By Sarah Nagem
As the leader of a rural North Carolina hospital, Joann Anderson has spent the last 18 months figuring out how to best care for patients sick with COVID-19.
Just when she thought the coronavirus pandemic had leveled off this summer, offering a glimmer of hope for a new and calmer kind of normal, a surge in cases began to overwhelm UNC Health Southeastern in Robeson County.
Now Anderson is mad, and she’s letting everybody know about it.
“I don’t use words like ‘infuriated’ or ‘frustrated,’” said Anderson, president and CEO of the hospital in Lumberton in southeastern North Carolina. “That’s not my norm. But I am about this situation.”
Fueled by desperation, an exhausted staff and her upcoming retirement, Anderson has emerged among the state’s health care leaders as a Facebook-posting, say-it-how-it-is advocate for COVID vaccines and a fighter against misinformation, conspiracy theories and political divides.
And she’s doing it in a region where many people remain skeptical of the vaccine and question the severity of the pandemic. Only 30% of people in Robeson County are fully vaccinated, the lowest rate among North Carolina’s 100 counties.
Thirty-nine people who tested positive for COVID died at UNC Heath Southeastern in August, surpassing the previous record high of 31 in January, according to the hospital.
UNC Health Southeastern recently brought a mobile morgue on its campus because the morgue inside the hospital, which has space for 12 bodies, was full, Anderson said. The hospital is postponing some elective surgeries because of the rising number of COVID patients.
In a Facebook post in mid-August, Anderson said health care professionals know how to control the spread of COVID – through vaccinations, mask wearing, social distancing and hand washing.
“Yet, we are going through another surge because people are not following what the medical community knows will make a difference,” she wrote.
Hospital workers appreciated the “recognition, food, parades, etc.” from the community last year, Anderson wrote. “This year, we need you to step up and take part in the solution.”
For a brief moment, Anderson said, she thought she might get in trouble for the post, which has been shared more than 530 times.
But the feedback has been mostly positive, she said, particularly among her hospital staff and other health care leaders – including her son, Chad, who is vice president of surgery and pharmacy at UNC Rex Healthcare in Raleigh.
“Whatever she says, it’s not going to be wrong, because it’s from the heart,” he said. “You don’t muzzle passion.”
‘Not listening to politicians’
Dr. Robin Gary Cummings, chancellor of the University of North Carolina at Pembroke and a member of the hospital’s board of directors, applauded Anderson’s willingness to be straight forward.
He said Anderson’s message, and his message to the university, is this: “Folks, this is real. People are dying. This is not some really neat conspiracy that someone has dreamed up.”
Anderson said she gets particularly upset when people accuse hospitals of trying to make extra money from the pandemic.
A 20% “add-on” payment for hospitals treating COVID patients who receive Medicare was included in the Coronavirus Aid, Relief, and Economic Security (CARES) Act passed by Congress and signed into law in March 2020 by then-President Donald Trump, according to the American Hospital Association.
“We’re going to get a little bit of a bump,” Anderson said, “but if you come in with a COVID diagnosis and you’re really sick, you’re going to be here a lot longer than that payment would ever cover. So no, we’re not getting rich off COVID.”
In rural communities like Robeson County, Anderson said, treating patients is personal. Health care workers routinely care for family members, friends and friends’ family members.
“We see these people at church, at the ball field, at the grocery store, in Walmart or wherever we might be,” she said. “These are people we know and love. We’re going to do the best we can for them. There’s absolutely no reason for us to fabricate or to over-dramatize what’s happening here.”
Then there are people who say the vaccine contains some sort of chip created by the government.
“There’s no chip,” Anderson said. “I don’t know how you’d even get a chip in there. The needle is teeny-tiny. There’s no chip there.”
Speaking of the government …
“OK, forget about the government,” she said. “I’m not being controlled by the government in any way right now. The decisions we’re making locally are the decisions that are being made by health care professionals in our community. And we’re reading the literature, the science of what’s going on. We’re not listening to politicians. We’re not listening to any of that other hoopla that’s going on.”
And politics …
“It’s become a Republican versus Democrat issue,” Anderson said. “I am a registered Republican. I took the vaccine.”
A passion for rural health care
Growing up in Peabody, Kentucky, in the Daniel Boone National Forest, Anderson said her family had to drive up to 40 minutes to reach the nearest hospital.
But the Frontier Nursing Service, which serves eastern Kentucky, set up a mobile unit in her community once a week. The nurses became role models for her, Anderson said, and she spent her summers during nursing school working for the organization.
There, she said, she saw “rural health care at its best and at its worst.” And she gained a passion for it.
“It was clear that if you let your diabetes get out of control, you’re going to lose your foot,” Anderson said. “If you don’t take care of your heart, lots of bad things can happen. Through their eyes, I got to see so many outcomes from not having regular access to care.”
After raising two sons and serving as CEO of the Pikeville Medical Center in Kentucky for about a decade, Anderson’s late husband took a job in the Carolinas. She considered working in a more urban setting, she said, but she took the helm at the Lumberton hospital 14 years ago.
Health care access is also a concern in Robeson County, which is the largest county in square miles in North Carolina but home to only about 117,000 people. It is one of the poorest and least healthy counties in the state.
“I felt like I could come and hopefully make a difference,” Anderson said.
She describes herself as a “unicorn.” Women make up about 75% of the hospital workforce in the United States, but only 13% of health care CEOs are women, according to the American College of Healthcare Executives.
Anderson doesn’t have a business degree, unlike many hospital leaders.
And, she said, “I’m a Kentucky basketball fan. In the state of North Carolina, that just really kind of makes you a unicorn in health care.”
‘Done about what I can do’
When the coronavirus pandemic began in North Carolina in early 2020, Anderson’s hospital was independent.
Chad Anderson said his mother was tasked with steering her organization through a time of uncertainty without being under the umbrella of a larger health care provider.
“How scrappy do you have to be to not have a system resource?” he asked.
Like many rural hospitals over the last decade or so, the Lumberton facility had been looking for a partner. It became UNC Health’s 12th hospital on Jan. 1.
Joann Anderson said the partnership has been good, but she’s ready to move on – this time, to retirement at the end of the year.
Chris Ellington, who has been with UNC since 2008, will serve as the new CEO. He is currently president of UNC Health Care Network Hospitals.
“I think they need the opportunity to have somebody who’s fully vested within the UNC system who can take it to that next level,” she said. “I think I’ve done about what I can do.”
Anderson, whose husband died in 2019, said she plans to move to Raleigh to be closer to her children and grandchildren. She likes to paint, and she might take an art class.
Soon she will join Campbell University’s board of trustees, and she plans to remain an advocate for rural health care.
That includes speaking up about ways to slow the spread of COVID.
“My plea has been, you have trusted the health care community in the past,” she said. “Trust us now. Don’t let all of this other noise get in the way.”