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Mission Hospital receives official notice of ‘immediate jeopardy’ violations, putting Medicare and Medicaid funding at risk

A sign outside Asheville's Mission Hospital.
Felicia Sonmez
A sign outside Asheville's Mission Hospital.

Asheville’s Mission Hospital has received official notice from federal authorities that conditions there pose “immediate jeopardy” to patients’ safety, putting the facility on track to potentially lose its Medicare and Medicaid funding if the issues are not resolved.

Management now has 23 days to rectify the problems at the hospital, which has seen mounting complaints, multiple lawsuits and an exodus of staff since it was purchased by HCA Healthcare in 2019.

State investigators identified the “immediate jeopardy” violations late last year, based on a total of nine incidents from April 2022 to November 2023. On Friday, the Asheville Watchdog reported that HCA North Carolina Division President Greg Lowe informed staff that management had received a report from the federal Centers for Medicare & Medicaid Services officially notifying them of the violations on Feb. 1.

Nancy Lindell, a spokeswoman for HCA Healthcare, confirmed to BPR the authenticity of Lowe's email.

In a statement Friday, Lindell said that the state investigators’ findings “are not the standard of care we expect, nor that our patients deserve, and we are working diligently to improve.”

“There are no excuses for our patients receiving anything other than exceptional care, and Mission Health has already taken action based on the preliminary findings shared last month,” Lindell said. “We are pleased to hear from our EMS partners and patients that those actions are yielding positive results, including decreased wait times for care. We respect the process of these surveys and will submit our corrective action plan to CMS by their deadline.”

CMS has not yet made public the details of the violations.

North Carolina Attorney General Josh Stein last month called news of the preliminary findings “extremely alarming.” Stein, who is running for governor as a Democrat, filed a lawsuit against HCA Healthcare in December, accusing the country’s largest for-profit hospital company of breaching the terms of its $1.5 billion purchase of Mission Health System by failing to provide quality, consistent emergency services and cancer care.

HCA has until Feb. 13 to file its response to the lawsuit.

CMS defines “immediate jeopardy” as “a situation in which the provider’s noncompliance with one or more requirements of participation has caused, or is likely to cause, serious injury, harm, impairment, or death to a resident.”

“The high potential for these outcomes to occur in the very near future also constitutes Immediate Jeopardy,” the CMS guidelines state.

The designation from federal authorities reflects the complaints many members of the community have been making in the years since for-profit HCA bought the previously-nonprofit Mission Health System.

Maureen Quinn, 65, is a former Mission Hospital nurse who worked at the facility for 11 years, prior to the purchase by HCA. She said that during those years, “it was the best hospital I had worked in in my 43-year career as a nurse.”

Things were different when she returned last year to bring her 89-year-old mother to the emergency room for health-related issues, Quinn said.

“It was very, very traumatic. I’ve worked in small rural [hospitals], and I’ve worked overseas in developing countries and large medical centers, and I’ve never experienced something so stress-inducing,” Quinn said.

Quinn said her mother ended up spending a total of 44 hours in the emergency room due to understaffing.

“I followed up with anyone who would listen to me at the hospital. I wrote a letter to the attorney general. … I really, really think they’ve lost the trust of the people in this community,” Quinn said of HCA Healthcare.

This story has been updated to reflect that HCA Healthcare confirmed the authenticity of Lowe's email to staff.

Felicia Sonmez is a reporter covering growth and development for Blue Ridge Public Radio.