North Carolina Attorney General Josh Stein (D) voiced concern Friday about a report on conditions at Mission Hospital, calling the news “extremely alarming.”
The Asheville Watchdog reported Thursday that state investigators have concluded that conditions at Mission Hospital pose “immediate jeopardy” to patients’ safety. The Asheville facility is at risk of losing Medicaid and Medicare funding if the issues are not rectified.
"Today’s news is extremely alarming and reinforces my deep concerns about the quality of care people in western North Carolina are receiving at HCA. I appreciate CMS and DHHS for their hard work to improve the situation for patients,” Stein said in a statement, referring to the Centers for Medicare & Medicaid Services and the North Carolina Department of Health and Human Services.
“I will continue to do everything in my power to protect people’s health care – including continuing to vigorously pursue my lawsuit against HCA,” he added.
Stein, who is running for governor, last month sued the hospital’s owner, HCA Healthcare, alleging that the for-profit company had breached the terms of its 2019 purchase of the previously-nonprofit Mission Health System.
At an Asheville news conference, Stein said HCA is not providing quality, consistent oncology and emergency care, in part due to understaffing at its facilities. The determination of “immediate jeopardy” from state investigators is separate from the attorney general’s 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.”
“Serious harm, injury, impairment, or death does NOT have to occur before considering Immediate Jeopardy. The high potential for these outcomes to occur in the very near future also constitutes Immediate Jeopardy,” the CMS guidelines state.
According to the Asheville Watchdog report, the North Carolina Department of Health and Human Services sent a letter Dec. 19 to Mission CEO Chad Patrick informing him of one “immediate jeopardy” designation as a result of incidents on seven dates from April 2022 to October 2023.
A second “immediate jeopardy” designation resulted from incidents on two other dates in November 2023, the letter stated. All of the incidents were related to conditions in the Mission Hospital emergency department, where staff allegedly “failed to provide a safe environment for patients” by, among other things, “failing to accept patients on arrival.”
“[Emergency department] nursing staff failed to assess, monitor and evaluate patients to identify and respond to changes in patient conditions,” the letter stated. “The hospital staff failed to ensure qualified staff were available to provide care and treatment for patients who arrived in the ED. The cumulative effects of these practices resulted in an unsafe environment for ED patients.”
In a statement Friday, HCA Healthcare spokeswoman Nancy Lindell said Mission Hospital has received preliminary results from the Centers for Medicare & Medicaid Services survey and that it is taking action to address the findings.
“We have taken those results seriously, and there are no excuses for our patients receiving anything other than exceptional care,” Lindell said. “This is not the standard of care we expect, nor that our patients deserve, and we will work diligently to improve.”
A spokesperson for the state Department of Health and Human Services declined to comment.
Some Mission Hospital staff hailed the state inspectors’ findings as a validation of the concerns they and others have raised for years.
“Unfortunately, I’m not surprised. But I am kind of relieved that they actually found what we’ve been reporting rather than the hospital being able to cover up like they have since HCA bought us,” Kerri Wilson, a registered nurse at Mission Hospital’s cardiac stepdown unit, told BPR in an interview Friday afternoon.
Wilson, 37, has worked at Mission for eight years and is a member of the Professional Practice Committee, a group of unionized nurses who regularly raise concerns with hospital leaders. Wilson said that while it is unfortunate that it has taken action by regulatory agencies to force change, she and other nurses hope the hospital will “do the right thing” by hiring more staff and “allowing us to actually take care of patients the way that they deserve.”
“Every time inspectors come to town, they bring in extra staff and they do all these things to try to cover up the problems,” she said. “But things have gotten so bad that they couldn’t hide it this time. And so I’m glad that the community knows and that they’re being held accountable.”
