The news arrived on Noble Health letterhead at 5:05 pm on Friday with the subject line “Urgent Notice”. His Audrain Community Hospital, where Paul Huemann worked for his 32 years, was letting workers go.

In small towns, words travel fast. Huemann’s wife, Kym, first heard the bad news when she got an email from her friend who also received a letter in her car.

“Your dismissal was unforeseen,” said a letter dated Sept. 8 and signed by Platinum Health Systems, adding that the dismissal was “unreliable” and permanent, adding that “medical facilities will be closed.”

“I don’t know what the next step will be,” said Huemann, 52, who oversaw the laboratory at Audrain Hospital.

The future of the Humans, hundreds of workers, and thousands of patients in two small Missouri towns began to emerge long before that afternoon. The drama unfolding in Paul Human’s hometown is familiar to many in rural America.

sometimes they lose.

Noble Health, a three-year-old private equity-backed startup, acquired Aurain and nearby Callaway Community Hospital during the pandemic. It suspended all hospital services in March and then laid off 181 employees, according to state records..

Noble, facing massive debt, more than a dozen lawsuits and at least two federal investigations, struck a deal in April to sell the hospital to Platinum Neighbors. Platinum Neighbors is affiliated with Texas-based Platinum Team Management and Platinum Health Systems. In late June, Platinum asked Missouri officials to extend the deadline for hospitals to reopen until Sept. 21. On Tuesday, Platinum officials told KHN, “on Noble’s behalf,” that they asked regulators in Missouri for another 30-day extension “in an attempt to explore all alternatives to reopening these facilities.” said Ryan Gordon, director of marketing for Platinum. “Employee backpay and health benefits are paramount.”

Hours before Wednesday’s license deadline, Platinum submitted a request for a 90-day waiver. Missouri regulations do not allow for another extension of less than a year, said Lisa Cox, spokesperson for the Missouri Department of Health and Senior Services. So the state “worked with them” and granted her request, she said.

Platinum said the hospital needs time to complete the construction project. Audren’s “emergency room area” has a broken window and Callaway’s hospital needs “major plumbing repairs,” according to a state clearance letter. Cox said the hospital can change ownership within his 90 days.

Cory Countryman, president of Platinum Health Systems, confirmed the dismissal of the remaining hospital staff. “We are working with multiple partners to reopen the hospital,” he said.

That could involve new owners. One of his prospects is Owen Shuler, a Georgia-based entrepreneur who says he’s considering a purchase. “I love what I’m seeing,” said Shuler, who was contacted by phone after visiting a rural area.

“It’s heartbreaking what happened,” said Shuler, who owns Bankers Realty Corporation and Shuler Capital Corporation. If he buys the hospital, he will do so as managing director of his new venture, CareOne Global, he said. “I don’t like what I’m seeing and learning when it comes to due diligence,” he said. What he concludes from his review is that “private equity and venture capital should stay out of healthcare.”

In his LinkedIn profile, Shuler says he “brings a lifelong perspective from a family-owned and skilled care business” and has expertise in “telemedicine and healthcare services.”

“I’m not ready to set the record straight on business strategy yet,” said Schuller, who confirmed that the hospital was “roughly” heavily indebted, between $45 million and $50 million. He said his approach was “holistic” and included telemedicine. It claims to be a way to bring quality health care to rural communities.

“Our goal is to buy hospitals in rural and disadvantaged areas and deploy our capabilities,” Schuller said, wiping out two hospitals in Missouri that were “basically broken.” Fixing it would be “much easier than trying to move to a healthy system,” he added. ”

Still, it’s unclear if Shuler or another buyer will succeed after years of ownership instability and financial troubles, and what it will take to get them back on track.

Venture capital and private equity firm Nueterra Capital launched Noble in December 2019. Among them were executives who had never run a hospital, including co-founder Donald R. Peterson, who had been accused of Medicare fraud before joining Noble. Peterson settled that lawsuit without admitting wrongdoing and agreed in August 2019 to be barred from Medicare, Medicaid, and all other federal health programs for his five years, according to the inspector general. The Department of Health and Human Services said.

Federal regulators did not block the acquisition Peterson was involved in. “All proprietary and custodial information is self-reported,” said Kristen Clemens, spokesperson for the Centers for Medicare and Medicaid Services.

It didn’t take long for problems to surface under Noble Health’s control. Noble accepted nearly $20 million in federal covid-19 relief funds, including $4.8 million from the Paycheck Protection Program, according to public records.

But doctors, nurses and patients have seen evidence that the new owners have neglected services. did. The former worker provided KHN bills and payslips which it said showed Noble had stopped paying employees health, dental, vision and life insurance benefits.

The Labor Department’s Office of Employee Benefits launched an investigation in early March after an employee complained about a sudden medical bill, according to a letter to the company obtained by KHN. The ministry has confirmed a second investigation into the management of Noble’s Audren Hospital and Clinic by another of its departments, Wages and Hours.

In April, Noble sold both hospitals for $2 and signed a deal to transfer the shares to Platinum, who assumed all responsibility. In his June 22 letter to state regulators regarding the hospital’s license to operate, Platinum said, “We are requesting this continuation as shares in Noble Health have been transferred to Platinum Medical Management.”

During a visit to the hospital in April, Countryman told employees that paying back the wages Noble owed them was a “priority.”

Since then, neither Noble nor Platinum has done it well, employees claim. Nine wage claims (up to $355,000) were filed against

By early August, some were aware of employee complaints. The principal, who provided dental and eye care insurance, sent a letter to workers stating that they would not require workers to repay benefits covered by the insurance company after Noble stopped paying employee insurance premiums. Sent. “Situation like this is not common,” Principal spokeswoman Ashley Miller wrote in an email.

Lab supervisor Huemann was one of the workers not laid off in the spring. They went to work every day in the hope that Audren Hospital would reopen. Huemann checked the reagents and kept his machine running despite tight funding for supplies.

“We didn’t get anything,” Huemann said.

Huemann, who provided KHN with a payslip, said he received his salary from Noble in late March. He said he did not receive another paycheck until late May. He received regular salaries in his June and his early July. But July’s second check under platinum was delayed by a week. His last paycheck arrived on August 8th, which was also late.

His last seven checks were from three companies. They were all under Platinum’s watch. First Platinum Neighbors issued the check, then Callaway County Community Hospital, and finally Noble Health Oudren.

“Everyone cashed their checks as soon as they received them,” says Huemann. “There are so many red flags. But as you know we are at their mercy and we have no control over them. increase.”

The check stub also shows that the hospital operator deducted a total of $1,385 from Human’s insurance premiums. Medical insurance was supposed to be in Blue Cross and Blue Shield, Texas, but Human did not receive a card and could not verify coverage.

“I called four or five times on different days,” he said. “They couldn’t find me no matter what I looked for, Social Security, date of birth, etc.”

Countryman referred all financial questions to Platinum’s corporate headquarters. Platinum and his team’s chief executive, Ryan Cole, did not directly respond to calls or emails seeking comment.

Some doctors left town as upheaval engulfed hospitals.

Others, such as family physician Diane Jacobi and her practitioner Regina Hill, joined MU Healthcare affiliated with the University of Missouri in Mexico, Missouri.

Jacobi said her patients want local care. “I don’t know if you’re a mom, but if you’re in labour, the thought of her having to wait 45 minutes in the car to get to the hospital is nerve-wracking,” she said. “It’s safer to be careful.”

Lou Leonatti, an attorney in Mexico, said he gave Noble a loan last year so the company could pay his salary because he feels strongly the community needs hospitals and emergency care. Leonatti’s personal loan, a $60,000 loan with an interest rate of about 3% and due in January, has not yet been repaid, he said.

Leonatti helped start Project Sunrise, a local economic development group. If no new deal is reached, he said, “I’d like to have a plan B.”

Peterson, who helped launch Noble’s failed efforts to rebuild two hospitals in Missouri, seems to have found his Plan B in Dubai. “I am sitting in the Emirates lounge in Dubai and am amazed at the experience given to me at the young age of 68,” he wrote to LinkedIn. I will finish the due diligence to launch the business.”

The post enraged Tonya Linthacum, a nurse practitioner who has worked at Audrain’s Cancer Screening Center for over 20 years. She said he “destroyed the lives and livelihoods of so many people” and “been tricked into doing so by someone” and “continues with no consequences. It’s the way the world is supposed to be.” not.”

Peterson declined to comment.