Today’s round of questions, my smart-aleck replies and the real answers:

Question: I’ve seen a lot of lawsuits against HCA lately, and North Carolina Attorney General Josh Stein has filed friend-of-the-court briefs in support of the plaintiffs. Is it possible that Stein could force the sale of the Mission hospital system to a nonprofit like Novant or UNC Healthcare?

My answer: If an underwear maker has not started producing “Friend of the Court briefs,” something is deeply wrong with America. 

Real answer: For the uninitiated, Nashville-based HCA Healthcare acquired the Mission Health system in February 2019 for $1.5 billion. Much turmoil has ensued, including the formation of a nurses’ union at Mission, multiple lawsuits, and claims by patients and staff that the hospital is understaffed.

But a forced sale by the Attorney General’s office is not in the cards.

“In regards to this question, our office does not have such authority under the law,” Nazneen Ahmed, press secretary for the AG’s office, said via email. “Under state law, the attorney general can only conduct a limited review of proposed transactions when nonprofit assets are being sold to for-profit corporations.”

Ahmed also addressed why Stein has filed briefs.

“Attorney General Stein has filed briefs in support of the plaintiffs in the federal and state antitrust cases moving forward to allow the people of Western North Carolina their day in court,” Ahmed said. “He is committed to doing everything in his power to make healthcare more affordable and accessible and is working with legislators on this issue.”

NC Attorney General Josh Stein // Watchdog photo by Peter H. Lewis

As Asheville Watchdog reported in August, “The Mission Health system could have been purchased by another nonprofit hospital chain in a deal that would have been at least as good, if not better than, the $1.5 billion sale that the hospital system’s board ultimately approved to HCA Healthcare in 2018, a former top Mission executive now says.”

Charles F. Ayscue, who was Mission’s top financial executive from 2007 to 2018, wrote that the HCA sale was “significantly detrimental” to the community. Ayscue now works for Novant as an independent contractor.

The story also noted that Novant, “the only other bidder for Mission, agreed to financially match any offer by HCA and guarantee employment to the hospital system’s staff for at least three years. Since the 2019 sale to HCA, the nation’s largest for-profit hospital chain, more than 3,500 Mission employees have left, Ayscue wrote.”

AdventHealth, which operates a hospital in northern Henderson County, announced Nov. 22 it was “honored to receive” the state Department of Health and Human Services approval to build a new 67-bed hospital in Buncombe County. Mission and Novant also had applied to build the new hospital.

This little nugget leads us to our next question …

Question: Those of us who live west of Asheville are happy about AdventHealth’s plans to build in Enka. However, access to the Enka-Candler area is difficult, with no exit off I-40 between exit 44 In West Asheville and exit 31 in East Canton. Can you update us on the planned Enka-Candler exit off I-40?

My answer: In other words, you need to be briefed. Legal or regular? I’m running a sale on legal briefs. Hey, nobody else was selling them…

Real answer: Mike Clark, a project engineer with the North Carolina Department of Transportation’s Asheville office, had the update.

“NCDOT is proposing to convert the existing Liberty Road bridge over I-40 to an interchange, and construct a new road between Smokey Park Highway and Monte Vista Road,” Clark said via email. “The new interchange will provide a new access point to and from I-40, to improve the roadway network connectivity in western Buncombe County.”

The NCDOT plans to convert the Liberty Road bridge over I-40 to an interchange, and construct a new road between Smokey Park Highway and Monte Vista Road // NCDCOT image

This should help in reducing travel times in the area.

“Currently, the project is in the right of way negotiations phase and construction is scheduled for the fall 2025,” Clark said.

I’ll note this Liberty Road project has been in planning or on the books for the better part of a decade, with the environmental assessment approved in January 2017. The DOT’s webpage about the project states, “The interchange is currently under redesign to accommodate the future widening of I-40 to eight lanes, four in each direction.”

If you’re relatively new to the area or not familiar with Enka, DOT also offers a good explainer of the area and why this project is needed:

“​Locally, I-40 serves as a key east-west roadway for residents traveling to Asheville. Motorists who want to use the interstate, however, currently must use the interchange at U.S. 19/23 (Exit 44) — approximately 2.5 miles to the east — or the interchange at Wiggins Road (Exit 37) — approximately 5.5 miles to the west.”

This creates problems for emergency vehicles, as well as locals who’d just like better traffic flow.

Got a question? Send it to John Boyle at or (828) 337-0941.

3 replies on “Can the AG’s office force a sale of Mission? New interchange for Enka?”

  1. Very funny! Thanks for a chuckle today!

    If an underwear maker has not started producing “Friend of the Court briefs,” something is deeply wrong with America.

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