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AVL Watchdog

Quality of Care Concerns Rise at Mission Hospital

[Editor’s Note: This story has been modified since its original publication. A correction and clarification was added at the bottom to explain the changes.]

Forrest Johnson fell in her garden on April 22 and broke her leg in two places. Her husband and stepdaughter rushed the 68-year-old former nurse to the Mission Hospital emergency room in Asheville from their home near Burnsville, about an hour’s drive. They arrived around 8 p.m.

Having spent 20 years in nursing, Johnson said, “I sort of knew what to expect.” But what she did not expect was that she would lie for nearly six hours in the emergency room without water, ice, a blanket, a pillow to elevate her leg, food, or pain medication. 

Forrest Johnson

“I just had a very busy nurse,” Johnson said. The nurse quickly apologized that he would not be able to check on her every 15 minutes,

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Profits are up at HCA. Ratings are down at Mission.

HCA Healthcare, which owns and operates Mission Hospital in Asheville, reported this month that it made $1.4 billion in profits for the first three months of 2021, more than double the amount for the same period last year. 

The new figures follow HCA’s report in February that annual profits rose to a record $3.8 billion in 2020, despite the pandemic, based on what the company called “solid cost management.”

In a proxy statement filed last month with the Securities and Exchange Commission, HCA stated its primary objective is “providing the highest quality health care to our patients, while making a positive impact on the communities in which we operate.” But the document shows that the company rewards top executives far more for taking care of shareholders than it does for taking care of patients. 

A year after announcing that its senior leaders would take up to 30 percent pay cuts during the pandemic,

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A Letter from the Publisher

Dear Watchdog Reader,

A year ago someone surfing the web might have come across this greeting:

“Hello Asheville! Welcome to AVL Watchdog … We’re here because of you, our friends and neighbors, who told us you want more thoughtful and explanatory journalism to help you stay abreast of the issues and challenges facing Asheville and Buncombe County.”

Those words introduced Asheville and the surrounding region to the free, nonpartisan, nonprofit online news service you are reading now.

The idea for Asheville Watchdog was born several weeks earlier in a eureka moment at a pre-pandemic cocktail party. Several journalists and media executives who had retired to Asheville were lamenting the decline of local reporting and in-depth analysis all across the country. Unlike a lot of party talk, this turned out not to be idle chatter

Our original logo

The journalists decided to put their years of professional experience and passion for their work into enhancing Asheville’s news environment. They gathered several other retired newsies who felt the same way, and here we are celebrating our first anniversary.

Asheville Watchdog doesn’t attempt to compete with existing local news outlets, which because of sharp financial cutbacks are sometimes limited in their ability to provide the kind of investigative journalism that advances understanding of important civic issues. Nor do we compete with local media for advertising dollars.

The all-volunteer Watchdog staff, which includes three Pulitzer Prize winners, produces stories for our own website, on our own schedule, but we also make those stories available free of charge to other local media. We believe this approach complements what existing media in our area are doing, and advances our overall goal of providing accurate, trustworthy news to the community we all love. 

Our first story was about the financial slump in downtown Asheville during the early stages of the Covid-19 pandemic shutdown. We have continued to cover the pandemic and much more.

In our first year, some highlights of Asheville Watchdog’s work include:

  • Heartbreaking profiles of some of the more than 300 Buncombe County neighbors who died in the first year of the pandemic.
  • The challenges looming for Asheville, a relatively “safe city” in the growing climate crisis, from an expected influx of climate refugees from more vulnerable places.
  • The disparity in Asheville between Black and white home ownership and its effects on generational wealth.
  • Problems faced by racial equity officials who resigned their jobs because of resistance in government and other organizations to proposals for Black reparations in Asheville.
  • Efforts to reshape the Asheville Police Department in the aftermath of last summer’s confrontations over racial injustice.
  • The sale of the local nonprofit Mission Hospital system to profit-hungry HCA, and the sale’s impact on community healthcare.
  • The loud and hard-fought campaign for western North Carolina’s seat in Congress, and its aftermath, in which young, conservative Republican Madison Cawthorn beat Democrat Moe Davis, a career military prosecutor. Our stories were cited by national news organizations including The Washington Post, The New York Times, CNN and others.
  • A split in the family of the late evangelist Billy Graham, in which one side believes Graham’s son, the Rev. Franklin Graham, tarnishes his father’s legacy with extreme views on religion and politics. This story was published in newspapers all across the state.

And all this happened during a pandemic that has kept us from venturing out into the community to introduce ourselves to you in person. We intend to remedy that as soon as health and safety allow. We’re eager to hear your ideas on what issues are important to you, and how we can do a better job covering them.

The challenges facing local journalism are still severe. Misinformation is rampant, reliable resources are scarce, and the need for trustworthy, in-depth local reporting has never been greater. While our stories are free, the cost of producing them is not. I hope you’ll consider our efforts worthy of your tax-deductible financial support.

By the way, readers will notice something new in today’s Watchdog. We begin our second year with a redesign of our website, which we think will make it more attractive and accessible. We’ve added space for shorter news items — we call them “barks” — and also space for links to stories in other publications that we think might be of interest to the citizens of western North Carolina.

To all our readers and supporters, thank you. We couldn’t have made it this far without you. Special thanks go to Steve Keeble, whose vision and generous support helped bring AVL Watchdog to life; to David Bralow, Kay Murray, Alexander Papachristou and Cindy Moore of Lawyers for Reporters, a joint project of the Cyrus R. Vance Center for International Justice and the Press Freedom Defense Fund, and Amanda Martin and the legal team at Stevens Martin Vaughn & Tadych, for their important work supporting local journalism and defending freedom of the press; to the many local writers and editors who initially contributed their talents and time to keep the Watchdog‘s virtual presses humming; and to the Asheville Citizen Times, Blue Ridge Public Radio, Mountain Xpress, AVLtoday, Asheville.com, Smoky Mountain News and The Mountaineer for unselfishly spreading our words to the community.

Bob Gremillion, Publisher

Covid-19: Those We’ve Lost

They taught students in school, delivered the mail, advised Congress, and served the country in wartime and peace.

One led public affairs for NASA and became the voice of launch control for Apollo space missions. Another was a composer and pianist who played in the original Mickey Mouse Orchestra.

A year has passed since Buncombe County recorded its first Covid-19 death on March 28, 2020. Since then, another 300 people have died. In the official government record, they’ll be remembered as statistics of a pandemic that killed swiftly and indiscriminately, but to their families, friends and neighbors, they were so much more.

Asheville Watchdog combed public health reports, obituaries and death certificates listing Covid-19 as a cause of death to examine the virus’s march through Buncombe. The lives lost include the working and the retired, journalists and college professors,

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Come Hell or High Water, Asheville Is Climate “Winner”

Back in 2006, when Scott Shuford was Asheville’s planning director, he reluctantly accepted a friend’s invitation to attend a meeting about the impact of climate change on local governments. 

“I didn’t see how a two-degree temperature change could affect the community,” he recalled, referring to the predicted rise in earth temperatures in years to come. “But I agreed to attend, thinking it would only be about 15 minutes. 

“After about an hour-and-a-half I came out of the meeting drenched in sweat.”

All the plans he had drafted up to that day suddenly seemed to have overlooked an unsettled future fraught with unanticipated challenges. Those two degrees of temperature change meant greater threats of weather extremes — of torrential rains, devastating floods, and landslides, and of their opposites, extended drought and wildfire. 

“We weren’t ready,” Shuford said of Asheville’s infrastructure at the time.

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Cawthorn’s First 2 Months in Office

Since Madison Cawthorn took office two months ago, vowing to represent everyone in his Western North Carolina district, not just those who voted for him, nearly all of his votes in Congress on substantial issues have been against proposals supported by Democrats, an analysis of his record by Asheville Watchdog found. 

Records show that Rep. Cawthorn has not introduced any original legislation so far in the 117th Congress. He has, however, co-sponsored 52 bills and resolutions as of Thursday, nearly all in support of causes that are popular with what he calls his “patriot” base.

One of the bills Cawthorn co-sponsored, H.R. 450, would prohibit the use of federal funds “to propose, establish, implement, or enforce any requirement that an individual wear a mask or other face covering, or be vaccinated, to prevent the spread of COVID-19.”

He is also one of a handful of co-sponsors for H.R.

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Black Home Ownership and the Promise of Reparations

Priscilla Ndiaye Robinson looked across the empty fields where her Southside neighborhood once thrived. “It’s all gone,” she said. “One thousand two hundred businesses and homes were lost.” 

The neighborhood, where approximately half of Asheville’s Black population lived, suffered major upheaval under Asheville’s urban renewal program in the 1970s and 1980s, one of the largest urban renewal projects in the Southeastern United States. 

Ndiaye Robinson’s memories of childhood delights — a neighbor’s cupcakes, playing with chickens, charging up the grassy hills — are tainted by sadness and umbrage at what happened. “It broke up a loving community. It tore up families,” she recalled.

Priscilla Ndiaye Robinson

For Asheville’s Black residents it, urban renewal also undercut the foundation of generational wealth and dashed a revered piece of the American Dream. Predominantly Black neighborhoods were razed to make way for proposed highways or real estate ventures,

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Cawthorn joins firebrand GOP colleagues on far-right media

Shortly after taking his seat in Congress last month, Madison Cawthorn emailed his Republican colleagues to tell them of his intended role. “I have built my staff around comms rather than legislation,” he wrote, using the slang word for public relations.

An Esquire magazine headline offered this translation of the freshman congressman’s words: “It’s not about legislating, or fixing problems. It’s about the show.” If so, the show is not designed to appeal to Western North Carolina’s mainstream Republicans, independents or Democrats, despite Cawthorn’s post-election promise to be the congressman for all his constituents. 

[Editor’s note: This story has been modified since initial publication to remove references to handwritten notes that we erroneously said were made by Rep. Cawthorn. The notes were not written by the congressman, and were posted online as parody. The Watchdog regrets the errors.]

A new and featured attraction of Cawthorn’s “comms” is his own channel on a Dubai-based social-media platform,

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Reparations, Six Months Later: So Far, Empty Promises

Six months ago, as part of a reckoning on racial injustice, the City of Asheville and Buncombe County both passed resolutions to consider reparations to the Black community as a way to begin making amends for slavery and generations of systemic discrimination. The votes were hailed as “historic” by The Asheville Citizen Times, and ABC News asked, “Is Asheville a national model?”

Since then, local officials concede, little has been done. Some in the Black community see zero progress.

“From my understanding, they’ve done nothing,” said Rob Thomas, community liaison for the Racial Justice Coalition. 

Despite the fanfare they received at the time, the reparations resolutions are in limbo, still as lacking in specific remedies as they are in financial commitment or engagement with the Black community. The Asheville resolution called for the creation of a Community Reparations Commission to begin drafting recommendations.

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