Asheville’s Mission Hospital could lose Medicare and Medicaid funding if the hospital doesn’t fix issues that pose “immediate jeopardy” to patients’ health and safety, according to a letter sent by the Centers for Medicare and Medicaid Services to Mission Hospital CEO Chad Patrick.
The state Department of Health and Human Services inspectors found Dec. 9 that Mission Hospital failed to meet six conditions of Medicare participation, including patient’s rights, nursing services and emergency services.
Mission Health submitted a plan of how to correct those deficiencies to CMS by the deadline of Feb. 6, according to an emailed statement from spokesperson Nancy Lindell.
CMS’s letter stated the hospital must correct the issues by Feb. 24.
Mission Hospital is still functioning and N.C. DHHS and CMS understand the region needs the hospital’s services, said Sen. Julie Mayfield, D-Buncombe. CMS can extend the deadline for the hospital to come back into compliance, Mayfield said.
If CMS accepts the corrective plan, state inspectors will revisit to see whether Mission Hospital is back in compliance.
At a Feb. 6 news conference, elected officials and advocates said hospital leadership needs to make systemic changes, as the failures have come from a corporate culture that prioritizes profit.
Mayfield said she is pushing to look at the corrective plan herself to make sure it’s sustainable and not “just a band-aid.”
“The bottom line is they have to increase staffing, and they have to increase the resources that are available to staff,” Mayfield said. “That’s medical equipment, supplies, people — it’s everything you need to serve patients and run a hospital.”
But staff at Mission Hospital have been made into scapegoats for these issues before, as some nurses were fired after regulator inspections in 2023, Mayfield said.
Management’s answer to previous issues was to assign learning modules to nurses instead of hiring more staff, said Mission Hospital nurse Kerri Wilson at the conference.
Hospital management is still cutting staff, which endangers patients, Wilson said.
Mission Hospital has seen a slight decline in emergency room patients since regulators found issues at the hospital in December, but is overall still full, Wilson said.
HCA spokesperson Lindell said Mission Health has taken action since the inspectors’ preliminary findings and wait times for care have decreased, according to their EMS partners and patients.
“Again, these findings are not the standard of care we expect, nor that our patients deserve, and we are working diligently to ensure Mission Hospital successfully serves the needs of the Western North Carolina community,” she said.
The Health Equity Coalition of Western N.C. called for a new hospital owner at the conference, saying in a statement that it’s the “only way to bring the system back to full health.”
But forcing a sale isn’t possible, Mayfield said, so HCA must fix the problems that its acquisition of Mission Health caused. If the owner can’t, then the company needs to step aside, she said.
HCA Healthcare acquired then-nonprofit Mission Health System in 2019. Mission Health operates hospitals and other services in Buncombe, Jackson, Transylvania, Macon, Mitchell and McDowell counties.
Since the acquisition, more than 200 physicians have left the Asheville community, Mayfield said.
N.C. Attorney General Josh Stein, who sued HCA Healthcare in Dec. 2023 for failing to provide agreed-upon services across the region, said in a statement read at the conference that his office will continue to pursue the suit.
Mission Hospital nurses protested against what they said were staffing shortages and unsafe pandemic-era conditions in 2020, and voted to approve a union.
Community members have also long raised concerns about the hospital and its affiliates in surrounding counties, including worries about staffing cuts and quality of care in a series of 2020 town hall meetings through Mission Health’s independent monitor, Gibbins Advisers.
Gibbins Advisers will also conduct upcoming community meetings in late Feb. 2024, regarding Mission Hospital McDowell in Marion and Blue Ridge Regional Hospital in Spruce Pine.
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