A state investigation into 35 complaints about patient care and management at Mission Hospital found it’s in compliance with federal standards, according to documents obtained by Asheville Watchdog.

Surveyors from the North Carolina Department of Health and Human Services visited western North Carolina’s largest hospital May 13 through May 16, following complaints from nurses about staffing issues in various departments, including the intensive care unit, and at least one patient death they alleged was avoidable.

“The purpose of conducting the complaint survey was to evaluate the Hospital’s compliance with the Federal Medicare Conditions of Participation,” NCDHHS nurse consultant Lea Gillis wrote to Mission Hospital CEO Greg Lowe on June 11. “As discussed in the exit conference, there were 35 intakes surveyed. Based on the investigative findings the hospital was determined to be in compliance and no deficiencies were cited.”

Gillis sent another letter to Lowe the same day, informing him that surveyors also conducted a federal Emergency Medical Treatment and Labor Act (EMTALA) investigation at Mission from May 14 through May 16 and sent their findings to the U.S. Centers for Medicare & Medicaid Services.

EMTALA ensures public access to emergency services regardless of ability to pay. It requires Medicare-participating hospitals to provide a medical screening when a request is made for examination or treatment for an emergency condition, according to CMS.

“The information gathered during the survey was forwarded to the Centers for Medicare & Medicaid Services (“CMS”) Regional Office in Atlanta (Region IV), who will make the determination of compliance or noncompliance and will notify you of their findings and of any action to be taken,” Gillis told Lowe.

In a May 27 email to staff, Lowe celebrated the outcome of the investigation into the 35 complaints. At that point, NCDHHS had not published its final report.

“This was a particularly rigorous survey process and even some of those conducting it acknowledged its excessive nature, but I am proud of how we fully cooperated and believe that the outcome will ultimately be a positive for our patients,” Lowe said. 

“While we are still waiting for the final report, we were incredibly pleased with these initial results,” Lowe said. “We are always trying to find ways to innovate to provide better care for our patients, and this process will help fuel ideas to do so.”

CMS did not immediately respond to a request for comment. MIssion spokesperson Nancy Lindell did not respond to a question about the EMTALA investigation.

The partially redacted NCDHHS inspection report did not include details about the 35 complaints. It is unclear whether any focused on the February death of an emergency department patient. The man died in a bathroom after his call for assistance went unanswered for several minutes.

Findings disappoint nurses

Mission nurses were disappointed with the NCDHHS findings. 

“I was shocked at first,” said Kelly Coward, a cardiovascular ICU nurse and union representative. “I cannot believe that they didn’t find anything.”

Coward said she couldn’t provide details about the complaints because of patient privacy laws, but she said she was disappointed that a complaint involving a death was not substantiated.

“I do feel like [NCDHHS] failed us with this investigation,” Coward said. Nurses will continue to submit complaints and advocate for better nurse-to-patient staffing ratios, she said.

“Just because the state didn’t find anything, it will not hinder us to continue to do what we’re doing,” Coward said.

The NCDHHS survey results differ greatly from those of a survey conducted in late 2023.

In November and December of that year, NCDHHS found that 18 people had been harmed over two years, including four who died, because of deficiencies in care in the emergency and oncology departments. CMS placed the hospital in immediate jeopardy, the most severe sanction a medical facility can face. After the hospital issued a plan of correction in early 2024, the federal government lifted the sanction.

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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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