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Posts published in “Healthcare”

Angered and Dissatisfied, Some Mission Patients Seek Healthcare Elsewhere

Hospital's formerly stellar reputation attracted people to region

They chose Asheville to live out their retirement years, drawn to the area not just for the mountains, the food, and the culture, but also for the safety net of a healthcare system considered one of the best in the country.

The flagship Mission Hospital provided a level of care that helped put Asheville on national lists as one of the top places to retire. One in five Buncombe County residents is now 65 or older. As recently as 2018, for the sixth time in the previous seven years, Mission Health was named one of the nation’s Top 15 Health Systems by IBM Watson Health.

But also in 2018, in a surprise decision, Mission’s board of directors voted to sell the successful nonprofit to HCA Healthcare — the largest for-profit hospital chain in the U.S., with a reputation for cost-cutting and skimping on staff.

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Mission Nurses Overburdened, Patients Suffer

‘Oh My God, I Never Expected to Have This Many Patients’

One nurse on a surgical floor at Mission Hospital reported “patients lying in stool for an unknown amount of time,” pain medications and insulin being administered late, and “irate family members.”

A nurse caring for the sickest patients on a surgical floor at Mission documented “delayed and missed medications due to RNs having 7-8 patients … Inadequate staffing led to patient fall.”

Still another nurse on an intensive care and cardiac care unit reported an “inability to care for critically ill patients at appropriate high level,” resulting in an increased risk of possibly serious harm to patients.

The alarming concerns were reported by nurses on forms known as Assignment Despite Objection (ADO), a formal complaint system developed by the labor union representing Mission nurses to document unsafe assignments that, in their professional judgment, put patients at risk. The forms are completed only after the nurses have informed their supervisors with no resolution.

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How Many Doctors Have Left Mission? HCA Won’t Say

Watchdog counts 223 departures since takeover in 2019

Two prominent physician groups quit the Mission Health system in the first two weeks of the year, the latest in an exodus from the hospital since its sale three years ago to for-profit HCA Healthcare.

The seven doctors at Asheville Ear, Nose & Throat “decided to no longer provide medical or surgical care at Mission Hospital or Asheville Surgery Center,” as of Jan. 1, they wrote in a letter to their patients.

Also on Jan. 1, the 10 surgeons at Carolina Spine & Neurosurgery Center parted ways with Mission and joined UNC Health’s Margaret R. Pardee Memorial Hospital in Hendersonville. They retain privileges to practice at Mission.

HCA declined repeated requests for the number of doctors who have left the Mission system since it took over in February 2019 and refuses to say how many doctors are on staff today,

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Attorney General’s Office Had ‘Great Concerns’ Mission-HCA Deal Was Rigged ‘From the Beginning’

2018 Memo Says “Deck Had Been Stacked” by Then-CEO

Then-CEO Ronald A. Paulus of Mission Health

The North Carolina attorney general’s office had “great concerns about how HCA was selected” as the purchaser of the Mission Health System, including that “the deck had been stacked in its favor from the beginning” by then-CEO Ronald A. Paulus and his advisor Philip D. Green, according to a 2018 internal document obtained by Asheville Watchdog.

“[W]ith no outside advice other than Phil Green,” whom the investigators wrote had an undisclosed “prior business relationship with HCA,” Mission Health’s board of directors decided not to issue requests for competitive bids or to hold an auction before agreeing to sell Asheville’s flagship hospital system to HCA Healthcare for $1.5 billion, according to the document, prepared in advance of a meeting between Department of Justice lawyers and HCA representatives on Oct. 30, 2018.

Instead, as Paulus “coached HCA behind the scenes on how to best present its case to the Mission Board,” the board invited only one other healthcare company — identified in other documents as Novant Health of Winston-Salem — to present a formal offer. 

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COVID Surge Forces Mission Hospital to Halt Elective Surgeries; Emergency Services Still Open

Hospital "challenged" as more healthcare staff enter quarantine, memo says

Mission Hospital Emergency Department in Asheville // Peter H. Lewis photo

Staggered by COVID-19 infections, both among incoming patients and its own healthcare staff, Mission Hospital in Asheville is postponing scheduled surgeries at the main hospital and will admit emergency and critically ill patients only after a case-by-case review, hospital administrators said Tuesday.

“Beginning this Wednesday, January 26, 2022, the Mission operating room and other procedural areas in the hospital (Endoscopy, cath lab, IR, and others) will only proceed with urgent and emergent cases,” Chad Patrick, chief executive of Mission Hospital, wrote in a confidential memo to staff dated Jan. 25.

“We will continue to evaluate daily on a case-by-case scenario,” the staff memo, obtained by Asheville Watchdog, continued. “Any urgent/emergent case where the patient has not already been admitted, but will require a hospital bed, needs approval by multidisciplinary hospital leadership.”

“The ASC will remain open at this time but we will continue to closely monitor and may need to adjust depending on patient needs,” the memo said,

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Hospitals Curtail Services as COVID Cases Surge to Record Levels

Unvaccinated patients fill beds as hospital workers fall ill

Slide presentation by Dr. William Hathaway, chief medical officer of HCA Mission. The latest surge began just after Christmas. // Screengrab, with added arrow, by Asheville Watchdog

Local hospitals, including Mission, are once again reeling under a perfect storm of pandemic pressures: record infection rates, overwhelmingly among people who refuse to be vaccinated; a sudden spike in the number of healthcare workers who are infected, on top of an already critical staffing shortage; and a shortage of COVID-19 test kits.

The latest surge began Dec. 27, following Christmas gatherings, William Hathaway, Mission’s chief medical officer, reported to the hospital’s medical staff on Monday. Children and people under the age of 44 are among the fastest-growing groups of patients, he said, and the rise in infected doctors, nurses, and other healthcare workers who care for them was almost literally off the charts.

State and local official reports indicate that there are now more COVID-19 infections in the Asheville metropolitan area than at any time since the pandemic began two years ago.

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Pandemic Is Financial Bonanza for HCA

CEO says "disciplined operating culture" enabled record earnings

Nashville-based HCA Healthcare, which operates Asheville’s Mission Hospital and five other hospitals in Western North Carolina, reported Friday that it made $2.27 billion in profits in the three-month period that ended Sept. 30, triple the amount in the same period last year.

The record earnings coincided with the summer surge in COVID-19 hospitalizations caused by the Delta variant. HCA said COVID patients accounted for 13 percent of all admissions to the chain’s 183 hospitals during the period.

Shares of HCA’s stock have also tripled in price since the start of the COVID-19 pandemic more than 20 months ago, creating a financial bonanza for investors and company executives. HCA is the largest employer in Asheville.

Samuel N. Hazen, HCA’s chief executive officer, credited the company’s record profit margins to a “disciplined operating culture.” He said HCA was on track to use its cash to buy back $8 billion in company stock in 2021.

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2 Quit Board of Transylvania Hospital, Saying ‘We Fear for Its Future’ under HCA

Parker Platt (left) and Mark Weinstein

Two long-time members of the Transylvania Regional Hospital board of directors resigned Monday, saying they were “embarrassed” to have supported the sale of the Mission Health System to giant HCA Healthcare and that they now fear for the future of the Brevard-based community hospital under HCA’s profit-driven management.

In an open letter to The Transylvania Times, the board members, Parker Platt and Mark Weinstein, said they had been sidelined and rendered “powerless” and “voiceless” by the HCA-dominated board. “It is our hope that our resignations might have a more positive influence on the hospital’s future direction than if we remained on the board,” they wrote.

Asked by The Watchdog to comment on Platt’s and Weinstein’s resignations, a hospital spokeswoman said, “We thank them for their service.”

The resignations highlight growing community dissatisfaction with HCA’s operation of the 92-bed,

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COVID Surge: 51 Dead in August. ‘We’re running out of ambulances’

Record Number of Cases Reported at Mission

Death certificate for one of 24 COVID victims who died at Mission in late August

Jessica Vaughn, a 33-year-old mother of five, was found dead in her Asheville apartment. The cause: COVID-19.

Brianna Justus, a 31-year-old expectant mother, went from healthy to COVID intensive care patient at Mission Hospital in less than a week. Her baby, delivered by emergency cesarean section, survived. Brianna Justus did not.

Thomas Turner of West Asheville waited nearly two hours at an urgent care center without being seen before driving himself to Mission, his family said. He never made it inside. Turner, 59, died in the parking lot while his wife, who also had COVID, was being treated in the emergency room.

Their deaths are just a few from a current surge that is overwhelming Buncombe County’s health care system, taxing already exhausted doctors and nurses, and afflicting a large swath of Western North Carolina in numbers not seen since the pre-vaccine pandemic peak.

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As Hospitals Elsewhere Mandate Vaccines for Staff, Mission and Others Resist

Despite "critical" need, administrators fear workers will quit

A choice to be made between an individual and their doctor

The largest healthcare providers in Western North Carolina, including Mission Hospital in Asheville, confirmed this week that they are not requiring doctors, nurses, volunteers, or other hospital staff to be vaccinated against the COVID-19 virus despite a resurgence of infections and hospitalizations.

Most of the other major hospital systems in the state have made full vaccinations mandatory, citing staff and patient safety as a highly contagious COVID-19 variant spreads nationwide, almost entirely among people who have not been vaccinated or are only partly vaccinated.

Hospital administrators and clinical leaders say they agree that vaccinations represent the most effective way to stop the pandemic that has killed more than 600,000 Americans, including hundreds of people in Asheville and surrounding communities.

Few people are more familiar with the impact of the COVID-19 pandemic than hospital workers. Even so, hospital administrators in Western North Carolina — where science and politics are not always compatible — said nurses,

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