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Compliance with Mission purchase deal in doubt for HCA

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carolinapublicpress.org – Jane Winik Sartwell – 2025-07-29 11:16:00


HCA, which bought Asheville-based Mission Health for $1.5 billion in 2019, faces potential noncompliance with its purchase agreement for the second year. Key issues include reductions in emergency, trauma, and oncology services, failure to maintain good standing with Medicare/Medicaid, and charity care policy problems. While two issues were resolved in 2024, emergency and oncology service reductions persist. Former Attorney General Josh Stein sued HCA in 2023, alleging broken promises harming patient care, with current Attorney General Jeff Jackson supporting the lawsuit. Meanwhile, HCA is contesting attempts by AdventHealth to build a competing hospital in Buncombe County, delaying the project through legal appeals.

For the second year running, HCA is potentially not in compliance with its 2019 purchase agreement for the Asheville-based Mission Health hospital system.

The repeated compliance issues raise questions about whether HCA is fulfilling its promise to maintain health care services for Western North Carolina residents. 

HCA purchased Mission Health, the region’s largest hospital system, for $1.5 billion in 2019. In allowing the acquisition, the attorney general’s office placed key stipulations on the purchase, to which HCA agreed. 

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Dogwood Health Trust, which is charged with monitoring HCA’s compliance with the purchase agreement, announced Tuesday that it intends to notify the health system of three instances of potential noncompliance:

  • Diminished emergency/trauma and oncology services at Mission Hospital due to staff reductions
  • Failure to remain in good standing with the Centers for Medicare and Medicaid Services
  • Issues with uninsured and charity care policies

These are the same three instances Dogwood found last year when it found HCA potentially not in compliance. Two of these three issues are no longer active thanks to corrective action HCA took in 2024, according to Dogwood. The charity care policy was updated to explicitly prohibit patient liens, and the CMS standing issue was resolved when federal regulators lifted their Immediate Jeopardy findings in June 2024.

This leaves the continuation of emergency and oncology services as the last outstanding instance of potentially not being in compliance for HCA. 

NC lawsuit over HCA compliance

HCA promised in 2019 that it would not stop emergency/trauma and cancer care at Mission Hospital. Current governor and former attorney general Josh Stein believes this promise was broken.

He sued HCA in 2023 for this alleged degradation of care, which he says leads to long wait and travel times and improper and unsafe care. Stein’s suit argues that reductions in staff in both these wings rendered care inadequate or unavailable. 

In his complaint, Stein alleges that doctors and nurses are forced to treat patients in the waiting room, without adequate and sterile equipment due to staffing shortages. He writes that Mission Cancer Center no longer employs a single medical oncologist, and that patients with leukemia and lymphoma must travel to Charlotte or the Triangle for care. All of this, in his view, represents a breach of Mission’s promise to retain quality care for Western North Carolinians.

That case remains pending in Buncombe County Superior Court, meaning the instance of potential noncompliance is still active. 

Attorney General Jeff Jackson has 30 days to inform Dogwood about whether he agrees or disagrees with the trust’s findings. Jackson has made his position on Stein’s suit against HCA clear: he supports it.

“I know HCA was hopeful that a new attorney general would drop our office’s lawsuit,” Jackson said in a statement earlier this year. “I am the attorney general, and that’s not going to happen. 

“HCA broke the promises it made to provide emergency and cancer care services to the people of Western North Carolina. We’ll keep fighting for this case as long as it takes to restore the health care HCA promised to provide and western North Carolinians deserve.”

By Aug. 28, either Dogwood or the attorney general must notify HCA of any area in which the company is not in compliance. 

In addition, Dogwood is accusing HCA of “delayed production of documents and blanketed confidentiality constraints.”

However, Dogwood’s ability to hold HCA accountable is limited.

“Under the contract, our only remedy is what’s called ‘specific performance,’” Dogwood’s general counsel Rachel Ryan told Carolina Public Press. “In layman’s terms, that is basically saying that the person has to do what they said they were going to do under the contract. You can’t drag them into court and ask for a bunch of money or anything like that.”

Dogwood will host a webinar on Thursday, Aug. 7, from 12 p.m. to 1 p.m., to provide an opportunity for community members to learn more about the 2024 monitoring report.

But compliance with the purchase agreement isn’t the only legal arena where Mission’s dominance is being tested.

CON issue heading to Supreme Court

Mission Hospital is bringing its fight to prevent AdventHealth from building a competitive hospital to the North Carolina Supreme Court. 

Because of North Carolina’s Certificate of Need laws, the state must award hospitals a certificate in order to offer more hospital beds. The state has continually awarded certificates to AdventHealth to fill a need for hospital beds in Buncombe County, but each time, HCA appeals this decision.

HCA is currently one of the largest providers of hospital care in the mountains, especially in the region’s largest county, Buncombe, and the multiple rural counties where HCA operates the only hospital or where no hospitals are located and HCA’s are the closest option. That near monopoly in the region appears to be one that the corporation would like to hold onto. 

In June, the Court of Appeals ruled against HCA’s appeal of the state’s decision to grant AdventHealth 67 beds. On Friday, the state Supreme Court granted HCA’s request for a temporary stay on this decision. This will further delay AdventHealth’s project to build a 222-bed facility in Weaverville, a project on which they’ve already started construction. 

The Supreme Court has no deadline to decide whether to hear the full case.

This article first appeared on Carolina Public Press and is republished here under a Creative Commons Attribution-NoDerivatives 4.0 International License.

The post Compliance with Mission purchase deal in doubt for HCA appeared first on carolinapublicpress.org



Note: The following A.I. based commentary is not part of the original article, reproduced above, but is offered in the hopes that it will promote greater media literacy and critical thinking, by making any potential bias more visible to the reader –Staff Editor.

Political Bias Rating: Center-Left

The content critiques a large healthcare corporation, HCA, for potentially failing to meet its commitments to maintain healthcare services, highlighting legal actions led by Democratic officials. It emphasizes concerns about healthcare access and corporate accountability, themes commonly associated with center-left perspectives. However, the article maintains a factual tone without overt partisan language, reflecting a balanced but slightly progressive viewpoint focused on consumer protection and public health interests.

News from the South - North Carolina News Feed

Updated COVID vaccine approval adds restrictions for some patients

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www.youtube.com – ABC11 – 2025-08-29 23:25:04


SUMMARY: As fall approaches, updated FDA guidelines restrict COVID-19 vaccine eligibility primarily to those 65 and older or younger high-risk individuals with underlying conditions like asthma, diabetes, or heart issues. Raleigh pharmacy manager Santa Rita Christian notes customers must meet these criteria or have a prescription. The CDC will review these updates next month, influencing insurance coverage. CVS now requires prescriptions for vaccines in North Carolina and 12 other states due to unclear ACIP guidance, causing pharmacy confusion. Health experts urge parents to consult healthcare providers about risks, especially for young children and high-risk contacts.

The vaccines are approved for use in people 65 and older, as well as those younger with at least one health condition that makes them high-risk.

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BRIC program cuts leave NC communities in limbo

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carolinapublicpress.org – Lucas Thomae – 2025-08-29 05:00:00


Dozens of North Carolina communities face uncertainty after FEMA canceled over $200 million in flood-mitigation grants from the Building Resilient Infrastructure and Communities (BRIC) program. Forest City, awarded $2.6 million for water and sewer improvements, lost critical funding amid FEMA’s April 2025 termination of BRIC, deemed “wasteful and ineffective.” Seventy-two communities with active projects were affected, prompting bipartisan congressional opposition and a lawsuit led by North Carolina Attorney General Jeff Jackson, arguing FEMA’s action was illegal. Some projects continue with obligated funds, while others seek alternative funding. Local officials express frustration over the political fallout impacting essential infrastructure resilience efforts.

Dozens of North Carolina communities are in limbo after FEMA canceled more than $200 million worth of grants for flood-mitigation projects earlier this year in the Building Resilient Infrastructure and Communities Grant program, also known as BRIC.

For Forest City in Rutherford County, the now defunct grant program was meant to be a safety net. Flooding along the Second Broad River exposed the area’s vulnerability to heavy rainfall five years ago, when rising water smashed debris into a main line and cut off running water to Forest City and the nearby towns of Ellenboro and Bostic.

Repair work following the storm revealed more problems.

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Erosion along the river left Forest City’s sewer system and raw water intake at risk of flood damage, but the town didn’t have the money to fix it. Federal emergency management officials told town officials that they would be a good fit for a new grant program aimed at pre-disaster mitigation.

Through its Building Resilient Infrastructure and Communities Grant program, FEMA awarded Forest City $2.6 million for improvements to the town’s water and sewer systems. The project was well into the planning and design process when the federal government revoked the grant.

FEMA announced the end of the BRIC program and canceled all applications from fiscal years 2020 through 2023 on April 4, calling the program created during President Donald Trump’s first term “wasteful and ineffective” in press releases.

In total, 72 North Carolina communities with active BRIC-funded projects worth about $225 million were affected.

Town officials across the state told Carolina Public Press that the mitigation projects they view as essential to keeping their communities safe are now caught in a federal political battle in Washington.

“I don’t consider water and sewer projects to be political or woke,” Town Manager Janet Mason said.

Neither did a bipartisan group of 80 members of Congress, which released a letter addressed to Secretary of Homeland Security Kristi Noem and acting FEMA Administrator David Richardson shortly after the grant program’s termination, urging them to reverse the decision.

“BRIC funds are spurring communities across the country to strengthen their resilience to extreme weather, and forgoing these critical investments will only make it harder and more expensive for communities to recover from the next storm,” the letter read.

Instead, the legislators suggested that FEMA and Congress work together to improve the grant program’s application review and funding distribution processes.

Sen. Thom Tillis and Rep. Chuck Edwards, both North Carolina Republicans, helped craft the letter. Rep. Don Davis, a Democrat representing the northeastern part of the state, and Rep. Alma Adams, a Democrat representing Charlotte, were the other two members of North Carolina’s Congressional delegation to add their signatures.

The Department of Homeland Security did not respond to CPP’s request for a comment on pushback from lawmakers and local governments over the ending of the BRIC program.

Meanwhile, the communities with active BRIC-funded projects have been left to wait as the future of those funds is litigated in court. North Carolina Attorney General Jeff Jackson joined 19 other U.S. states in suing Noem and Richardson last month, arguing that FEMA’s termination of the grant program was illegal.

The lawsuit has three components.

First, it argues that a 2006 federal law protecting FEMA from being dissolved also prevents the government from “substantially reducing FEMA’s mitigation functions.”

Secondly, the complaint states that FEMA’s refusal to spend funds directed towards the BRIC grant program by Congress violates the legislature’s power of the purse, as granted by the Constitution.

Lastly, it claims that Richardson and his predecessor Cameron Hamilton, who was removed from his position as acting FEMA administrator on May 8, did not have legal authority to end the BRIC program because neither were ever confirmed by the U.S. Senate.

Those plaintiff states won a small victory on Aug. 5 when a United States District Judge placed an injunction on preventing the federal government from spending the BRIC funds until the court gives a final decision.

As noted in the lawsuit, FEMA had planned to return about $882 million of the BRIC funds to the U.S. Treasury and another $4 billion to its Disaster Relief Fund, which is reserved for post-disaster spending.

While many BRIC-funded projects in North Carolina have been put on pause as the federal money is withheld, some projects which have begun construction using already-obligated funds continue to advance.

Such is the case with Princeville, a low-lying community in Edgecombe County which was awarded $11 million to develop a 53-acre plot of land outside of the floodplain which encompasses much of the town.

Princeville Mayor Bobby Jones told CPP that the town continues to draw BRIC funds to work on the project.

Other communities, like Salisbury in Rowan County, are actively searching for alternative funding sources to complete their BRIC projects.

Salisbury was previously awarded $22.5 million through BRIC to relocate its existing water treatment facilities to a location more resilient to flooding. Utilities director Jason Wilson told CPP that the site of the new facilities is shovel-ready, which the city hopes makes it an attractive candidate for other grant programs.

The city intends to apply for FEMA’s Hazard Mitigation Grant Program, which unlike BRIC is a post-disaster relief program. Salisbury is eligible to apply since Rowan County was included in the federally declared disaster area following Hurricane Helene.

The City of Lumberton is also searching for a new source of funding for stream restoration, wetland preservation and trail construction projects, which it received a $1.9 million BRIC grant for several years ago.

The Robeson County city, which sits on the Lumber River, has been working since 2016 to develop land it bought from property owners following Hurricane Matthew into an expansive public trails system.

Deputy City Manager Brandon Love told CPP that he’s optimistic that the city will find an alternate source of funding to keep the project moving forward, but it’s nonetheless a disappointing development after years of planning.

“Getting caught up in the politics of things going on in Washington is hitting home here at the local level,” Love said, “and that’s unfortunate.”

This article first appeared on Carolina Public Press and is republished here under a Creative Commons Attribution-NoDerivatives 4.0 International License.

The post BRIC program cuts leave NC communities in limbo appeared first on carolinapublicpress.org



Note: The following A.I. based commentary is not part of the original article, reproduced above, but is offered in the hopes that it will promote greater media literacy and critical thinking, by making any potential bias more visible to the reader –Staff Editor.

Political Bias Rating: Center-Left

The content presents a critical view of the cancellation of a federal grant program initiated under the Trump administration, highlighting bipartisan concern and legal challenges against the decision. It emphasizes the negative local impacts and frames the termination as a politically motivated action that harms community safety and resilience efforts. The article leans slightly left by focusing on government responsibility in disaster mitigation and portraying the current administration’s actions as detrimental, while also acknowledging bipartisan opposition and including voices from both Republican and Democratic officials.

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Inside NC’s tourism push: Tracking Helene’s impact, ‘playing heartstrings’ & wrangling social media

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ncnewsline.com – Galen Bacharier – 2025-08-29 04:30:00

SUMMARY: After Hurricane Helene caused flooding and damage to western North Carolina’s Biltmore Estate and surrounding areas, Visit NC launched marketing campaigns to revive tourism. Initially urging in-state residents and visitors to cautiously return, they shifted to the “Rediscover the Unforgettable” campaign, promoting outdoor activities and local attractions. Despite sluggish tourism in 2025, spending remained near 2024 levels. Visit NC invested nearly $14 million in targeted advertising, leveraging social media influencers to counter negative online flood imagery impacting visitor sentiment. Support from Governor Josh Stein, a vocal advocate for the region’s recovery, has been crucial in maintaining positive momentum and encouraging travel.

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The post Inside NC’s tourism push: Tracking Helene’s impact, ‘playing heartstrings’ & wrangling social media appeared first on ncnewsline.com

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