Federal regulators have officially placed Asheville’s Mission Hospital in Immediate Jeopardy for the second straight year. The hospital now has 18 days to make things right, or else lose its Medicaid certification and the critical funding that comes along with it.
Preventable patient death, unsafe patient transport, patient misidentification and harmful infection protocol — instances of all four were found at Mission in recent months.
In response, the North Carolina Department of Health and Human Services recommended the hospital face Immediate Jeopardy, the most serious citation regulators can deliver.
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The federal Centers for Medicare and Medicaid Services in Atlanta, or CMS, agreed. Mission, then, is officially in violation of the conditions of participation in Medicaid.
By Nov. 9, Mission must outline and enact a plan to stop and prevent harm to patients.
If CMS approves Mission’s removal plan, and verifies the plan’s enactment, this could all be over without much consequence for the hospital. That’s what happened last year, even after DHHS identified four instances of preventable patient death.
If CMS does not approve Mission’s plan, it would be disastrous for the hospital. Mission would lose Medicare and Medicaid funding, face fines and potentially lose its state license to operate.
Mission CEO Greg Lowe claimed that widespread misinformation and outside pressure were key factors in the disastrous ruling.
Lowe emailed hospital staff in the wake of the CMS citation, so that his employees could hear directly from him, “given the large amount of misinformation that has been circulating online and in the press about the incidents that prompted the survey leading to these developments.”
“There were several aspects of this survey that were unusual,” Lowe wrote.
“This includes the length of time surveyors were on-site and … that more than two-thirds of the complaints they were sent to investigate were determined to be baseless. …. I want to be clear: I have a tremendous amount of respect for the surveyors and they were simply doing the jobs required of them. However, it is unfortunate that there seemed to be outside pressure on these surveyors to find a problem.”
This is the third time Mission has been threatened with Immediate Jeopardy since Tennessee-based, for-profit HCA Healthcare purchased the formerly nonprofit Mission Health hospital system in 2019. Mission Hospital in Asheville is the flagship hospital of the Mission Health group, which is the primary health care provider for several Western North Carolina counties.
“CMS has taken appropriate action to hold HCA accountable,” said Aaron Sarver, a spokesperson for Reclaim Healthcare WNC, a coalition whose goal is to replace HCA as owner of Mission Health.
“Unfortunately, this is not the first-time that Immediate Jeopardy has been invoked against them due to staffing that continues to put patients in danger of serious injury, harm, impairment, or death,” Sarver said.
“Step one is to restore staffing at Mission to safe levels. The core issue is that nurses, techs and support staff are overburdened and cannot reasonably provide quality care to all the patients they are responsible for.
“The pattern we now can see clearly since HCA purchased Mission in 2019, is after being sanctioned by regulators, HCA surges resources to the hospital for a period of time to have an IJ lifted. Then, they return to a baseline of unsafe staffing levels. That can be fixed tomorrow by bringing in more staff, but it must be a permanent fix.”
The hospital has already formulated a plan to correct the violations, according to Lowe, and that plan has been proactively shared with CMS.
“We welcome the follow-up survey and remain confident in the ability of our team to provide compassionate, high-quality care,” Lowe wrote in his email.
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