At this point, six years after HCA’s purchase of Mission Health, I think we can all agree that HCA Mission is not exactly the most popular health care provider around here.

At Asheville Watchdog, investigative reporter Andrew R. Jones has spearheaded our coverage of many of Mission’s shortcomings under the ownership of HCA Healthcare, a for-profit company based in Nashville that bought then-nonprofit Mission in 2019 for $1.5 billion. Those issues range from an exodus of doctors and nurses, dirty patient rooms and inadequate patient care to lax oversight at the hospital’s morgue, an unattended patient dying in the emergency department’s bathroom and, in 2024, Mission being hit with “immediate jeopardy” by the U.S. Centers for Medicare & Medicaid Services, the most severe sanction a hospital can face.

Asheville Mayor Esther Manheimer, along with a handful of other elected officials, has been critical of HCA and its actions since its takeover. The community at large has freely expressed its disappointment and anger with Mission, with many lamenting the demise of a once-great community hospital.

So when a 30-second ad popped up recently on WLOS-News 13 featuring Manheimer praising HCA Mission for its performance after Tropical Storm Helene devastated our area, it raised a lot of hackles.

Here’s a taste from a Facebook posting about the ad on Asheville Politics:

“We’ve known for a long time that our mayor is a corporate shill and yet she got voted in against Roney in the last election because (people) were afraid Roney wouldn’t be tough enough on homelessness,” Lauren Loiacono wrote in the comments, referring to Councilmember Kim Roney.

“She what? She obviously hasn’t had to sit in the ER for 12 hours to get seen. But it’s about the $$ they earn for the city. Makes me sick. Mission used to be a wonderful hospital,” Teryll Higgins wrote.

Folks on Reddit were way less restrained.

Here’s what Manheimer says in the ad:

“This storm tested any readiness you could possibly have, and that was critical that we all had strong partners, and HCA Healthcare was that strong partner, doing their part to help all the people of western North Carolina. Having HCA Healthcare continue to treat everybody who walked through their door was fundamental to not losing more lives in our community.”

A female announcer then intones, “In a disaster response and every day, our goal is the same: caring for western North Carolina. HCA Healthcare, your partner in health.”

So, how did this happen?

I texted and emailed with Manheimer about this last week, and she told me she’s “disappointed that HCA would leverage our devastating experience with Helene to run advertisements” and that she “had no idea they were going to make the documentary piece into an ad.”

“HCA gave me a heads-up last week that they are using footage of me in a promotional video,” Manheimer continued. “They advised me that they have the rights to the footage because it was taken from a documentary about Helene that I, along with many other people, consented to be interviewed for.”

You can find that 5-minute HCA documentary here. The 30-second ad does take Manheimer quotes from the longer piece.

Manheimer also said that over the past seven months she’s been interviewed by several different folks filming Helene documentaries.

“I assume HCA gave me a heads-up about this ad because I am on record as harshly criticizing HCA Healthcare and, among other instances, giving them a wakeup call last year when I called on HCA, which is an enormous for-profit hospital company, to put patient safety first or sell Mission Health System to a nonprofit entity,” Manheimer told me. She was referring to a February 2024 news conference, just days after the immediate jeopardy sanction, in which multiple local leaders and elected officials criticized HCA Mission and made the demand to improve or sell.

Manheimer said she agreed to do the longer “documentary” video “because it was important to me to recognize the work and sacrifice that the employees in HCA made in the days and weeks following the storm.”

“They truly went above and beyond, and in this dispute between HCA and the city, county and state (all three of which are suing HCA) I worry that the employees suffer as collateral damage and don’t get the recognition they deserve for their work,” Manheimer said.

Allow me to note, in full disclosure, that my wife has worked at HCA Mission for 25 years as a registered nurse. I’ll also note that HCA did bring in supplies and extra personnel to help after the storm, and in the immediate aftermath of Helene, The Watchdog’s Jones wrote about heroic efforts to provide care under harrowing conditions. 

Mission Health spokesperson Nancy Lindell said via email that they were upfront with Manheimer about the video.

“Of course we have a release, and she understood that it would be used as a 30-second spot before we aired it,” Lindell said. “This TV spot is similar to others seen throughout our region sponsored by key organizations expressing the same gratitude and pride in their team efforts as HCA Healthcare is expressing.”

I asked for the release but did not receive it by deadline.

Lindell said Mission is “tremendously proud of the care our team provided during Hurricane Helene, and we are honored that the mayor was one of several community leaders who expressed their appreciation as part of a longer video developed to recognize these incredible efforts six months after the storm.

“That powerful video received such an overwhelmingly positive response from the thousands of HCA Healthcare colleagues who live here, were affected by the storm, and answered the call to serve our community, that we wanted to share a shorter version more broadly,” Lindell continued. “These videos are intended to celebrate the ingenuity, resilience and determination demonstrated by our team and our western North Carolina community. We have many amazing stories about the care provided within Mission Health that we have and will continue to share as an anchor institution in western North Carolina.”

‘It’s clearly bad politics’

Chris Cooper, a political scientist at Western Carolina University, says no matter how it came about, Manheimer appearing in an ad for HCA Mission is “clearly bad politics”.

“I think we can go ahead and dispose of that question,” Cooper said. “You’ve watched ‘Tom and Jerry’ (cartoons) when you’re a kid — it’d be like if Tom did an ad for Jerry.”

It’s for these keen analogies that Cooper makes the big bucks. Seriously, he dove a little deeper into this imbroglio.

“I think it was a mistake, but one born out of good intentions,” Cooper said. “I believe her that she wanted to say thanks to the employees of HCA who did objectively do a great job, and do deserve some credit.

“At the same time, she’s a lawyer, and if she’s gonna sit down and give her name and likeness and quotations to HCA, she’s got to understand that they can do what they want to with it.”.

So it’s understandable that Manheimer, especially in the gut-wrenching weeks after Helene, felt like she was offering quotes for a documentary lauding employees. But it was also a little naive to think HCA Mission might not do something else with her comments.

“I think ‘naive’ is probably a good adjective,” Cooper said. “Certainly not evil, certainly not duplicitous, certainly not unethical, but just a little naive.”

Cooper also noted that Manheimer’s quotes used in both videos basically extol the larger institution, not employees. We don’t know what got edited out, though.

After the storm, we were all trying to unite, and by many accounts, Mission and HCA did step up. So Manheimer giving credit where it was due made sense, Cooper said.

“At the same time, this is still the same ‘big bad HCA’ that she and others have been fighting against for years,” Cooper said. “And the storm wasn’t going to change who HCA is, and the fact that, at the end of the day, they’re trying to make money.”

The documentary also included local leaders of United Way of Asheville and Buncombe County, the Mountain Community Health Partnership in Burnsville, the McDowell County Emergency Medical Services and the head of Mercy Chefs, which provided meals after the storm.

But Manheimer is the only elected official in the longer piece, and the only person in the shorter ad. Her appearance in the ad, whether she knew it was coming or not, “reads as an implicit endorsement from the city,” as she is the mayor, Cooper said.

“I don’t think that’s what she was trying to do, but that is how it looks,” Cooper said.

On the HCA Mission side, this is what corporations and their marketing people do — promote themselves. 

“I think if they described this to the mayor as a documentary, that’s a little misleading, but I would expect nothing more or less from HCA or most any corporation,” Cooper said. “Unfortunately, there’s a lot of people trying to use the storm to their own benefit, and HCA is not the first or the last, unfortunately.”

Manheimer was pretty gushy about HCA in the longer documentary, too, at one point saying, “An event like this makes you realize that you’re all on the same team, and you’re partners in an effort to serve the people, and that was critical that we all had strong partners and HCA Healthcare was that strong partner, doing their part to help all the people of Western North Carolina.”

Cooper views this whole incident as a “one-off” — a mistake for Manheimer, for sure, but not one that’ll cause lasting damage. 

“I think the fact that it was a mistake was implicit in what she wrote,” Cooper said, referring to Manheimer’s messages to me. “But no, I don’t see this as the kind of thing that would stop her political career. If she decides to run for the 11th Congressional District, this isn’t gonna matter one way or the other.”

For the record, I haven’t heard anything about Manheimer running for Congress, but if she does, I suspect an opponent might make some hay out of the ad. Politics get ugly, you know, and some folks have very long memories. 

In the meantime, I suspect the mayor has learned a valuable lesson about who to give “documentary” interviews to.

Asheville Watchdog welcomes thoughtful reader comments about 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. John Boyle has been covering Asheville and surrounding communities since the 20th century. You can reach him at (828) 337-0941, or via email at jboyle@avlwatchdog.org. To show your support for this vital public service go to avlwatchdog.org/support-our-publication/.

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