one mountain community over the future of its local hospital.

Elected officials in Brevard say they're worried after several doctors recently announced they were leaving Transylvania Regional Hospital (TRH).

News 13 has confirmed through Mission Health that 14 doctors have recently parted ways with the community hospital. That prompted the Brevard City Council to send a letter to the North Carolina Attorney General's office asking for an independent review from the state.

"This is not what I expected..."

Maureen Copelof is a member of the Brevard City Council. She also meets quarterly with Mission Health's independent monitor, Gibbins Advisors.

She tells us she's been watching the changes at the community hospital closely.

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"I was absolutely floored when I heard that they were leaving," Copelof said, adding that she was alarmed by the amount of doctors leaving around the same time.

"I'm actually shocked because our hospital is something we are really really proud about in our community and most of our doctors have been associated with the hospital for years," Copelof told News 13.

One of those 14 doctors who recently left posted the following online:

...I fear that the result of the former TRH docs going to Pardee and Advent is that it will dry up the work at TRH and that in the long run is very very dangerous to the long term viability of our wonderful hospital...

None of doctors News 13 talked with would do an on-camera interview.

But, Copelof says it's the doctors' experiences that caused them to write the letter to AG Stein.

The letter says, in part, "it appears that the main reason the providers are leaving is because HCA Healthcare changed the method of compensation in the hiring contract."

News 13 has previously confirmed through a former Mission doctor at Transylvania Regional Hospital that the new contracts being offered were for 10-25 percent less pay.

The letter goes on to say local. elected officials are "concerned that this shift will substantially change how rural health care is provided and will result in a reduction in availability and accessibility for care locally."

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Copelof tells News 13, "We want to be able to get the specialized care here, the acute care here; you have an ER with a surgeon available so that the emergency cases can be treated here, that is what we expected and our fear is that is being whittled away, little by little."

The Brevard city councilwoman says she recently sat down with the hospital's leadership, demanding answers. She says she was told it's unclear how many of the 14 doctors will be replaced.

Mission Health wouldn't talk to us on camera, but did send us the following statement:

Mission Health is committed to the Transylvania County community and the people we serve there. We are actively recruiting to fill any vacancies that we anticipate, and recently signed contracts with several new providers. Our primary care locations continue to be available to the community for their care needs, and we are prepared to expand staff as the needs of the community expand, further, patients of any primary care practice can continue to receive any hospital services at Transylvania Regional Hospital. HCA Healthcare continues to expand their support of physicians across all of Western North Carolina and while the employment relationship with some has changed, these physicians are still part of our medical staff and hospital team.

Mission also tells us there are 425 active and affiliated physicians on medical staff at Transylvania Regional Hospital.

"No metrics" when it comes to required services

For Copelof, less doctors, particularly specialists like surgeons, means less access to care. It's something she believed wouldn't change under HCA.

"So it says you're supposed to have surgical services available, well if you reduce the number of days and hours that you have a surgeon available, at what point does it become non-compliance?" asked Copelof.

News 13 took that question to Ron Winters with Mission Health's independent monitor, Gibbins Advisors.

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Winters tells us HCA's purchase agreement for Mission Health does require specific services like surgeries at community hospitals. But, he says there are no metrics to gauge the level of service.

We recently talked with Winters about the 15 promises Mission Health must comply with under HCA. He says Mission Health can use "reasonable discretion" when it comes to offering those services, as long as it's at least equal to or better than the average of what's available at other HCA-owned community hospitals.

"There is a level of judgement that's going to be involved based upon looking at data, looking at what they are providing, discussing it with them and asking them how their discretion was executed," said Winters.

Winters tells us he does not believe Mission Health is out of compliance right now when it comes to the rural hospital, but is aware that some in the community are fearful that services will be lost.

News 13 asked Winters how much he's concerned about this issue.

"If it affects their ability to provide the services they undertake to provide, it's a big deal, it's an issue," Winters answered.

What's next?

Mike McCarthy's doctor recently left Mission Health, but stayed in Brevard. He moved to a new practice, Pardee Medical Associates, with six other former Mission Health doctors.

McCarthy's followed his doctor to that office and says the transition was easy.

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"I'm very grateful my doctor stayed and that Pardee created an opportunity for them to move in," he said.

McCarthy says he's hopeful these changes won't impact his hospital.

"I'm not concerned as long as they are considered community doctors with the hospital so that they would still have privileges at the hospital," he told News 13.

Copelof tells us the city has not yet gotten a response from the Attorney General's office.

We checked in with the office as well about the concerns from the City of Brevard. We're told the Attorney General's office is reviewing the letter and preparing a response.

The councilwoman also says the CEO of Transylvania Regional Hospital is scheduled to speak at a city council meeting in June.

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