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HCA says it honored Mission sale agreement in 2024, the same year hospital faced immediate jeopardy • Asheville Watchdog

Published

12 hours ago

May 22, 2025

avlwatchdog.org – ANDREW R. JONES – 2025-05-22 15:16:00

HCA Healthcare, the corporate owner of Mission Hospital, maintains it honored its asset purchase agreement (APA) in 2024, the same year the federal government placed the facility in immediate jeopardy because of deficiencies in care in its emergency and oncology departments.

HCA’s report, submitted to the independent monitor of Mission’s sale and obtained by Asheville Watchdog, makes no mention of the federal sanction, the toughest a hospital can face.

The APA, created in 2019 at the time of HCA’s purchase of the Mission Health system, binds HCA to several commitments regarding how it would maintain and expand services throughout the hospital system. HCA is required to submit a report on its compliance each year to Dogwood Health Trust and the independent monitor it employs to ensure HCA is staying in compliance with the APA.

One of those commitments was that the hospital would “remain enrolled and in good standing” with the U.S. Centers for Medicare & Medicaid Services.

“During the Reporting Period, the Material Facilities and the Local Hospital Facilities remained enrolled and in good standing in the Medicare and Medicaid programs,” HCA said in its 2024 report.

But the report did not acknowledge that on Feb. 1, 2024, Mission announced it had been placed into immediate jeopardy after state and federal investigators found 18 incidents in 2023 of patient harm, including four deaths.

A finding of immediate jeopardy places a healthcare facility’s Medicare and Medicaid funding in jeopardy. HCA and Mission were given 23 days to issue a plan of correction. CMS lifted the sanction after reviewing the plan less than a month later.

HCA and Mission Health spokesperson Nancy Lindell did not respond directly to questions about why the immediate jeopardy finding wasn’t included in the report.

“This is covered in the report you have,” she said.

This isn’t the first time HCA has given itself sterling marks despite controversies surrounding Mission.

In its 2023 self-report, HCA maintained that it had honored all commitments in the APA, despite then-North Carolina Attorney General Josh Stein suing HCA and Mission. Stein’s litigation alleged HCA has mismanaged Mission, endangering patients and prompting an exodus of doctors and nurses, and has shuttered or reduced some services, which he says violate the APA.

HCA countered that it never promised to deliver quality care, arguing that APA commitments “are not promises to meet subjective healthcare standards.”

Last year’s finding of potential non-compliance

Affiliated Monitors, Inc., the independent monitor responsible for assessing HCA’s compliance with the APA, disagreed with the company’s previous self-assessment. In 2024, AMI published a report that found HCA in potential non-compliance for several issues, including the immediate jeopardy finding.

Addressing HCA’s 2024 self-report, AMI Managing Director Gerald Coyne said the company made “a similar claim … in last year’s report (2023), which we analyzed in light of the initial immediate jeopardy findings brought against the company late in 2023.”

“Our analysis concluded that although the company did, in fact, remain enrolled in Medicare and Medicaid, it did not remain ‘in good standing,’ Coyne said. “That determination was cited as one of the grounds that we concluded that HCA was in potential non-compliance with the Asset Purchase Agreement.”

“This issue was discussed in our recent community meetings in Marion and Asheville. Our review of activities in the calendar year of 2024 is ongoing, but the analysis of this issue we used last year is consistent.”

In a community meeting in Asheville earlier this month, Coyne said that his group is paying attention to quality-of-care issues at Mission.

AMI is employed by Dogwood, the independent entity created from the proceeds of the Mission sale and responsible for improving health care, education and economic opportunity in western North Carolina. Dogwood also is responsible for holding HCA accountable by reviewing the independent monitor’s recommendations and deciding if the hospital is out of compliance.

“Dogwood wants to honor and follow the established monitoring process, allowing the Independent Monitor to finish its active review of HCA’s annual report,” a spokesperson said when asked about the apparent gap in HCA’s report. “As our advisor, the Independent Monitor will complete their review and submit a report to Dogwood for our review. From there, we will be able to share our findings with the Attorney General and any statements with the public as we have in the past, typically by the end of July.”

HCA has touted its ownership of Mission since Tropical Storm Helene and highlighted the hospital’s response to the disaster.

The company, whose revenue is up $1 billion from the previous fiscal year, showed multiple images of Mission Health staff serving during Tropical Storm Helene response efforts in its annual nationwide impact report. One photo shows Melina Arrowood, COO at Sweeten Creek Mental Health and Wellness Center, hugging HCA CEO Sam Hazen.

HCA was broadly praised for its response to the storm’s impact and aftermath. It provided water, food, gas, volunteer health care workers and other resources badly needed to help weather the hardships brought on by the disaster.

Despite this triumph, Mission still faced physician departures, frustrations from nurses whose pay was cut, the shuttering of the only long-term acute care facility in the region — which was permitted by the APA — and ongoing outcry over a lack of staff.

In February, a patient died in an emergency department bathroom after his call for assistance went unanswered for several minutes.

Surveyors from the North Carolina Department of Health and Human Services returned to Mission Hospital last week, investigating nurse complaints about staffing and at least one patient death.

Asheville Watchdog welcomes thoughtful reader comments on this story, which has been republished on our Facebook page. Please submit your comments there.

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/.

Original article

The post HCA says it honored Mission sale agreement in 2024, the same year hospital faced immediate jeopardy • Asheville Watchdog appeared first on avlwatchdog.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

This article exhibits a center-left bias by focusing critically on a large healthcare corporation’s failures and regulatory issues, emphasizing patient harm, legal challenges, and accountability. The language highlights controversies, lawsuits, and whistleblower concerns, which align with values of consumer protection and oversight often associated with center-left perspectives. However, the reporting remains largely fact-based and sourced, including responses from the company and regulators, avoiding overt editorializing or ideological rhetoric that would push it further left. The coverage leans toward holding corporate power accountable while maintaining journalistic restraint.

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News from the South - North Carolina News Feed

Man pleads guilty in death of 82-year-old man at Home Depot

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May 22, 2025

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www.youtube.com – WRAL – 2025-05-22 13:08:12

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News from the South - North Carolina News Feed

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Published

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May 22, 2025

Staff Editor

www.youtube.com – ABC11 – 2025-05-22 12:42:07

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News from the South - North Carolina News Feed

Veterans Affairs cuts create concern in NC

Published

19 hours ago

May 22, 2025

Staff Editor

carolinapublicpress.org – Jane Winik Sartwell – 2025-05-22 08:43:00

by Jane Winik Sartwell, Carolina Public Press
May 22, 2025

Darlene Fore is terrified. She’s a nurse at the Veterans Affairs Medical Center in Asheville: a hard, but stable, federal job. Last year, her family was devastated by Tropical Storm Helene. Now, as she reaches 60 years old, her job, and her retirement benefits, could be taken away at any moment.

So too her union rights to bargain.

Veterans Affairs, the federal agency responsible for providing veterans’ health care, benefits and support services, is cutting staffing by 15% in the name of efficiency.

That means nearly 2,600 people out of a job in North Carolina alone. And more than 72,000 nationwide.

Fore is not a bedside nurse in Asheville. She reviews charts for medical documentation to judge whether a veteran should be billed for services, asking questions like: Should this person still be in the hospital? Why is this person’s chest pain not going away? Is the doctor following the right care plan?

It’s exactly the kind of behind-the-scenes job President Donald Trump intends to cut.

Some worry that this reduction in force — coupled with an executive order barring federal workers from organizing — will diminish the quality of health care for North Carolina’s 615,000 veterans and their families. North Carolina is the ninth-most populated state, but has the eighth-largest population of veterans.

Others genuinely believe the federal agency is bloated, and that a long, hard look at that bloat will directly benefit veterans: less bureaucracy and waste will mean that veterans are connected with the services they need more quickly.

For Fore, it’s a question of livelihood.

“The thing that bothers me the most is my countrymen saying I’m not worth it,” Fore told Carolina Public Press. “I’m the same nurse who worked in their local hospitals and local health departments. I’m the same nurse who’s always been there for them all this time, and now, all of a sudden, they think I’m a waste of money. I’m furious about that. I’m extremely hurt by my community.”

The Asheville VA is one of the largest employers in Western North Carolina. Since Tropical Storm Helene devastated the area last September, unemployment rates in the area have skyrocketed. The loss of even more jobs is a frightening prospect.

Fore’s daughter and sister both lost their homes in Helene. She is working not only to support herself but to help her family get back on their feet.

On the other side of the equation are the veterans themselves, who come to the VA to receive care. One of these is state Rep. Eric Ager, D-Buncombe, who served in the Navy from 1996 to 2021.

“The VA is more than just a place to show up and get medical service,” Ager told CPP. “It’s a place to support the whole veteran. The VA in Asheville is such a welcoming environment: people have the time to talk to people. That’s not something you see in the regular medical community.

“I’m worried that the cuts will make the workforce at the VA more stressed out and give them less time to actually engage with veterans who need that. Veterans should feel like they’re welcome in a place, as opposed to just getting run through like a number.”

It’s not just Asheville. The VA operates medical centers in Fayetteville, Salisbury and Durham as well.

Ann Marie Patterson-Powell, a nurse at the Durham VA, thinks that cuts anywhere in the system will make bedside nurses’ and doctors’ jobs harder. They will be the ones to pick up the slack, leaving them with less time to actually treat patients.

Front entrance of the Veterans Administration hospital in Durham, seen here on May 20, 2025. Frank Taylor / Carolina Public Press

The right to unionize and bargain is extremely important to Patterson-Powell, who is a union leader for National Nurses United. In her view, VA nurses stand up for veterans, and the union stands up for VA nurses.

Now, President Trump wants to strip federal workers of their union rights.

“You don’t get to do that — to tell me I’m not a part of an organization that keeps me safe at work — even if you are the President of the United States,” Patterson-Powell said.

She is outraged on behalf of the veterans she serves.

“We should all feel shocked and disappointed,” Patterson-Powell said. “The level of disrespect for people who put on a uniform and risked their lives to defend this country is just wrong. Someone has to stand up for them.”

In 2024, the Office of Inspector General determined that the VA was suffering from severe occupational staffing shortages. Before any cuts were proposed, 82% of VA facilities reported nurse shortages. Now, the worry is that wait times and barriers to specialty care will increase even further for veterans.

The current VA leadership doesn’t see it that way.

“As we reform VA, we are guided by the fact that, even though the Biden Administration astronomically grew the department’s budget and number of employees, VA wait times and backlogs increased,” wrote VA press secretary Pete Kasperowicz.

“We are doing things differently. Our goal is to increase productivity, eliminate waste and bureaucracy, increase efficiency and improve health care and benefits to Veterans. We will accomplish this without making cuts to health care or benefits to Veterans or VA beneficiaries.”

Some veterans in North Carolina tentatively agree with this view. One of these is Shawn Kane, chief medical officer at UNC THRIVE, a health program for veterans.

Kane thinks that cuts could be beneficial if they target redundancy, cutting administrative or ancillary positions, while redirecting that saved money directly to patient care. Some old-fashioned inefficiencies exist, like excessive snail-mail appointment reminders, that could be modernized to save money, Kane said.

Detailed, targeted cuts really could improve the system, he thinks. But he isn’t sure that’s what’s in store.

“The devil is in the details,” Kane said.

“The bottom line is that if inappropriate cuts are made, there can be a drastic impact on the provision of health care access across the VA, in North Carolina and across the country. It comes down to nuance, and trying to stay apolitical. But currently, the leaders in our government are not very good at details.”

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

The post Veterans Affairs cuts create concern in NC appeared first on carolinapublicpress.org

Political Bias Rating: Center-Left

This article primarily emphasizes the potential negative impacts of federal workforce reductions and union rights restrictions on veterans and healthcare workers, portraying the cuts as threats to public service quality and worker security. It presents sympathetic perspectives from affected nurses and veterans, highlighting personal stories and concerns about job losses and care quality. While it includes the administration’s defense of efficiency and reform, the overall tone and framing lean toward advocating for protecting labor rights and public sector jobs, consistent with center-left viewpoints that prioritize social welfare and labor protections.