Mission Health has permanently closed Asheville Specialty Hospital, the only long-term acute care hospital in western North Carolina, less than two months after suspending its services following Tropical Storm Helene.

“We have made the difficult decision to not reopen Asheville Specialty Hospital, a small, long-term acute care facility located inside the St. Joseph’s campus,” Mission Health spokesperson Nancy Lindell said Monday. “We have had to focus on prioritizing our resources during and after Hurricane Helene to care for the most urgent medical needs of our community. Since Hurricane Helene, ASH employees have been caring for patients at Mission Hospital and that continues to be where they are most needed.”

The 34-bed Asheville Specialty included a comprehensive stroke center, dialysis services, physical and speech therapy, and traumatic brain injury rehabilitation, among other services, according to Mission’s website. The next closest long-term acute facility, or LTACH, is in Greenville, South Carolina, a little more than 60 miles away.

The facility was one of three services that Mission Health temporarily shut down after Helene crippled western North Carolina and left Asheville, and Mission Hospital, without water. CarePartners and Solace hospice care also closed and more than 250 employees had to take temporary positions as patients were ported out to facilities in the region and out of state.

Asheville Watchdog reached out to Asheville Specialty’s current medical director Ronnie Jacobs, but did not hear back before publication. 

Dr. Scott Joslin, once director of Mission’s hospitalist program, currently works at the Asheville VA but served as medical director of Asheville Specialty from January through September 2022.

“It is a big deal,” Joslin said of the closure. “Having a long-term acute care hospital provides the western North Carolina area with a site where patients who have been ill for a very long period of time and still have some acute care needs can get that long-term acute care.”

Patients who would have been admitted to Asheville Specialty will now go to inpatient rehabilitation, skilled nursing care or another long-term acute care facility, Lindell said, but she did not provide specifics. Lindell also did not respond to questions about how many patients and employees the closure affected. 

Mission has permanent roles available for every caregiver who wants to stay with the company, Lindell said. 

Independent monitor: Move doesn’t violate purchase agreement

The closure does not violate agreements HCA made when it bought the Mission Health system, according to Gerald Coyne of Affiliated Monitors, the independent monitor responsible for holding HCA accountable for honoring agreements it made to the North Carolina attorney general’s office before the sale.

“I don’t believe it’s a required service,” Coyne said. He said he looked at the Asset Purchase Agreement (APA) when he heard the news of the closure but didn’t see anything that required Asheville Specialty to stay open for 10 years after the purchase.

“If it’s not part of the APA, there’s a limit to what we as the monitor can critique,” Coyne said. “We can’t say they’re violating it for sure. We are, of course, concerned, with the overall delivery of healthcare services. But… I’m not surprised that in the wake of some really horrific events, that there’s going to be some changes and we’ll just kind of try to look at them as a whole, rather than individually.”

Joslin, the former hospitalist, worked on and off with Asheville Specialty for more than 20 years and said the shuttering is likely related to operational efficiency. He said the age of the building could have contributed to the decision as well.

He said the building of the North Tower at least in part was influenced by the quality of the St. Joseph’s building where Asheville Specialty resides.

“One of the drivers behind the decision to build the North Tower was that, over time, the old St Joseph Hospital was becoming more expensive to maintain,” Joslin said. “It was nearing the end of its useful life at about age 50, and I was aware that we were having water leaks and electrical failures and infrastructure failures that they were trying to keep up with.” 

There were conversations about potentially relocating, he noted. Lindell did not answer The Watchdog’s question when asked if Mission would try to re-establish another LTACH in the region.  

“As more and more resources have moved out of the St Joseph building … the utility of keeping that open has become more and more questionable, both as a strategic decision as well as a financial decision, at least by my understanding.”

Although Asheville Specialty won’t reopen, Mission Health is starting to resume CarePartner services, Lindell said.

“With the return of municipal water, we began reopening CarePartners Inpatient Rehabilitation Hospital on Nov. 21,” Lindell said. “Teams are starting to return to roles there and we have begun admitting patients. We hope to have a date set soon for when we can begin to reopen CarePartners Solace.”

Since HCA Healthcare purchased Mission Hospital in 2019 for $1.5 billion, the once nonprofit hospital has faced an exodus of staff, including in medical oncology, urology, cancer pharmacy services and neurology.

In December 2023, North Carolina Attorney General Josh Stein sued HCA and Mission Health, alleging that they violated commitments made in the asset purchase agreement regarding cancer care and emergency services at Mission Hospital. 

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 during this crisis 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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