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Mission Health fined by NC Department of Labor for failing to report an employee’s COVID-19 death

Lilly Knoepp

Mission Health has been fined almost $30,000 by the NC Department of Labor for violating health and safety laws. The eight violations include not reporting a work-related COVID-19 hospitalization or the employee’s subsequent death in November 2021.

HCA Healthcare and Copestone, a mental health service that is part of Mission Health, were both cited for failing to ensure that respirator masks such as N-95 masks were fit-tested or tracking fit-testing in October 2021. The N-95 respirator masks are worn by staff when working with COVID-positive patients.

National Nurses Organizing Committee, which represents 1,500 nurses at Mission Health, applauded action.

“We union nurses have been fighting for a safer workplace throughout the pandemic,” said Kerri Wilson, RN in the cardiac step-down unit at Mission Hospital in an NNOC press release.

“Our workplace is safer because we spoke up, we reported safety violations, and we took the time to show OSH investigators what needed to be corrected. Because our union contract protects our ability to advocate, we know that we can play an active role in exposing the shortcomings of management,” Wilson said.

HCA, which owns Mission Health, has 15 working days starting March 22, 2022 to respond to the citations by requesting a conference or an appeal. The other option is to pay the penalties.

Mission Health spokesperson Nancy Lindell said that Mission is looking into the citations.

"The safety and well-being of our patients and caregivers is our top priority," said Lindell in an email. 

"We know the importance in fit-testing and only paused the practice at the guidance of the North Carolina Department of Labor and OSHA early in the pandemic. Once it was deemed appropriate to reinstate the practice in 2021, Mission Hospital took steps to do so. We value the OSHA tracking and reporting process, however, we are working with them to clarify these recent findings," she continued.

When asked about the COVID-19 related employee death at Mission, Lindell said that there was no evidence that the death was work-related.

"We are deeply saddened by the loss of one of our caregivers. We have no evidence that directly ties their illness to the loving care they gave our patients," said Lindell in an email.

NC DOL says that it cannot comment on Mission’s specific case because it is still in the 15-day open inspection. However, the department clarified that a workplace fatality is one that can clearly be tied to the workplace.

“Basically, if there’s a reasonable belief that the employee contracted COVID at the worksite and the person subsequently died of COVID, the employer should report the fatality to the OSH Division,” explained Jennifer Haigwood, Director of Communications and Policy Development at NC DOL in an email.

The department also shared an April 2020 memo which outlined temporary enforcement guidance during the COVID-19 pandemic. The memo explained that as long as employers were attempting to comply with OSHA standards, due to difficulties related to the pandemic employers would be given “good-faith discretion.”

The memo states, “Discretionary enforcement of OSHA standards by the OSH Division, and in accordance with the attached OSHA memorandum is contingent upon evidence that the employer has made good-faith efforts to comply with annual and other recurring requirements of an OSHA standard and has a contingency plan in place to fulfill these requirements when business and availability of services have resumed.”

Here’s the full breakdown of the citations:

  • In response to a October 2021 inspection, NC DOL issued a citation to Mission Health because the employer did not ensure that the employees using a tight-fitting facepiece respirator were fit-tested prior to wearing the respirators; and then fit-tested annually afterwards. Mission also didn’t keep track the fit tests administered. These were serious and non-serious violations totaling a proposed penalty of $7,275 dollars.
  • In response to a November 2021 inspection, NC DOL issued a citation to Mission Health for the same fit test issues. This time the penalty increased to $7,000 and $975 respectively. Mission Health is also cited for not reporting the COVID-19 work-related hospitalization and subsequent death of an employee on 11/10/2021. These are both non-serious violations with a proposed penalty of $5,000 dollars and $2,250 dollars respectively with the fit test citations the penalties total $15,225 dollars.
  • In response to a October 2021 inspection at Copestone, NC DOL issued a citation to Mission Health because the employer did not ensure that the employees using a tight-fitting facepiece respirator were fit-tested prior to wearing the respirators; and then fit-tested annually afterwards. Mission also didn’t keep track the fit tests administered. These were serious and non-serious violations totaling a proposed penalty of $7,275 dollars.

Total proposed penalties equal $29,775 dollars.
This story has been updated with Mission's response.

Lilly Knoepp is Senior Regional Reporter for Blue Ridge Public Radio. She has served as BPR’s first fulltime reporter covering Western North Carolina since 2018. She is from Franklin, NC. She returns to WNC after serving as the assistant editor of Women@Forbes and digital producer of the Forbes podcast network. She holds a master’s degree in international journalism from the City University of New York and earned a double major from UNC-Chapel Hill in religious studies and political science.
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  • There were no requests for bids. Other than the giant for-profit Hospital Corporation of America (HCA), the board of Mission Health held substantive discussions with only two other potential partners: Novant and Atrium. Only Novant was invited to make a formal offer to counter the one Mission executives had solicited from HCA six months earlier.“In the end," a North Carolina Department of Justice investigator wrote, "an outside observer could conclude that HCA rose to the top among a limited number of bidders because the deck had been stacked in its favor from the beginning" by Dr. Ronald A. Paulus, then Mission Health's president and CEO, and Philip D. Green, Paulus's long-time friend and strategic advisor.Watchdog managing editor Peter H. Lewis and Pulitzer Prize-winning reporter Sally Kestin found those revelations — and many, many more — among more than 6,000 records released by the office of Attorney General Josh Stein in partial response to public records requests filed by Asheville Watchdog over the past two years.