Buncombe County doesn’t have any legal control over how its morgue is run, elected officials say, countering state health department statements in an Asheville Watchdog report that found more than 100 bodies had been released from Mission Hospital to funeral homes without legally required examinations.

Buncombe County’s manager and two commissioners cited limitations in state law when asked if there was anything that should be done to prevent more bodies being released from Mission without a required review. The HCA Healthcare-owned hospital operates the morgue for Buncombe and Madison counties.

“When I came to Buncombe, an early priority was establishing a written contract to ensure we were in compliance with NCGS. § 130A-381,” said County Manager Avril Pinder via email, referring to the state statute that requires each county to provide or contract for facilities to store and inspect bodies needing medical examiner review.

“Through our contract with Mission/HCA, we provide or contract an appropriate facility for the examination and storage of bodies under Medical Examiner jurisdiction. We do not have a statutory role in oversight/supervision of morgue operations/medical examiners or the release of the bodies to the next of kin,” said Pinder, who started her role in 2019.

The North Carolina Department of Health and Human Services, which oversees the state’s Chief Medical Examiner’s Office, told The Watchdog in April that oversight must happen at a local level.

Under state law, Mission’s morgue is “under the direction of” the county manager, NCDHHS spokesperson Summer Tonizzo said. The Office of the Chief Medical Examiner under NCDHHS “does not have oversight or enforcement authority,” Tonizzo said.

The Watchdog sent messages and made calls to all Buncombe County commissioners for comment. Commission Chair Amanda Edwards responded with a message nearly identical to Pinder’s. Commissioners Terri Wells and Drew Ball’s responses were similar. 

The responses were crafted by staff attorneys, county spokesperson Lillian Govus said.

Commissioner Martin Moore said he was talking to staff about The Watchdog’s questions but did not provide further comment before publication. Commissioners Al Whitesides, Jennifer Horton and Parker Sloan did not provide statements.

State legislators said they would be willing to look into gaps in state law and county oversight.

“Clearly, the county should ensure that it meets its obligations under state law,” said Democratic Rep. Eric Ager. “I’m not an expert on the county’s contract with Mission Health, but it seems to me that a review is necessary in light of your findings … I would certainly be willing to investigate possible legislative fixes at the state level to ensure that morgue operations are held to a high standard.” 

Democratic Sen. Julie Mayfield contacted a NCDHHS and a North Carolina Department of Justice official following The Watchdog’s story, which found Mission had released at least 111 bodies between 2021 through March 2025 without legally required reviews, according to a list kept by local medical examiners. In North Carolina, there is no law that levels consequences when an entity skips these examinations.

“Please let me know if we need to address the lack of enforcement authority legislatively or whether either of you has a mechanism available to you,” Mayfield wrote in an April 19 email.

Karen Burkes, NCDHHS acting deputy secretary for health and director of the Division of State Operated Healthcare Facilities, told Mayfield on April 22 she would speak with team members.

Democratic Rep. Lindsay Prather said she thought the issue was worth examining.

“I’d be interested to hear what reasons are given for why these bodies are being released early, as that would help determine at what level the change needs to be made, or if enforcing/strengthening current law would be enough, or whether it’s a staffing issue or space issue, etc.”

Democratic Rep. Brian Turner said there was a possibility the legislature could discuss the issue and noted some elected officials have worked in the funeral business.

“I think that regardless of your beliefs, your faith, your spirituality, there’s always a concern about how human remains are handled,” Turner said. “To [read] what we would consider our biggest healthcare system in western North Carolina doesn’t have the processes in place to make sure that these laws are being met is concerning.”

Republican Sen. Warren Daniel did not respond to The Watchdog’s questions.

Mayfield told The Watchdog that the issues presented in its investigation show potential gaps in HCA’s management.

“The morgue story raises the question of why can’t HCA, which is a sophisticated, well-resourced company with smart lawyers, comply with NC law?” Mayfield said. “They can, of course, if they choose to. This points once again to the negative impact of HCA intentionally under-staffing the morgue, which of course is a cost center rather than a profit center for them.  As in so many other instances, the problems are self-imposed and fixable with more investment by HCA.”

Mayfield is a founding member of Reclaim Healthcare WNC, an organization focused in part on finding a way to get the Mission Health system back into control of a nonprofit, restoring the model it operated under before Nashville-based HCA bought it for $1.5 billion in 2019.

Asked if HCA had made any recent changes to Mission’s decedent affairs system at Mission Hospital, spokesperson Nancy Lindell said, “I don’t have anything further for you.”

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Asheville Watchdog is a nonprofit news team producing stories that matter to Asheville and Buncombe County. Andrew R. Jones is a Watchdog investigative reporter. Email arjones@avlwatchdog.org. The Watchdog’s local reporting is made possible by donations from the community. To show your support for this vital public service go to avlwatchdog.org/support-our-publication/.

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