Fifty doctors, including a former member of the board of directors of Mission Hospital and a former chief of staff, have written a letter condemning what they say is HCA Healthcare’s “for-profit-driven” management after buying the nonprofit hospital system in 2019 for $1.5 billion.
Dr. Robert Kline, the former board member before the purchase, read the letter Thursday night at a public meeting hosted by Gibbins Advisors, the independent monitor hired by Dogwood Health Trust to oversee HCA’s compliance with the terms of the sale. It was the second of six such meetings planned for western North Carolina.
“Many of the for-profit-driven changes that HCA has wrought, despite advocacy and protests from multiple sectors, have gutted the heart and soul of our community healthcare system,” stated the letter, addressed to Ronald Winters, managing director of Nashville-based Gibbins. “The relationships and deep personal investment that historically mattered to staff across the board have been stifled. Emblematic of this is the loss of over 200 physicians and countless healthcare staff who have left Mission and/or the medical community since the sale.”
Chad Patrick, chief executive of HCA-Mission Hospital, attended the meeting but left quickly without commenting. Later Nancy Lindell, director of public and media relations for HCA Healthcare’s North Carolina Division, which includes Asheville’s flagship Mission Hospital, issued a statement to Asheville Watchdog:
We are pleased that the Independent Monitor acknowledges Mission Health has continued to honor our commitments in the Purchase Agreement. While quality of care does not fall under the monitor’s role, Mission Hospital is regularly surveyed by officials from The Centers for Medicare & Medicaid Services, The Joint Commission and the North Carolina Department of Health and Human Services to ensure we are delivering safe care. Additionally, other independent third-party organizations have deemed Mission Hospital one of the nation’s best.
We have numerous opportunities and processes in place for frequent feedback from our patients, colleagues and medical staff. Our Quality and Care Experience teams welcome direct comments about patient care and diligently work to address any concerns during or after a visit. Mission Hospital leaders regularly round on all hospital units and attend shift huddles. There are also multiple professional practice councils, nursing governance, and medical staff committees where we discuss any staff concerns and solutions to address them. Semi-annual employee engagement surveys also provide our teams an anonymous way to use their voice. From these surveys, we have made significant strides in our engagement since this time last year.
We continue to invest in expanding quality care for the patients we are privileged to serve and are incredibly proud of our teams and their dedication to our community.
Nancy Lindell, HCA Healthcare’s North Carolina Division spokeswoman
Read the full letter below:
The letter was signed by 42 physicians across a range of specialties, including Dr. Bruce Kelly and Dr. Allen Lalor, a former Mission Emergency Department doctor.
In addition to the 42 named physicians, five initially were listed in the letter as “anonymous” because they were concerned about the possibility of retribution from HCA, Kelly said. By the time of the reading, three more anonymous doctors were added, he said.
“It is difficult, if not impossible, for members of the community to speak with pride about the hospital that has been our healthcare home on the hill,” the letter stated. “It feels like a rental now, the landlord impervious to calls for needed improvements.”
The letter asked HCA leadership to start “meaningful engagement” with doctors, stating that the Nashville-based corporation — the largest hospital system in the U.S. — had shown “little to no interest” in such engagement thus far.
“We implore HCA leadership to demonstrate substantive collaboration to address the crisis of relationships and resources. We will be forthright and transparent, and we respectfully request the same from HCA,” the letter stated.
Lalor, a plaintiff in a whistleblower lawsuit filed earlier this year alleging fraudulent overcharging by HCA Healthcare, told The Watchdog that the letter writing effort began two weeks ago.
Asked what he hoped the letter accomplished, Lalor said its intended purpose was “to try and get HCA to behave differently, not as a corporate entity that seems primarily interested in making money, but to run as a hospital system that takes into account the health care of the people in the region … in a way that is not burning out the staff or putting the patients in jeopardy.”
Concerns about quality of care had already surfaced at the first independent monitor meeting Tuesday in Transylvania County, home to Mission Health Transylvania Regional Hospital. Attendees, including Brevard’s mayor, pressed Winters, the Gibbins managing director, for answers on declining quality of care, including the loss of doctors and long wait times at the emergency department.
Winters repeatedly responded that many quality-of-care issues fell outside of the 10-year, 15-commitment asset purchase agreement and were matters he couldn’t address.
“We understand that it’s outside the purview of the asset purchase agreement,” Kelly told The Watchdog on Thursday. “And yet, this is an opportunity to have our collective voice heard. It’s an opportunity for us to get that out there, as we continue to build support and represent the voices of physicians across the western region.”
Kelly said the doctors who signed onto the letter will continue to push on HCA, even if nothing changes.
“We continue to build voices that we hope will, at some point, effect some meaningful change,” Kelly said.
“(The letter) is that it’s just the beginning of hopefully a larger attempt to bring together the community and western North Carolina,” said retired Dr. Mike Messino, founder of Messino Cancer Centers and a signee on the letter. “The independent monitor is not going to do anything and I’m not quite sure where the Department of Justice stands. But if the community knows that there are a number of physicians and other health care people that are really unhappy with the situation, it might bear a little bit of pressure on (HCA).”
North Carolina Attorney General Josh Stein told The Watchdog in a recent interview that he has been investigating Mission Hospital since the start of the year for potentially not adhering to the purchase agreement after recent deficiencies in cancer care services. Since February, Stein, who is the Democratic frontrunner for governor in 2024, has sent four letters to HCA and two to Gibbins Advisors, seeking information and warning that HCA and Mission face potential litigation if they don’t honor the purchase agreement.
State Sen. Julie Mayfield (D-Buncombe) is supporting Stein. She attended the Tuesday night meeting in Brevard, where she invited audience members to speak with her if they had questions about what the attorney general’s office could do about Mission issues.
“I am glad to see physicians coming together with a collective voice,” Mayfield told The Watchdog on Thursday. “They know firsthand how much the healthcare system and the medical community have been degraded since the sale of Mission. I am encouraged that they now want to collectively dig in and work to repair it.”
The letter echoes a sentiment voiced by unionized nurses at Mission who, according to recent reports from The Watchdog, say HCA has brought a profit-above-all-else mindset to Mission since 2019, which the nurses say is a mindset that is putting patients in harm’s way because of strained staff and rushed procedures.
“We join the chorus of advocates in asking for the relationships and resources needed for the medical staff, all staff, to function at their highest ability,” the letter stated. “We ask that hospital leadership look at economics as if people mattered. With our many hundreds of years on the front line of patient care, we know what a fully resourced system looks like.”
“We don’t see it now,” the doctors wrote.
This story has been updated to include a statement from Nancy Lindell, a spokeswoman for HCA Healthcare’s North Carolina Division.
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. To show your support for this vital public service please visit avlwatchdog.org/donate.
Why didn’t these doctors and this board member speak out when the former board member were negotiating the sale?Who were the members of the boar?d that let this happen?’
I think if you look, you will find that many are on the dogwood trust board of directors. Doesn’t make you feel very trusting of dogwood
The purchase agreement gave Dogwood the right to bid if HCA decides to sell. That was creepy.
John F. A. V. Cecil, Chair
Jacqueline L. Godlock, Vice Chair
Vivian A. Bolaños, Treasurer
Casey Cooper, Secretary
Janice W. Brumit
Carol Burton
Dawna D. Goode-Ledbetter
Richard Houck
Fred Jones
Samuel D. Lupas
José A. McLoughlin
Jamie McMahan
Jacquelyn S. Simms
George D. Renfro
Donna Tipton-Rogers, Ed.D
Martha C. Tyner
Which of these Dogwood Health Trust Board members were on the Mission Board which negotiated and approved its sale to HCA? Perhaps Mr. Jones can look into this.
How much property from Mr. Cecil’s Biltmore Farms has been sold to Mission, HCA, and other health facilities? Perhaps Mr. Jones can look into this.
The level of passionate frustration and anger at HCA voiced at the Asheville meeting was striking, all the more so since there was so little notice that public comments were welcome. Not just physicians, but nurses, other support staff and patients each gave a different window onto the gut-wrenching drop in quality of care at Mission. As one long-time physician put it, he is not sure he would choose Mission for his own health care now, where that used to be unquestioned. The independent monitor, Mr. Winters, repeatedly made the point that quality of care was not in the list of things his firm was asked to assess. I’m sure that’s true, and it’s not clear what recourse our community has. For issues that are dangerous, or even unpleasant, perhaps letters to the Joint Commission are an option. But really, what we want is a health care system that is excellent, compassionate and responsive. Thus far, Mission/HCA has been great at marketing and spin, but woeful on excellence and responsiveness. The current CEO of Mission was present during the hearing. He got an earful. I hope it goes deeper than that.
Josh Stein has said quality of care was not in the contract since the first complaints began. He oversaw the agreement and signed it. Shouldn’t quality of care have been included in a hospital contract? Who is responsible for the contract if not Jost Stein? Everyone with hospital oversight can’t now just say “quality of care wasn’t in the contract so we can’t do anything about it”. Something has to give. Perhaps billboards should be put up warning visitors and people considering moving here: You do NOT want to find yourself in Mission Hospital. It would be less miserable to stay home and die.
Truth. It would be less miserable to stay home and die from what I have seen there. If you end up there your chances of survival for whatever you go there for, diminish greatly.
It is THAT BAD.
I’d be happy to support a billboard fund. There are many that do not know and not reading the watchdog. I’d love to put it up so those criminals in the C suite could see it from their cushy offices.
Letters to the joint commission are certainly key. They should be written on their website using specific examples
The sale was done mainly behind closed doors. The board was sold a bill of goods. The community wasn’t aware of the details.
All the board had to do was run a background check on HCA to know it was a bad idea. A simple google would have sufficed. HCA is a documented criminal enterprise. They were convicted of the largest health care fraud, both criminal and civil in the history of the US. The Board did not do their due diligence, nor did any of our government representatives. They let this happen to us. There were people trying to warn against it, but nobody in power would listen at the time.
I recall that Rick Scott, a current member of Congress, was held responsible for having to pay this this huge MCR fraud penality. That was several years ago, which is testimony to their historical “mission” of money before people.
Actually, I did run a background check on HCA while employed at Mission, when the sale was being proposed. We had a video of employee – CEO Q&A and I raised the fact that HCA had had to pay the largest fine to date for Medicare Fraud. The CEO swept my comment under the carpet, despite acknowledging this fact was true.
Yep, they knew. They were all in on it for their own interests. Corruption through and through. Thank you for trying to speak up. HCA didn’t stop after that biggest fraud either, they have been caught multiple times again since then. All of these people complicit have blood on their hands. If the HCA stockholders had any conscience, they would divest.
That is more true than we realize. HCA surgeons had moved to Asheville from Nasheville with their families before it was finalized. Absolutely done in secrecy.
Yes why didn’t they. But I guess they were hoping it worked work. The hospital has gone so far down. That they will have a time coming back up to what they once was.
Thank you clinicians, patients, former administrators and others pulling the curtain back wide. Attorney General Stein, Governor Cooper, state politicians, NCMB, professional associations, NCDDH, CMS, OCR, JCAHO, NPDB, OCR etc…..
could we at least see fines in NC? Speeding down Biltmore or paying a healthcare bill late results in a fine, right?
The discussion needs to include impact on non-profit providers such as MAHEC. They are “independent” from HCA, but insiders say that mostly everything they do has to take HCA into account. I do not know how this works, exactly, and quality of care from my primary provider is top notch, but access to other services, including procedures and consultations in-house through MAHEC have deteriorated. My understanding/experience is that MAHEC support services providers have been cut to the bone.
Several years ago I had breakfast with Senator TVD, she specifically voiced her concern for MAHEC related to the sale. At the time I was confused. Now, it makes perfect sense. People that had power were well aware.
If you dislike the changes going on at mahec, then a petition to ask for the replacement of its new director who was in mission board and made these changes would seem like a good idea
Thank you Mr. Jones for your dedication to this topic. Lives indeed are at stake and have already been lost because of HCA’s ghoulish greed and malfeasance.
I am particularly grateful for your coverage of HCA’s profit motivated destruction of Mission Hospital. It is nothing short of criminal, IMHO.
Marlene you are absolutely right. We need to quit allowing this narrow focus on the agreement to limit the concerns our state can deal with. Long past time to come down on these crooks with the full weight of whatever laws apply. We need our Governor, AG, Treasurer, legislators—all—to turn this around. Under Rick Scott in FL, this corporation was guilty of the greatest Medicare fraud in US history. The penalty? Made him governor, now Senator, and the corporation continues its rampage to consume community hospitals and healthcare at a frightening and deadly pace. they must be stopped. In what other system do we allow a whole region to fall prey to such dangerous profiteers? If a system doesn’t make patients and their doctors and nurses the primary stakeholders, not the shareholders, then the system has no business being in the business of healthcare.
I worked at Mission for over 20 years as an RN. I was so proud of the quality of the care that our patients received. Now I seriously consider moving from Asheville to a area where the hospital is recognized as a top quality facility. How did this happen?
Mission Hospital had a lot of problems also. It was top heavy in administration to the detriment of clinical care. It promoted services that would make money, like key hole cardiac surgery to the detriment of psychiatric services that it left in an out of date st.Joseph’s facility , leaving the new facility to be built by HCA . Mission also started the cancer care facility as another money making adventure that turned into an albatross that it now is. One of the Board Members of Mission is now the boss at MAHEC and it is reported that 15 long serving staff have quit apparently over issues of increasing the number of patient contacts for MDs which was a key target of Mission for its staff especially psychiatrists. That was never the purpose of MAHEC, so it appears that this is making problems at MAHEC
Kathy commented above: “In what other system do we allow a whole region to fall prey to such dangerous profiteers?” This strikes me as the root of the struggle in our beautiful city, on every level; Asheville has fallen prey to profiteers. Hospitals, hotels, homes that have been turned into Air BnB’s, rentals that very few Ashevillians can afford. All of these shortfalls directly affect the quality of life and security of the citizens of Asheville, not those who come here for a quick weekend to admire the fall colors. Corporations, hedge funds, private equity – they see no value in our community, other than the profit that can be extracted at any cost. And frankly, they don’t give a second thought to the scorched earth that they will leave behind.
Exactly. It’s all related, and local and state politicians are complicit in the many failures. Then they have the audacity to self-righteously sound off about Israel, Ukraine, gun control, diversity and Roe v. Wade.
There must have been a tipping point for these doctors to finally come out of the shadows after nearly 5 years. Josh Stein led us up a creek by telling us he was “investigating” the purchase agreement and threatened litigation to enforce it when he knew damn well that was not an option. That was disingenuous at best. Now that the cats out of the bag, we can all forget the purchase agreement enforcement false narrative and work on other options. Thank you Watchdog.
Thank you for continuing to spotlight this important issue, Watchdog. Surely if everyone keeps the pressure on them, we’ll see some much needed improvements.
Short-term profits at the cost of long term health should be criminalized, and HCA should pay.
Stein and the Board clearly mishandled the Commitment Agreement by leaving out quality of care metrics and a provision to undo the sale. It’s too late now. The damage is done.
Those responsible to approve or reject the sale of Mission failed us. Could it have been that many were more interested in the taxes that HCA would pay? The history of HCA was publicly available. What happened behind closed doors is not. This information was denied to the public when the nondisclosure agreements were signed. All this resulted in the sale of one of the Crown Jewels of this region. The history of the changes made by HCA has been documented in many ways. The public forum that evolved about concerns of the actions by HCA still exists as do the personal statements of many citizens made on that page. HCA has turned Mission into its primary cash cow. That is money going out – to coming in to Mission. The people of WNC deserve and should have better.
It’s critical to discover what MMH’s liquid assets were at time of sale and where they went, how they were dealt with
I was at the Gibbons meeting and was told that the staff at Mission need to continue to document all grievances and send as much information to all the proper regulatory agencies, as well as, to the Attorney General’s office. Whether we like it or not, this agreement is a binding contract and we will only have leverage with evidence such as the current Oncology case that clearly appears to breach the contract if not corrected. And if not corrected, then the AG needs to respond in a similar manner as he did with the “fire in the belly” action he took part in to settle the national Opioid case against the Sechler’s . This community deserves, not a minor slap on the wrist for HCA but, penalties and retribution for their actions so they feel it in their wallets and reverberates all the way to Wall Street. Only then will we get the attention of HCA.
I commend the nurses and doctors who are trying to do their jobs every day while working with the HCA corporate handcuffs that are tying their hands preventing them from upholding their oaths to serve our community.
Also, I’d like to thank Sen Julie Mayfield for her attendance. And, while I know this issue is not under the purview of the city or county, I was highly disappointed by the fact that there were no elected representatives there from either body. The Brevard Mayor’s concern for her community is to be commended by her participation in these meetings.
I’d like to thank Watchdog for their continued coverage.
I have lost two ob/gyn doctors in three years. They both left to get them and their family away from Mission. We will lose every good doctor, the doctors don’t want to operate in dirty, under staffed operating rooms. And they want their family to be near a good hospital in case something happened to their family. I recently dislocated my shoulder instead of driving 15 mins to Mission I was driven over an hour to TN. After my last experience over two years ago at Mission I will never go back. I wish we had a honest count of how many people HCA have been responsible for their deaths.
Rebecca, your comments are spot on. If anyone has had a loved one die there prematurely or unexpectedly, they ought to question what happened. They cover up mistakes to protect themselves. The NBC story that came out a few months ago about HCA, including HCA hospitals in NC, forcing and coercing people into hospice against their will and before their time is common practice. Yet no local media or gov’t official ever followed up on it.
Reposted comment from WLOS site:
My cousin was recently admitted to Mission/HCA due to losing control of his bowels and bladder after they botched a kidney stone removal surgery. The nurse actually refused to change his diaper(on the rare occasion he saw one) and the cna complained each time she did it. He was released home, still defalcating himself at least once an hour. No resolution was given except he was over weight most of his life prior to gastric bypass a few years ago. He managed to get an appointment at Wake Forest mid November and on a wait list for any cancellations that may arise. He mentally could not deal with it. He committed suicide on Monday. He was 58. This abhorrent health care profit only system is silently taking many lives in our area. SHUT IT DOWN. TAKE BACK OUR HEALTH CARE.
I hope Attorney General Stein, Governor Cooper, politicians, NCMD, state and federal agencies read about the suicide. How many others are dying or financially ruined? I am so sorry.
They know people are dying there from horrible treatment, they don’t care. That’s why the doctors finally spoke up, their conscience couldn’t take it anymore.
50 doctors speaking out is a big deal. NCDHHS and Medicare Services should be swarming the place. There is no doubt patients continue to be harmed. Also, someone needs to put a halt on the new ER.
Absolutely the new ER should be halted and whoever approved it questioned about why they would approved another ER for a hospital that can’t manage the one it has. What a farce! NCDHHS and whoever was involved needs to be called out. Is there no oversight authority anywhere willing to help us?
People, please understand AG Stein will do nothing to assist us with recourse for this blatant, nefarious, situation we’re in over our once beloved Mission. He’s running for Governor and as I’ve said before HCA will “take care” of him to cause no problems for their cash cow. Politicians are all talk …and no action. HCA has too much legal firepower, nothing will happen until we the people stand up.
Mayfield is supporting Stein. Good for her. Now we know who else NOT to vote for in the future. Our very lives are affected by HCA but sure, let’s support the guy that signed off on the whole deal and then ignored WNC for 4 years.
Abject failure of all gov’t entities involved, with the exception of Mayor Copelof of Brevard. She’s been trying but with no support from anyone in power. HCA knows the State and Medicare have no resources to investigate. Stein has done nothing but hoodwink us all throughout this travesty. He should not be Governor.
The doctors coming forward speaks volumes. However, it’s a bit late in the game and I can’t help but think there is some CYA on their part. By not speaking up sooner, they were complicit and certainly have known that patients lives have been at risk for a long time. We don’t even know how many doctors are employed there because HCA won’t say. All I can say is don’t ever go to Mission, even for something minor. Your odds are worse than playing Russian Roulette.
If anyone thinks the gov’t is going to step in and make HCA provide decent and humane medical care, you are sadly mistaken. They’ve had plenty of time. It’s up to us to keep our friends and family safe and make sure they never step foot in that place.
October 21, 2023
I still remember seeing the top person over all of HCA hospitals in the US talk about his company. I believe it was on Sixty Minutes. He distinctly said that his company always put the stockholders above all else, all other people, all hospital systems, patient care, everything, etc. Money came first. I’m guessing this is still the case. Money is more important than giving excellent care and advocating for those who cannot speak for themselves, etc. I no longer live in Asheville, but having worked at Mission Hospital for six years, I can say that it was a pretty good hospital. Most employees put patients first and cared what happened to them.
I still can hardly believe the HCA person with no shame announced that stockholders always came first, profits first, before other less important matters, like safety and excellent patient care.
I am thankful I left that job and moved away before HCA bought Mission Hospital. Knowing what I came to know, I don’t think I could have continued to work with the mental health component of the hospital system.
Thank you for being in healthcare and sharing, but oh how sad.
I would suggest the Watchdog contact Kody Kinsley who serves as North Carolina’s Secretary of Health and Human Services, The Department has a staff of 18,000 and an annual budget of over $26 billion. Ask him why they have not been able to send investigators to Mission despite the Nurse’s multiple desperate pleas for some time. I’d stop wasting time with Josh Stein and Julie Mayfield. That’s going nowhere, fast.
I have been keeping up with the tumult at Mission since they have been sold. I knew the hospital before the sale and experienced what a gem we had in the community. I had an emergency yesterday, Saturday 10/21 and went to Urgent Care to be told I had to go to the hospital to get treatment as there was no other place I could get a C-Scan.I proceeded with dread. I was fortunate that there was no one else in line at at emergency admissions, and was extremely pleased at the time it took me to see a Dr. (20 minutes) and have an x ray and a c scan and be out of there in a couple of hours! Everyone was exceptionally pleasant and extremely professional that I want to give them a “shout out” of thanks for a great experience under the extreme conditions you are working under. These professionals deserve the best! Because they are the best of the best! Thank you for working so hard under the conditions you have been given to work! Our community deserves better than the staff cuts that HCA has given them! But they were nothing but professional and caring about me and my care and I want them to be praised!
Mark Payne
Director, Division of Health Service Regulation at North Carolina Department of Health and Human Services
This is the guy who is supposed to be in charge of investigating complaints against hospitals and also certificate of need stuff. See what he has to say. We need the watchdog to turn up the heat, because no one else will.
Has anyone asked Josh Stein why he refused to join the ER whistleblower lawsuit? His failure to so sent a clear message to HCA and their co-conspirators that NC will do nothing to protect the citizens of WNC. HCA has free reign to continue to pillage and harm us. Thanks Josh.
It’s hard to boycott a hospital. It’s a place we depend on. But it may be the only way to protect us. Unfortunately, not everyone has that luxury to go elsewhere and HCA will take advantage of the most vulnerable, because that’s what they do. Godspeed.
Pointing fingers does nothing to fix the problem. The question is: What can be done now? The Dogwood Trust is handing out the money here and there that was derived from the sale to HCA. Is there any oversight from the State on how and where this money is going? Can this money be escrowed until some determination of the conditions of the sale are investigated adequately? Can the State force the relinquishment of HCA ownership if an investigation proves what we all suspect really happened in this sale? It would appear that we have a healthcare emergency in Western North Carolina, and it is down to the purchase of a County owned not-for-profit hospital by a known criminal entity. It is the debacle that we all knew it was going to be. Only a fool would believe that a not-for-profit could be changed into a stockholder owned greed factory without the quality of care being sacrificed in favor of profit.
Agreed it is a healthcare emergency. Nobody is going in there investigate. Pharmacists have left in droves without being replaced, more ambulances than normal have been backed up for hours waiting to handoff patients to a dysfunctional ER. With the lack of pharmacists I can only imagine the medication errors being made. It is a literal death trap but seems nobody cares all that much to do anything about it.
Noteworthy that HCA stock has taken a dive as of late. They will be looking for more ways to increase revenue and decrease expenses to keep their shareholders happy. Things will only get worse.
A-CT is reporting that Buncombe county Manager Avril Pender wrote a letter in support of HCA getting approved for a freestanding ER. That’s really disturbing on many levels knowing what we know. I hope the watchdog keeps peeling back the layers of this rotten onion.
Sarah Cannon institute is the HCA expert in Oncology services for all of its facilities. It might be helpful for Mission/HCA to invite executive Staff from the Sarah Cannon Institute to come to Asheville and meet with all the local oncologists and , perhaps, a few patients. The meeting of the Local Oncologist experts and those from HCA might be able to come up with a solution for the Oncology issues that are currenty problems here.
Here’s a number HCA can not plug into its spreadsheet: how many patients are going elsewhere for care? After my GP, ENT, and Chemo oncologist, all left HCA, it did not take a rocket scientist for me to make a decision to travel 45 minutes to another facility to avoid HCA.
Separately, the stand alone ER HCA is planning in West Asheville is another money grab by a greed driven corporation. Does any one wonder why the state of Colorado is shutting down most of these stand alone ERs? They are mainly a glorified urgent care where unsuspecting patients will pay a $1,500 facility fee for an aspirin. Additionally, note that for most insurance to cover the ER cost, the facility needs to be at least 6 miles from a main emergency facility. The West Asheville location is 6.9 miles from HCA’s main emergency room.