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Federal authorities accept latest Mission Hospital plan of correction; June 5 deadline remains

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

Federal authorities have accepted Mission Hospital’s latest proposal to correct issues related to patient safety, as inspectors continue to investigate conditions at the facility following its 2019 purchase by for-profit HCA Healthcare.

In a letter Tuesday to Mission CEO Chad Patrick, the Centers for Medicare and Medicaid Services said Mission’s plan to correct violations of the Emergency Medical Treatment & Labor Act, or EMTALA, had been reviewed and found acceptable.

However, HCA could still lose its federal Medicare and Medicaid funding if it does not pass another inspection in the coming months.

“When the North Carolina State Survey Agency has determined that the noncompliance with EMTALA requirements has been corrected, CMS will withdraw its current termination action. Failure to correct the deficient practice by June 5, 2024 will result in the termination of your Medicare provider agreement,” reads the letter, a copy of which was obtained Friday by BPR.

The violations were uncovered during a November 2023 visit to the hospital by state inspectors. CMS informed HCA of the violations earlier this month.

Nancy Lindell, a spokeswoman for HCA Healthcare, said the company is "pleased that our amended plan has been accepted."

"As we continue to state, we take these matters very seriously and have made significant process changes to improve our patient care experience," Lindell said. "Ongoing measurement of various indicators, including EMS offload times and patient satisfaction, validates what we are hearing from our patients, providers, and EMS partners—that our care teams are excellent and significant improvement in emergency care has been recognized."

State investigators concluded in December that conditions at Mission Hospital posed “immediate jeopardy” to patient safety – the most serious warning a hospital can receive. That designation has since been lifted, but HCA faces continued pressure to address conditions at its facilities.

HCA is also facing a slew of lawsuits, including one filed late last year by state attorney general Josh Stein alleging HCA breached the terms of its purchase agreement by failing to provide quality emergency and oncology care at its facilities.

A 384-page report released by CMS last month detailed multiple safety issues – including delayed treatment, understaffing and failures to provide timely care – that in several cases led to patient death.

According to the latest documents from CMS, the EMTALA violations were related to the previously-reported case of a 66-year-old man who was brought to Mission Hospital by emergency medical services in October 2023 with complaints of chest pain and shortness of breath.

The inspectors found that “there was a delay in triage, medical screening and interventions” for the patient, who died after going into cardiac arrest just before 8 p.m., about two hours after his arrival at Mission Hospital.

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