Conditions at Asheville’s Mission Hospital pose ‘immediate jeopardy to patients’ health and safety,’ state investigators report

1. Healthcare and raging capitalism simply do not go together.

   1. Very true.

   2. I think the U.S. is the only nation that allows hospitals to owned by vultures like HCA

      1. AMEN ! Vultures indeed ! 🦅🦅

      2. Please do not insult vultures. They are useful, valuable, and valid creatures.

   3. Exactly. Saw this coming back in 2018 when the sale to HCA first came to light. HCA is the Walmart of “healthcare” – cheapen the product, oppress the employee, browbeat suppliers to cut costs, the customer be damned

      1. cheapen the product indeed ! I am a Retired, certified nutritionist and food service manager in healthcare settings for a total of 35 years. as a patient recently at the Mission Hospital I could see a huge downfall in the quality of the food service meals. The food service staff were excellent as far as I could see as a patient, very courteous and kind and timely. . I could tell that the diets served seem to be all prepared under the same quality, example, serving as many diets as Possible the food items . Ex:” oh, let’s just prepare all of the green beans with no seasoning or salt. It won’t hurt a regular diet to eat what the cardiac patients do.!” Just serve everybody sugar-free Jello pudding for dessert, and we won’t have the expense of making homemade desserts for those patients who can eat it “. With 35 years of experience writing menus for up to 17 different diets per meal , certainly see immediately what is being required of these cooks and assistants in the kitchen !
         It is not the doings of the chef or the head cook or the dietary aide, things suck. This is simply a BIG money saving technique ! Reducing the food budget per meal extremely.! I don’t know about you, but when I’m in the hospital on REGULAR DIET order , expect some good tasting Tender meats and tasty nutritious vegetables, and appetizing desserts with drinks of my choice on my tray ! Also, some nice crusty bread or roll . ( I was not served any bread during my entire day at the hospital on a regular diet)
         With bread counting about 20% of the meal served, that alone was quite a savings to HCA but consequently made the food service department look kind of bad , although, not their fault !!

   4. As a retired RN, this is my mantra … healthcare for profit .. what could go wrong?
      And now sadly we know specifically.

      1. I can’t stand it when then they always want to put the blame on those poor hard working NURSES!!! They work hard and and long , long hours!!! Oh but they don’t talk about that !! They cut way back on NURSES and the ones they do have they are working to death! Shame on them!!!

         1. 100% agree. The last time I was there less than a month ago there were 2 nurses running the entire ED.

      2. Oh one other red flag is they no longer give you a copy of your lab reports so you can take it to a doctor who cares to figure out what’s wrong .

   5. Amem

   6. Mission used to have a good reputation even in surrounding counties until the 2019 sell.

      1. FINALLY!!!! As a person with several family members with serious medical conditions I have watched this hospital go from one that cared about it’s patients to a cesspool of corporate greed. We don’t go to this hospital anymore if we have a choice we drive 30mins to an hr to a different hospital. I’ve even said myself when I was seriously ill, I told my family if I pass out do not call an ambulance because they will take me to Mission. Take me somewhere else. Or I’d probably stand better chances laying on the floor at home. The staff that cared left this place and went to other hospitals. The ED is a zoo full of suffering where you wait a minimum of 6 hours to be evaluated beyond blood pressure and oxygen levels. Walking in the waiting room is like walking into a FEMA camp. My friend who I went with by ambulance less than a month ago had two rounds of nitroglycerin and an aspirin in the ambulance to stop a heart attack and we sat in the waiting room for 8 hours before he was discharged with nothing more than a PA looking at an EKG and telling him he wasn’t having a heart attack now so he needed to go home. This is not a hospital. This is a careless, disgusting, money hungry death trap. Force HCA out or close it down.

2. If the hospital loses its Medicare and Medicaid certification, and if Josh Stein’s lawsuit is successful, can the state take over HCA/Mission and return it to nonprofit status, so that basically it’s confiscated from HCA?

   1. Let’s hope so Andy, so we can get our hospital back.

      1. Let’s hope and pray they take it away from HCA.

   2. The only recourse we might have is to have the hospital shut down, and the State and County step in and rid ourselves of the HCA profiteers.

   3. As a parent of a daughter diagnosed at 1 year old I think I can speak on this matter being since early 2000’s she has had to be rushed to Mission many times being there sometimes for weeks. We have seen the care and quality of staff go down overworked to sometimes confused in the past few years. Yes Covid had some retire some change careers. Yes Mission had traveling nurses bought in to help but it amazed us to the money they paid for them. We are appreciative of them but why not offer incentives for western NC people to get into nursing and other jobs there. Yes if anyone cares to post what they paid and pdm for food lodging etc. Ian not saying they were not neede they were. We were shocked what a cpl said what they paid them. Why not put some of it into keeping the quantity people who were there that left and went to Hendersonville to Haywood or Sylva. We need you all . At one time we were all proud to see the old mission was rated one of the best in the state. We were proud but just one paren has seen my daughter wait over 6 hours at the emergency room. She was on dialysis and numerous other medical things that can go wrong fast. Please rise up and take care of the people and the people will take care of you .

      1. For every 6h of the $30/hr surge pay, I could give an employee a $1.50/hr raise for 120hrs (not including overtime). Our team reported >200 errors for the 30% of pts admitted that our team reviewed last year. Teasing out now which are related to staffing. More staffing was cut in the budget for next year…

      2. Why not increase pay and incentives for NC people?
         It’s a sinister tactic. Traveling nurses are not invested in the people or the community and are less likely to hold their employers accountable.

         1. Plus, training is severely lacking. I often see incorrect procedures being ordered, because the providers don’t know what is what in the system. Then they get mad if they are corrected. I’ve been there over two years now, and can’t see how they will fix it with the staff that they now have. New trains new without looking at the standards that are needed. Each generation of staff receives less and less training. I really feel for the patients that get sent to that facility.

   4. Really good question.

   5. I sure hope so. I had a friend who worked inside the quality office right before the transition from non profit to HCA and oh my the writing on the wall was right there before the transition. Also Patrick the CEO of Mission ended all contract workers and said either become Mission employee or you are out. Local Anathesiology grouo whi contracted with Mission for decades had contract ended and indicated a no competition clause for hundreds of miles even though Mission breached the contract. Friend moved to Kentucky.

   6. My question too. It needs to be confiscated from HCA.

3. OH. MY. GOD.!!!

4. Some of the statements in the article are erroneous. It sounds as though there’s a lot of rumor being presented. I am nurse of 36 years and have worked in all kinds of disciplines in the healthcare industry. I have also traveled the US as a travel nurse as well moving to permanent positions throughout the different parts of the country.
   1. Mission Memorial is licensed for 815 beds which are fully open and to meet the staffing needs for the patients, Mission has hired travel nurses and permanent nurse to meet the demand.
   2. The Medical/Surgical units are staffed well with nurse to patient ratio of 5 patients per nurse. That nurse does not work in a vacuum as other clinicians (patient care tech, respiratory therapy, physical and occupational therapy, charge nurses without a patient care load, and nurse leaders who see patients at the bedside. In addition, Mission Hospital has a very strong case management group which includes nurses and social workers. Although the public wants to be seen in the ED within 1 hour – this is not a reasonable time limit. If you investigated other large hospital whether for profit or non profit you will discover that that goal is unattainable considering patient’s comorbidities as well as how they maintain their own health through their PCP (primary care physician) and being responsible and involved to maintain their health status at a top level. Patients have a duty to care for themselves before entering an ED. Most patients who are admitted have multiple and complex health needs. I find that patients tend to want a magic bullet to “FIX” everything. Many conditions can’t be FIXED because the patient has allowed themselves to decline or debilitate. They may have cancer, heart disease, autoimmune diseases, don’t reduce their obesity and lifestyle that contributes to their illness. Many of the patients seen in the ED have disease states that they decided to not increase their own quality of life.
   Rest assured that the patients entering the ED at the “back entrance” via trauma calls and immediate care on the spot are quickly cared for. Tge ED is not appropriate for low to medium level of care needs.
   I understand that everyone who visits the ED feel they should be top priority no matter the clinical situation.
   I worked at Mission Hospital during the heavy Covid days. Then I started travel nursing. Travel nursing elucidates the problens in healthcare overall throughout the country. I challenge anyone to check with the top 20 hospitals (teaching or community) to see that in actuallity, the problems identified at Mission are equatable to any hospital in NC and/or the US.
   What are the benchmarks with Duke. UNC hospitals, Novant and Atrium in Charlotte. Also compare to Emory, Grady, Piedmont , Northside, Med Ctr of GA in Augusta, Medical University of South Carolina, University of AL Birmingham, Chop, John’s Hopkins, Mayo, University of Cal San Francisco, Northwestern, NYU Langone.

   Please do a complete deep dive into the data and benchmarks before trashing Mission Memorial Hospital/HCA.

   Lastly, if the Asheville Watchdog wants to spread untruths, they should complete the full research and report on not only Mission Health but compare the data to the rest of the United Stares.

   Be thorough. Be truthful. Be research backed. Be fair. Be non-judge mental. Talk to not only people with a negative bias but research tge people who have a positive perspective in order to present a “fair and balanced” report – which means the Asheville Watchdog has interviewed a multiple variety of patients, family members, and staff (nursing and all other disciplines. Thank you.

   1. The commenter is certainly entitled to her views. But I feel it’s important to respond when a Watchdog reporter is accused of spreading “untruths” and making erroneous statements. All of the allegations in our article were made not by The Watchdog, but rather by state health regulators after a months-long, on-site inspection of Memorial Mission Hospital and the Asheville Surgery Center. They are not “rumors,” but rather stringently documented facts and observations. A copy of the letter to Mission CEO Chad Patrick from the NC Department of Health and Human Services is embedded in the article for your inspection. These are the findings of healthcare professionals called in to investigate hundreds of complaints filed against Mission in recent years.

      The Watchdog team has interviewed hundreds of doctors, nurses, technicians, patients, family members, and healthcare officials, spending hundreds of hours in research. And yes, we are confident that “the problems identified at Mission” — that patients at Mission are in “immediate jeopardy for health and safety” — do not currently apply to Duke, UNC, Mayo, Johns Hopkins, or any of the top 20 teaching hospitals in the United States. None is currently designated as “unsafe,” as Mission is.

      Our research will always be incomplete because of HCA-Mission’s refusal to make its executives available to talk, or to respond completely to our questions — if they respond at all. Mission has never challenged the truth or accuracy of our reporting.

      Consider this an open invitation from Asheville Watchdog to any current Mission administrators, doctors, nurses, and other providers to speak to us on the record about conditions at Asheville’s flagship hospital. I promise we’ll continue to be thorough, truthful, research-backed, fair, and balanced. Thank you.

      1. With all due respect, Mr. Lewis, you and Mr. Jones may want to do a little more research before responding to suggestions such as this other commenter had with such definitive confidence. Per your reply, “And yes, we are confident that “the problems identified at Mission” — that patients at Mission are in “immediate jeopardy for health and safety” — do not currently apply to Duke, UNC, Mayo, Johns Hopkins, or any of the top 20 teaching hospitals in the United States. None is currently designated as “unsafe,” as Mission is.”

         And yet, a simple Google search would turn up an article from June 2022 titled “ CMS threatens to ax UNC Health’s Medicare funding after flagship hospital cited for serious noncompliance” detailing this same scenario.

         While not a preeminent teaching hospital, Novant’s New Hanover also received IJs – yet another large hospital with the same challenges.

         While you all would like to sensationalize what’s happening, it’s not all that rare and can happen to great facilities. Just slow down and do your research instead of responding with such arrogance without all the facts.

         1. And yet……the care….or lack of care at Mission keeps surfacing.
            Valid, substantial claims keep coming up. Physicians are leaving or have left in disgust with the HCA policies and greed.
            No amount of papering over the crisis that HCA has wrought on what was once on outstanding hospital will stand up to the damage that has been done.

         2. With all due respect, we need to have a mindset of focus on the issues at hand at Mission, not always comparing the issues to other hospitals nationwide. We need to establish better policies and then monitor for adherence at all times. Once a protocol is in place, then other hospitals should go through the same process for improvement.

         3. Been to emergency room in spruce pine. Going to Tennessee next time. Mission needs shut down. Worst hospital I have ever seen. I want a hospital like Cooper in New Jersey, or Johns Hopkins where I was born

      2. Thanks for responding quickly to Callie Belle’s outrageous defense of Mission and her comments against your journalistic coverage of the problems at Mission. May she never be your nurse, nor mine.

         1. You are absolutely correct-but understand that nursing as a whole has changed so dramatically in the last 30 years (my experience) that we have a lot of change that needs to happen for safe appropriate healthcare provision everywhere. People value degrees and money too much now, and patient care has been placed on the back burner. Nurses of today are not the same in many ways as they used to be; their mindset is totally different, leading to a different standard and imparting of care. Everything is just so different unfortunately.

            1. Please consider, the nurses at Mission put in complaints for years prior to this event. Most nurses are serious about advocating for patient needs, and the education and job is too rigorous to be worth it for money alone. Yes, there are always some people who shouldn’t be there, not denying that- it is not the majority. Moral injury is the term used for healthcare professionals who know what should ideally be done for the patient yet are forced to spread themselves so thin that they can only take care of the most urgent needs instead of delivering appropriately thorough care. They are not upset solely on their own behalf. It’s a terrible feeling to work as hard as you can for 12 + hours and still feel like your care is substandard. Is it fair to blame the nurse when the deck is stacked against them, caring for real human needs with inadequate resources? They still keep showing up to do the job because quite a few of them feel called to a caring profession. What has changed is the level of unmitigated corporate greed. Please look at the real root of the issue.

      3. Come investigate the HCA in georgia Memorial Health in Savannah. And there Icu units for (baby’s) labor delivery department. All HCA should be shut down

      4. Thanks to Asheville Watchdog for your keen, unflinching reporting.

   2. Blaming patients for their conditions isn’t a good look. Regardless of how or why people present to a facility, they deserve to be cared for and treated with dignity. Do better.

      1. I agree. I picked up on “Callie Belle’s” dig at patients, too. She spent a lot of time blaming the patient and didn’t really address the issues cited in the article. She wants us to be truthful. The truth is, Mission used to be a hospital we Ashevilleans were very proud of. Not anymore. That all changed with HCA. And I can’t help but think that posts such as Callie Belle’s, that defend it and want to distract us with “whataboutisms,” are actually written by an HCA exec.

      2. Amen!! My doctor sent me to Mission last year in June WITH papers stating my medical needs-I arrived at the E.R. at 4pm-was ‘admitted’ to an e.r. room at 2:30AM- I sat with HUNDREDS of other people-no one wanted to look at my ‘papers’ and I was not seen by a doctor until 10am the next day….vitals were not taken, etc. etc. At one point, nurses said I may have staph infection-I told them I did come in with staph-how did I get it? I slept in my street clothes for 2 1/2 days-never offered a gown, extra blanket, etc. I could go on but I don’t think this is ‘normal’ If my family had not assisted me, I would have been in deep trouble!

   3. Sounds like you are only blaming the patients. I have lived here all my life, I also have been to other hospitals nationwide and mission is awful.

   4. You’re a nurse?…..with this type of vitriol you spew against patients needing care? I think you need to find another line of work.

      1. Peter Lewis: Thank you for responding to Callie Belle. The Asheville Watchdog is doing its journalistic duty to the public.

         Callie Belle: It’s Mission Hospital. Not Mission Memorial Hospital. This was the first clue to suspect your lengthy comment. Your comment(s) about patients were appalling.

   5. To Callie Lewis: I’m grateful you were never my nurse. You chose the wrong profession. Arrogance, lack of empathy, and blaming patients are the opposite of what any good nurse or healthcare provider should have as basic qualities. But your values do seem to align more with the HCA management and owners. Please stay away from WNC healthcare.

   6. Wow! You make an excellent argument for socialized medicine!

   7. The med/surge units do not have a 5:1 ratio. The step down units are running at 5:1. Med/surge is 6-7:1

      1. CNA was 18:1 when I was on Med Surg.

   8. An IJ or J tag is hard to get. As you know nurses will tolerate a lot before notifying the State. You continue to make excuses for the lack of care people receive while at Mission and this is not all floors just the ED. Mission Heart is fantastic, Kudos to the Nurse staff and Doctors as they are truly wonderful. Good luck in Med Surg. Your night nurse may be asleep. When I notified her supervisor nothing was done. The nepotism and clicks are rampant. Protection from family and who you know makes for a poor employee. Lack of funding for staff, meds and supplies is still a huge issue. There is a reason for the mass exodus of nurses and doctors leaving Mission, lack of concern for patients and staff and the inability to do your job effectively is it and it’s corporate greed and people being in power that have no qualifications to do their jobs. Mission’s letter to doctors in the ED is just proof of their incompetence and willingness to place blame on anyone other than themselves. If a doctor walks by a room of a patient in dire duress and does not render aid the doctor should be fired, same as a nurse. Mission will fix the J tag for a while and care will go right back to what it was, that’s the way it works. HCA now has the monopoly on healthcare for the area which never should have been allowed, patients don’t have a choice. The onus is on HCA and they don’t care. Mission charges exorbitant prices compared to other hospitals. Profit over patient care.

      1. Profit over patient care is SO RIGHT. It’s sad to say, but the WHOLE MEDICAL FIELD IS A MONEY RACKET. HCA doesn’t give a dam about RHEIR RESIDENTS or THEIR STAFF.

   9. How much did they pay you to say that? Begone, shill. Mission used to be great. Now it’s not, and the problem lies 100% with the new owners. They have to go. Period.

   10. Callie Belle…I’m just a bit curious as to how on earth you were able to drag yourself away from your employ at a hospital offering its community such impeccable care and service, but I’m grateful you did and hope you are doing well.

       After sitting with my husband who was barely able to breathe from the pain of appendicitis onset for several hours in the ED, I came to realize it was going to take me making a scene in order to get someone to attend to him and give him something for the pain, much less get him admitted to a room. So I did. A very classy, loud, well thought out one I’d put together in my mind while waiting, patting, rubbing, reassuring him we were indeed in the ED at the hospital. It worked.

       A couple of hospital staff responded immediately. It seemed the loud disturbance compelled others to jump in it with us, after all we’d become like family during our tenure there. A nurse miraculously rushed him something for pain, someone else rushed him for a CT Scan, then rushed him to surgery in hopes, I want to believe, his appendix wouldn’t rupture.

       The surgeon and his entire team were a collective Godsend. After a successful surgery and recovery, they found him a bed. In a room. At some point I spilled some water on the floor, located some paper towels and cleaned up the floor. And I mean cleaned. The paper towels came up black. It made my skin crawl. The staff seemed a little annoyed when I asked for a mop. Under the current dire circumstances, conditions and situation, I was just trying to help.

       One more thing, if my reply gets printed…nowhere am I able to find where our once beloved hospital was ever called Mission Memorial. I’m a little embarrassed for you over that.

       A big thank you to everyone at Asheville Watchdog and to everyone at Mission who care and try.

       1. According to no less an authority than Wikipedia: In 1947, Mission Hospital merged with Clarence Barker Memorial Hospital (at that time known as Biltmore Hospital) … and became Memorial Mission Hospital. It remained Memorial Mission until it purchased St. Joseph’s Hospital from the Sisters of Mercy in 1998.

          1. Memorial Mission, yes; “Mission Memorial”, never. The “Memorial” was dropped when the merger was consummated, to the consternation of several veteran groups. The memorial wall may have been relocated to Memorial Stadium.

             And it was “not-for-profit”, not “non-profit”. I don’t think it was ever unprofitable, but the money was spent on buildings and equipment (and no doubt administrative bloat). The money stayed local, not sent to out-of-state corporate or investors.

       2. Good for you! Whatever it takes to get the care we all need at sometime in our lives.

   11. I am a Nurse Practitioner of 15 years & nurse since 1984. I had the unfortunate experience of urgently having to go to the ER at Mission in August 2023 . It was like being in a 3rd world country. I experienced 12 hours of being treated in a ER lobby chair with critical meds and IV fluids before I was moved to a dirty , blood stained floor “ER stretcher /room”. I was told they had many of them but no staff. I met my first nurse then. Many waiting patients chose to lay on the floors. Elderly, sick adults waiting just as long or longer and no staff checking on them or me. Nothing more than assembly lines to get lab drawn, an EKG and seen by a doctor in corners with no privacy, other patients 4 feet away. Those few staff I encountered were so obviously overwhemed. I was in pain, short of breath, ultimately diagnosed with a blood clot and cardiac effusion but in triage was told I could not utilize a wheelchair because there was a shortage, no other assistance offered. A man who I had watched for hours, collapsed and coded, staff rushing to lift him to a stretcher , bagging him breaths, rolling him off behind closed doors. It was the most shocking , scary time of my life and career. I finally got to a regular room and a bed at midnight 48 hrs later. No nurse ever identified themselves in the ER and none ever checked on me or all those other patients routinely. My provider says I have PTSD from this in addition to my heart surgery 2 weeks before. My heart breaks for Asheville and all those people who need appropriate healthcare there. I will never go back.

       1. I’m so sorry that happened. 😢😞

       2. How awful; I am so sorry that you had to go through that trauma. Thank you for sharing your experience because your status as a medical professional might bolster the accounts of SO MANY other Asheville residents.

   12. Wow. Blaming the community for HCA’s dangerously negligent level of care is absurd. Sure! It’s the patients’ fault for having cancer, heart issues, etc.
       You must be one of their spokesperson or have stock in HCA.

   13. Sam Hazen could not have said it any better Callie Belle. Former Mission RN here. You need to find another line of work. Thank you Asheville Watchdog for your thorough, fair,
       informative reporting. You are making a difference in Asheville.

   14. My brother came to the Mercy ED recently with severe seizure like symptoms. He did not get the MRI he needed for FOUR DAYS. My sister asked for a patient advocate to assist her in getting the care he needed to no avail. My sister had my brother transferred finally to Duke. Later when she spoke with my brother’s Asheville doctor and told him her concerns, the doctor acknowledged that Mercy “is not the hospital it used to be”.

   15. Your facts are not straight either. All charge nurses now have full case loads. Med surg ratios are now 7:1 on a good day. Gone are the days of support staff, unit secretaries and nursing assistants. Wake up. You speak as if you are on HCAs payroll.

   16. I can tell you for a fact that the medsurg units are NOT taking 5:1 patients. They are taking 6/7 patients per nurse. Stepdown/ heart floors are taking 5:1 patients.

   17. Perhaps you aren’t a part of the problem, or can’t see clearly through your biased views as someone on the other side, but to assume that this investigation is based on rumor – well, that just shows how lucky you’ve been to not be a patient negatively impacted by poor care in the ER.

       I have video evidence from a friend of mine, while at the Mission ER last year. He took the video and others, because he was genuinely in fear due to how he was being treated. The specific video I have, without sharing too much as it’s not mine to share, shows him being threatened by his nurse, only because he and his family were desperately needing him to be transferred to the local VA where his medical team was located. His condition is ranked as one of the most painful conditions currently known of, and is very difficult to treat. The ER staff at Mission hadn’t even heard of it and certainly had no idea how to treat it, yet there was no urgency in transferring him to a facility that COULD meet his needs (at least with a familiar team that knows him well). He was in a level of pain that most will never experience in their lifetime, a true level 10, and as a nurse, I know you know how a level 10 pain is defined. He did not choose to go to Mission, in fact, that was the last place he wanted to end up while in a pain crisis, but that’s where EMS took him. There was no medical reason to delay his transfer for days, while he suffered from indescribable pain, and his pain team located at another hospital.

       As someone who has worked in the industry myself, and also a chronic pain patient, I’ve seen it from both sides, and I can assure you that the treatment I witnessed was inhumane, in violation of his patient rights and was downright terrifying as a fellow patient.

       Call it rumor, all you want. I have video and witnesses. If it can happen to my best friend, no doubt it’s happened and is happening to other patients.

       I’m glad they are being called out for it, and hopefully, as a result, patient care will improve. I’ll quote you in saying that the things you are asking for here – “Be thorough. Be truthful. Be research backed. Be fair. Be non-judge mental.” – that all should apply to healthcare workers as well. Pain patients are TIRED of the judgemental assumptions made by ER staff, yet it’s the only place to go when in crisis. Give us a better option and I promise, we’ll never step foot in an ER again for a pain-related emergency. Additionally, since all documentation in a hospital is done by staff, records alone can not be used to assess issues with patient care. I have found MANY untruths or partial truths in my own record, and it’s always from the POV of the medical professional. So, whether you like it or not, complaints from patients, and issues identified during an agency visit, also have to be considered when investigating a hospital or other healthcare provider. Patient experiences are not necessarily rumors just because you don’t agree with it.

       1. “since all documentation in a hospital is done by staff, records alone can not be used to assess issues with patient care. I have found MANY untruths or partial truths in my own record, and it’s always from the POV of the medical professional. So, whether you like it or not, complaints from patients, and issues identified during an agency visit, also have to be considered when investigating a hospital or other healthcare provider. Patient experiences are not necessarily rumors just because you don’t agree with it.” Katie is right about this– the records are the hospital’s version of events, which are not always, let’s say…honest, or accurate. Records are written to protect the hospital, not the patient. Y’all need to get your records and go over them with a fine tooth comb.

   18. You would be hard pressed to find any floor where it’s 5:1. The renal floor is 7:1, sometimes more and without a CNA often. I call the K building at times where there were only TWO nurses and no CNAs for the entire unit. Staffing is not what it used to be and it hasn’t been 5:1 in a very long time.

   19. The point of this whole thing is to investigate to ensure that quality healthcare is given in the community. Yes, Mission has the same issues as other hospitals nationwide-but let’s hold administration accountable and remedy this dangerous situation. Mission is an integral service for a large community and needs to be corrected and remain viable. As with other systems, the money and resources need to be appropriate and dispersed correctly for needed patient care and positive outcomes. I have been a patient there, as well as an employee. I can answer for all aspects of care. They absolutely have a superb nursing team in my opinion, even the traveling nurses. However, they do not utilize resources necessary to impart safe appropriate care consistently. Nursing needs supportive personnel on a consistent basis to give good quality care, such as Patient Techs and Respiratory services. This will require a mindset shift from money to needed services. I’ve been a nurse for many years, and Mission DOES get it right a lot of the time; they have literally saved my life on several occasions. As a healthcare professional, we have a unique perspective into the workings of theses issues. THINGS WILL NOT CHANGE OR CERTAINLY IMPROVE WITHOUT CITIZENS (community and staff) STANDING UP FOR WHAT IS RIGHT!!

   20. I can tell you that when my mother had to make an emergency visit after fall, she arrived by ambulance. When my father and I were finally allowed back to the room, she was alone on a bed they didn’t even have a sheet. The room was filthy. The wound on her head was open and bleeding. There was one nurse who was busy in another room and nobody else in the entire area. It was horrendous. As a physician in the community, I’ve taken care of many nurses and staff who have been extremely stressed due to the conditions they are being forced to work under.

   21. Callie,
       You sound like a spokesperson for HCA, one wonders if it a self appointed position or that of a paid one?
       The fact The Attorney General has been investigating Mission Hospital during 2023 speaks volumes about the seriousness of the allegations and is hardly erroneous, as your comment alludes. W all await your further commentary with bated breath but somehow doubt you’ll respond .

   22. Callie Belle, just BS. You can kiss off with your blame and lies.

       My husband was told he was dying of a large mass which was cancer from a door way with a ER doctor who didn’t even bother to walk into the room to alert him, no compassion, no suggestion to call a loved one before he told him, no I’m sorry, just “you have cancer, it’s bad, it’s your whole chest about 10cm” and walked away. My husband had no idea he was that sick, had been to urgent care three times and was sent to mission… and the doctor didn’t even walk into the f-ing room to tell him. He was then admitted (unstable) to oncology from there.

       One night while my husband was on oncology (which we were there over a month) his nurse (who also was the charge nurse) was 8/1 ratio (possibly 9after another nurse was floated) and there was only one CNA. That floor never had lower than 5 or 6/1 rations the entire time we were there and those nurses were also getting floated off the floor while they had 5 or more patients at a time who were getting active chemo with no one checking in at times. (With the infusions running). This is an acute illness floor with speciality nurses needed.

       Don’t blame the patients. We are NOT blaming nurses. It’s the management putting them in these rolls.

   23. I was a nurse at Mission BEFORE HCA and I can tell that management didn’t give a damn then either.

       However, after being a very sick emergency room patient 2 years ago I can tell you that the level of care has PLUMMETED since I worked there. I feel lucky that I escaped with my life after my ED visit 2 years ago.

       In the middle of the night I was to be transferred from the ED to the Heart Tower. The attendants were wheeling me through am unpopulated section of the hospital that was literally in the midst of some sort of construction project.

       I was parked in an alcove under an emergency exit sign (NOT IN A ROOM). I was told that my nurse would be with me in a few minutes. I needed help, but my call bell was not plugged into anything because I WASN’T EVEN IN A ROOM.

       Finally, after almost an hour had passed, someone was hurrying by down the dark hallway. I called out to them and asked if they were my nurse. He said no and kept going. About 15 minutes later, they returned and said that they were my nurse. I asked him to tell me about my case. — HE DIDN’T KNOW ANYTHING ABOUT ME BUT MY NAME.

       There were other things horrifying about this visit as well. It pains me to think about them.

       The place is a death trap.

   24. You completely skipped over the facts that it was an entity that all hospitals are subject to that discovered these facts about your beloved abusive hospital. I have seen a girl with a massive head wound be abandoned in the hall of the ED. I have been in semi recently for CI (cochlear implant)surgery induced vertigo from hell and was rudely treated and told it was going to be a five hour wait. My partner and I left and went to Advent and was immediately placed in a room, got an IV and meds to correct the vertigo and nausea in less than 15 minutes, my partner timed them so he could file a complaint with Mission with a comparison. Mission is neglectful. No if ands or buts about it.

   25. Your comment implies that the patients seeking care, their illness, their body habitus and their expectations are the problem. By your logic, HCA is the victim and we are a horrible community to care for. This is an easy fix! I vote we immediately release HCA from the responsibility of caring for us. HCA should be set free to pack up and move somewhere with a perfectly healthy population, where everyone has insurance coverage, a PCP with available appointments, and weigh ins are every Wednesday night. Problem solved.

       You also say you have a 5:1 nurse patient ratio. But if you don’t have techs, respiratory therapists, a charge nurse, a unit clerk, equipment, housekeeping, etc., is 5 nurses enough? I don’t know about others, but I want my nurse to have the necessary support to care for me and my fellow patients safely.

       The list of hospitals we should compare ourselves to. No hospital is perfect. So does that mean we should all just give up and let HCA continue their race to the bottom? Allow HCA to normalize what used to be considered rare or never events? Just all stand around while people suffer and say, “welp, that’s just the way it is”? That isn’t good enough for me and mine. Or my community. Or my profession. Nope.

5. Also. Let’s be realistic. The State of NC, the City of Asheville, the County – Buncombe and surrounding WNC towns and cities can’t possibly financially support just Mission Memorial, much less than all of the WNC counties, hospitals, physician offices. That’s exactly why Mission Memorial Hospital sought after a buyer.

   1. You seem to think you know ‘exactly why’ that particular Mission deal happened. Could you shed some light on various members of the Board of Directors who approved the sale and then may have parlayed their new HCA alliance into lucrative new jobs?

   2. Do you know why HCA bought mission health? Because it was already financially healthy! It was a non-profit, not a community funded health system. Even non-profits generate profit, the difference is that they put the month back into the hospital. How do you think the new ED and tower were built? Not by HCA, It was already funded, planned and under construction when HCA took over.

      1. The idea that a for-profit corporation that would have to pay taxes and amortize the price for purchasing a nonprofit hospital and yet offer the same services for less money was classic voodoo economics. Also, a damned lie.

   3. Hmmmmm. You seem so out of touch with this issue as to be a troll with a mission (not to be confused with “Mission Memorial”) of muddying the true picture of an urgent community problem.

6. Callie Belle,
   I was a patient in ED over the summer. The articles being presented by Asheville Watchdog have been truthful and accurate. There is a difference in being busy and being negligent. ED’s are busy and can run efficiently. I saw firsthand shocking examples of improper care when I was there, including things that happened to me.
   Thanks to Asheville Watchdog for keeping us informed!

   1. Last Father’s Day I sat in the ED for over 6 hours and saw a man go I to convulsions while waiting to be seen and it took another patient to grab the attention of the staff and then another minute or two to get staff to attend to the man. It was dirty, unorganized and extremely under staffed. They literally had nurses from surgery come down to draw my blood, I think I saw literally one actual doctor (based on name tags) and most of the “physicians” seeing patients where PA’s. I made the decision after that if anyone in my family ever had to go to the ED and it wasn’t life or death, we will drive south to Hendersonville to Advent. Mission is a joke of a hospital 100% because of HCA.

7. Yes! It’s true. Justification. It’s not all in are head!

8. To Callie Belle,

   I am an RN and was also a patient at HCA in the Emergency Department (ED) this past October. (I refuse to call it ‘Mission’ anymore…it is NOT the same hospital that Mission was). Mr. Andrew Jones and the Watchdog are entirely unbiased and correct. I went to an outside provider at 5:00 p.m. after a very bad fall. When I checked into the ED at 6:00 p.m., my doc had already sent my X-Rays to the HCA ED. I had a triple fracture and 2 dislocations in my lower leg.

   Your statement: “Although the public wants to be seen in the ED within 1 hour – this is not a reasonable time limit.”

   Well, what is? I sat for over three hours before I saw a doc and got an IV push pain med that took the pain from a 10 to a 9.8. Then the doc wanted to do X-Rays, and I asked him to please check my file because Emerge Ortho had already sent the X-Rays and I was in severe pain. Then I sat in the ER for another 4 hours until I could get a bed in the ER to reduce my 2 dislocations. By then the pain was back to a 10.

   Next, your comment that “ Patients have a duty to care for themselves before entering an ED. Most patients who are admitted have multiple and complex health needs…Many conditions can’t be FIXED because the patient has allowed themselves to decline or debilitate. They may have cancer, heart disease, autoimmune diseases, don’t reduce their obesity and lifestyle that contributes to their illness. Many of the patients seen in the ED have disease states that they decided to not increase their own quality of life.”

   Wow. Just Wow. That statement is a shocking, ‘holier than thou’ judgement from a nurse. I am in GREAT health, but even if I were not, you are basically passing judgement on patients you have never even cared for. I am grateful that I had better nursing care than I would have received if I had been unfortunate enough to be assigned to you.

   After my stay in the HCA ED, the provider wanted to discharge me at 3:15 in the morning, marking 9.25 hours from the time I arrived at the ER. I was given crutches that were unintentionally set at 2 different lengths, and I fell again when I tried to take my first step. They decided to keep me overnight.

   I had surgery later that morning. I spent a lot longer in the Recovery Room (with wonderfully compassionate nurses) than I needed to because there were no beds in the hospital that could take me.

   When I did finally get a room, I respectfully dispute your specious clam that “[t]he Medical/Surgical units are staffed well with nurse to patient ratio of 5 patients per nurse.” I spent the night post-surgery in a bed at the hospital. I used my call bell exactly 4 times. My IV infiltrated, after which I called my nurse every 15 minutes (and told him on the speaker that my IV had infiltrated) until he finally came to take it out after over an hour had passed.

   Finally, you list a lot of hospitals that you want to “benchmark” against HCA. I COMPLETELY agree with Mr. Peter Lewis that “the problems identified at Mission” — that patients at Mission are in “immediate jeopardy for health and safety” — do not currently apply to Duke, UNC, Mayo, Johns Hopkins, or any of the top 20 teaching hospitals in the United States. None is currently designated as “unsafe,” as Mission is.

   So, I thank the Asheville Watchdog for its timely, accurate reporting. There are those of us in Western North Carolina who do not appreciate being in “immediate jeopardy.”

9. They can make all the excuses they want at missions hospital but I have been there myself and my husband who was dying of cancer and my son who has very bad health .
   we were treated very badly.
   we were misdiagnosed or we were pushed aside as though we were hypochondriacs .

   we were treated as though my husband’s life was not that important he was dying anyway. We had some good nurses and we had some very bad nurses. I had to stay at the hospital with my husband to make sure and my son to make sure that they were cared for properly because the staff is poor ly enforced and the patient’s often go neglected. When I was there I was so badly mistreated at one point I broke down and cried and could not stop and begged for the head nurse to come in .missions was when we first moved here the best hospital we’d ever been to but since the takeover it has gone down the tube. I am actually very afraid of what I am going to do .I am 78 years old and I don’t know where to go to to go to a hospital because I am now scared to go back to missions. And I know many others who have voiced the same opinion. People cannot help be sick they didn’t put themselves there I don’t care what they say and being sick should not make you a victim.

   1. You should check out Advent Hospital. They are actually pretty awesome and very thorough and caring there. It’s not a horrible drive for people in that area either. I myself have been very pleased with them.

10. The care I received in the ER post-open heart surgery was frightening. I was left shivering in a dark hallway for hours by myself. When “Tina” finally responded to my banging my legs on the gurney she told me there was only one doctor on duty (8/16/23) and I needed to “wait my turn.” I told her what she said was “frightening and how could that be? This big of a hospital with only one ER doctor?” I showed her my trembling legs from the cold and she brought me a cold blanket. I told her I needed to “get the hell out of here.” She wheeled by back to the heart tower and I felt lucky to have gotten out of the Emergency Room alive.

    1. Heart Tower is fantastic. It’s also a huge money maker.

11. That sure explains the mad rush to hire ER staff over the past month. Job Postings galore. Addressing the first comment above, if you are a healthcare worker and you are judging and blaming patients for their conditions, you ought not work in healthcare.

12. They’d better be taking it seriously. Some years ago CMS virtually shut down the Haywood County hospital because of deficiencies the state found. It lost Medicare, Medicaid AND most if not all of the commercial insurors that track CMS authorizations. It took a while for the hospital to earn its way back, during which time outpatients had to go elsewhere even for simple procedures and so did people needing to be admitted. But if a hospital as large as mission is shut down, where do so many people go? I still think, even though I’ve been whistling into the wind, that there needs to a federal grand jury investigation of Mission’s sale to the nation’s most avaricious hospital racket. Among other things the public needs to know: How much, if at all, did Mission’s directors gain for selling what wasn’t theirs to sell? What kind of jobs? Why was there a need for an absolute silence clause?

    1. Excellent points. You’d think Josh Stein might have considered that. 🙄

    2. Thank you for that reminder of Haywood County Hospital and the lives that were impacted and lost. I would truly like to know what the voting members of the Mission Board voted to sell and how much stock in HCA they received. Stay on it Watchdog.

    3. Advent, they have been nothing short of amazing every time I’ve gone.

13. Anyone that has experienced being a patient at HCA/Mission or staying with a patient at Mission knows it’s a horror show. One doctor shows up and prescribes xyz and the next day another doctor takes it away and prescribes abc. The next day some new traveling doctor takes everything away to evaluate. Meanwhile, patients can’t get help to the bathroom, no food is provided or it’s awful slop, no pain meds given. It’s terrifying to watch. Has anyone captured any video of the things that go on? I just bet they have.

14. HCA wanted this health system in large part due to the Medicare population here. The myth that Medicare doesn’t reimburse enough is false. There are studies proving that there is big profit in Medicare. Even much more profit in Medicare fraud, something HCA is very well versed in going back to at least 2003. HCA also presumably thought we were a bunch of old, sick, dumb hillbillies who would settle for their depraved, broken assembly line version of care and that we wouldn’t rise up. Just sad it took regulators this long to show up and find immediate jeopardy when the nurses have been sounding the alarm for years. There was immediate jeopardy before the ink dried on the contract for the shady sale.

15. HCA, like Boeing and so many others, decided that their product is actually not their product. Positive health outcomes, as they clearly state in their share holders reports, are of little concern. Their Primary product is money. Shareholder value. “Buy the cow and milk it until it is dead” is the Private Equity motto. Then just go out and buy another cow.

16. I am a Hospital Administrator, my husband was a Director of Biomedical Engineering. We moved to Asheville in 2009 partly because of the stellar reputation of Mission Hospital. We volunteered our time as Mission Ambassadors to help with the planning of the new construction around 2011-14. We were so impressed with just about everything that Mission was doing at that time. It makes me sad & angry that a private hospital that worked so hard to earn its reputation has been reduced in a few short years to a substandard institution.

17. HCA hospitals are all unsafe. They are not concerned with patient care. They are concerned with how they can cut costs and save money.

18. NBC’s national reports on HCA make articles on Mission Hospital operations seem par for the course to me. HCA owns hospitals in the UK now, and I have looked at patients’ online reviews for their facilities there. The reviews for HCA in the UK seem similar to HCA reviews in the US— not good. CMS might need to take action for the whole country, in my opinion. I don’t believe that it’s the clinicians in the trenches that are the problem, having gone to some of their rallies in Asheville for better staffing ratios. As a side note, someone posted in the closed Facebook Group Mountain Maladies about a recent home sale for one of the HCA top level staff. I may be wrong, but I think the post said that the HCA individual just sold a house for over $30 million in Tennessee. Imagine how many bedside staff might be hired for that amount of money.

19. I just checked with a union nurse from Mission and up until recently Med Surg units were taking on average 6 patients with administration pushing for nurses to take 7. (Most of HCAs med surg units on average take 8/9, but the union has been able to keep the ratios lower). AFTER the state investigation the nurses are now averaging 4-5 patients…for now. Charge nurses most days have a patient load (I know because I use to do charge on my unit and take a full team). There are too many shifts nursing assistants are assigned 15-30 patients requiring nurses to do primary care for their patients on top of their nursing needs.
    As far as patients brought in per ambulance services being seen immediately is untrue. County ambulance services are sitting in the bays for up to 2 hrs waiting for patients to be accepted into the ED. This has caused a dangerous situation for our surrounding communities and much turmoil for local EMS that cannot answer calls while caring for patients in the ambulance bays.
    Case Management/Social worker department at one time was a well staffed, but like every area of Mission their case loads have doubled since the purchase of HCA.
    I do not know who Callie Belle is, (I was a 18 year Mission nurse) but she sounds like a talking head for HCA.

20. HCA stock is up $4 a share at the opening bell. Doesn’t sound like investors are scared over this news.

21. The only way this gets solved is when it costs more for HCA to understaff than to adequately staff, which means lawsuits. Lots and lots of expensive lawsuits.

    1. You are not going to get lots of lawsuits in any tort reform state, and NC is tort reform, as are about 3/4 of states. Many attorneys switched to personal injury, retired, and not many in law school want to go into med mal. ProPublica wrote about how only a tiny amount of poor outcome cases ever get an attorney. So, it’s always going to be cheaper to pay for a few poor outcome cases that staff at higher levels, I am afraid.

22. My daughter formerly worked at HCA-Mission as an RN on a Med-Surg floor. Per the nurses’ contact, staffing should be 4 patients per nurse. Actually, it is 5-6 patients per nurse on day shift with night shift having up to 8 patients per nurse. There are to be 2 CNA’s per floor per the contact, which rarely happens. Charge nurses usually do not have a patient load but at HCA they do. Grievances are filed constantly but go unaddressed or disappear like nothing is wrong. Now the hospital is being sued by the widow of a patient for wrongful death, negligence & incompetence. HCA has gutted a once great hospital. They hoped that the detractors who spoke out about the sale would die down, but it has only grown louder. Maybe now that they may lose Medicare/Medicaid funding, they will take the necessary steps to restore the hospital to its lost reputation & confidence with the public.

23. My wife spent several mo at mission/st Joseph/miss rehab in 2019
    Service and doctors were excellent -twice weekly med team reviewed status with family—-dr jacobs at st Joseph’s kept the spirit of patients up
    A lot happened with doctors I never new of until wife was out. ( after release app at —ash plu doctors I began seeing their interest as a group oh specialist). Infectious doctor ( lady) was excellent also——as many other unknown
    In 2019 I felt the were the very best
    Mgt has the responsibility of getting this back
    Let us be proud of mission

    1. Johnny —
       My wife also spent months at “then” Mission in 2019 [as detailed in a reply on another Watchdog article], with many, many weeks at Asheville Speciality Hospital [ASH] (the one you call St. Joseph and she also had Dr. Jacobs and as far as “living in a hospital goes,” the ASH portion was better.

       However, this was pre-HCA and pre-COVID. Mission had issues then, but nowhere near the “cluster-f*, dumpster fire, killer of souls, both medical staff and parents, alike,” that it had lowered it standards too.

24. Good work, Watchdoggers! I have a story suggestion: How about publishing the names of all the Mission board members who voted to sell our excellent local hospital system to the for-profit corporate bloodsuckers, along with their justifications for their ruinous deed. You could run a list of their names and contact information as a weekly feature. Go for it!

    1. Good idea Clarke!
       Who’s behind creation of this HCA healthcare desert everyone in WNC lives in?

25. I have seen some of the dangerous practices at mission both first hand with other patients that were family and friends and from my short time spent working there right before HCA took over and afterwards. I have seen them repeatedly send patients home before they were ready with no good reason for the patient issues, resulting in the death of two people I cared deeply for. I’ve also seen the nursing shortage cause delay in patient care and medication that caused some very bad outcomes for the patient..I would hate to see it worse than it even was then. I wouldn’t take a dog to that hospital. No way. It’s very sad, because several years back, mission was the place to go. Now it’s the place to avoid. I drive to Winston for my care and would recommend everyone else look elsewhere for care as well.

    1. This is how my grandmother died. She went to the ER and was sent home. Her Doc told her to go right back to the ER, dead from an infection a few days later.

26. Great ,but sad, story by Andrew Jones. And, Great response/clarification by Peter Lewis. Tragic that a once Outstanding non profit hospital has declined so to such dangerous levels under HCA–profit over patients. So admire all the doctors/nurses who have spoken up, and so admire current staff trying to do their best under Terrible conditions.

27. I would be dead today if it had not been for the help , healing and charitable giving and expertise of HCA and their nursing staff . As well as The Care Partners of Hospice, which thanks to their social working staff and their doctors and nurses , I have lived 2 more years when I was not expected to even live through the night. God bless this medical institution and what they have done for me. Thank you. Thank you thank you. Especially , the team at Hospice.

28. Saw this in real time this summer. Got transferred for my 4 year old son with a serious elbow fracture. No one acknowledged us for an hour in the ER. Then we waited after check in from 10pm to 3am until we got a room. Thankfully the prior hospital had given us children’s Tylenol, otherwise my poor son would have been in even more pain. He cried on the floor and eventually I had my husband take him to the car to wait. It was abhorrent and below even what I would expect from a busy night in the ER. When we finally got back to the room it was just wings and wings of empty rooms and no staff. The nurse then immediately wanted to set his elbow (without any morphine yet!) even though that made no sense and we refused until we spoke with ortho. If my husband who is a physician hadn’t been present to push back and ask questions my son would have had received horrible care. Will never be back. Next time I’ll drive to Spartanburg or Charlotte for emergency care for my children.

    1. Go to Advent, they got me in everytime Ive gone in less than 15 minutes and they actually listen to you.

29. The union nurses at Mission have been complaining about unsafe staffing ratios , lack of supplies, lack of quality supplies and broken equipment for over two years. After each action, interview etc , the hospital spokesperson responds by denying our concerns and even go so far as to call us liars . Mmm guess we were telling the truth after all Ms Lindell. How many patients have suffered because HCA saw dollar bills rather than a human being in those beds?

30. You really do have to wonder what motivated the sale of Mission to HCA in the first place if money was not the reason. I cannot think of any other reason. And, as I have asked before in this forum, who
    benefitted and by how much?
    Excuse me for quoting the Bible,
    but it tells us that “the love of money is the root of all kinds of evil.” Seems spot on to me, at least on this subject.

    1. Ron Paulus was one of them. The CEO & CFO were the others. They got perpetual NDA’s & jobs at the Nashville headquarters while laughing their way out of town & to the bank.

31. I wish everyone concerned by this would write the U.S. Attorney for the Western District of North Carolina and ask for a grand jury investigation of the Mission sale to rapacious HCA. I did. I got no answer.

32. I can tell you first hand how bad the E.D. is…I went there twice in one week. It was an awful experience that I can’t get out of my head. Infuriating. The sanitation level was mind blowing. The doctor that treated me was clueless. I’m glad someone has stepped in to shine a light on that place.

33. A couple of things I think worth mentioning:
    1) The Mission/HCA saga is being duplicated all across this country. In many instances, the hospital/clinic is just closed. Gone. Goodbye. Not the major city hospitals/teaching hospitals, etc. But there time is coming also.
    2) Mission sounds like a star hospital everyone talks about; however, I have to believe that was coming to an end; whether it was sold to HCA or someone else or if they continued to operate as Mission. Why? The most important reason is that the US healthcare system itself is unsustainable. (Just like our entire US economic system is unsustainable.) Our expectations now far exceed what we can pay for individually or as a society. “Healthcare is a right” Well, we’re going to soon find out how untrue that statement is. Major fault lines exist and will widen. And for Mission, as cogently pointed out by Callie Belle, Asheville/Buncombe County is actually quite poor relative to most of the major cities across NC; so that reduces hospital revenue even more (please don’t tell me that medicaid/medicare adquately covers all of the expenses around the procedures and treatment we desire). Furthermore, in relation to Ms. Belle’s comments about general health, we know that poorer area populations generally do not take care of themselves all that well and this leads to additional burden on the healthcare system. When the system is flush with money (and care), medical staff can be more “forgiving” for lack of one’s personal responsibility health-wise; however, when the system is stressed and even “drowning”, one should be able to seee how front line workers may find it difficult to be as compassionate as we would like. You may not like that, but it’s reality. I have no doubt that the ER at Mission is a shit show. Asheville’s homeless population frequests the ER as do many other low income people without regular medical support. That makes for a very busy ER. If you’re not suffering from a life threatening condition (e.g. heart attack), go south a few more minutes to Pardee or Advent. Finally, I agree that the “for profit” model in healthcare is flawed but don’t fool yourself that the “non-profit” model (at least of recent years) wasn’t skewed for greed as well. Where we are headed in the coming decades is back to the true non-profit model where county taxpayers subsidized the “city” hospital for indigent care. Everyone else paid for their care within reason. That meant too that expensive or risky life-saving procedures didn’t take place as much back then. People couldn’t pay, society couldn’t pay and people died.

    1. AMEN

34. As a frequent user of health services for myself and my wife, I have some survival suggestions: (1) Never go alone if you are seriously ill. (2) Get all insurance you afford. (3) Write up your regular problems (a doc will do it). If you end up in the ER you’ll get faster treatment with the writeup if they can get through the triage easily.(4) have a GP who can not only heal you, but who can guide specialists in what works and doesn’t work for you.(5) The ER is not a luxury hotel. Your personal needs will get about the same level of attention you would get at Motel 6. (6) Having a million$$$ in the bank will not save your life in the ER. You must prepare ahead (7) There are serious, uncommon diseases. The specialists who can treat it may be in a different city. You MUST go there at your expense. (8) DO NOT put up with incompetence. Go elsewhere.(9) I do a lot of bullshitting myself, but horseshitting is different. If a doctor bullshits you. and then changes to horseshitting, LEAVE. (look it up for yourself) (10) Stop doping, drinking, smoking, etc. You are not only hurting yourself, but you are also killing the rest of us as well. . . my Medicare Advantage insurance paid out over $800.000.00 last year to keep me alive and functional. In the end it is really up to you. Quit your ‘bitchm, and thank you for contributing to caring for me.

35. I am an RN with 14 years of experience. I get at least one text or Email a day asking me to apply…No thanks…

36. I witness this personally. My father arrived by ambulance Mission at 7:00pm and I arrived 10 minutes later. We waited for someone to come to come in to assess his current condition. At 10:30 my father’s blood pressure went way to low .. the bells and whistles were going off and I called for help and the lady at the desk told me his BP of 63/70 was normal. Finally at 11:05 after constant calling for a doctor she came in and took him for a scan and told me my father was constipated. Really.. she didn’t even look at his blood pressure.. moving forward.. they determined due to the lack of supervision my father had a major heart attack and it had destroyed his heart due to his blood pressure being so low for along period of time. My Dad passed away 3 days later. The day my Dad died.. I was preparing for him to be transferred to hospice.. and the hospital never called me to let me know it would be any time that he wouldn’t make it to hospice. The hospital took that away from me! Does Mission have compassion NO! There is more to this story—this is the short version. The Emergency Room Staff lack of COMPASSION, negligence AND CARE led to my dad’s passing.
    Do not go to Mission if you are having any health issues or need help. Go to another hospital. It may say your love one.

    1. I am so sorry for this wretched experience. The Mission ER should be shut down. Better to drive south to Advent.

    2. Terryl Evans,
       I am very sorry for your loss. I lost my brother to a fatal drug overdose given to him by a psychiatrist who had lost his license in one state only to move to another. This for profit system we have here in this country that we unfortunately call healthcare is appalling .

    3. Terryl,
       My heart is with you and your father who just passed. My father was an inmate at Mission “Asylum” back in October. He was admitted to a room and neglected. He had a traumatic head injury and bleeding on the brain. The medical team attempted to send him to rehab. I put a stop to that. And yet, even after signing over papers for Hospice, he was stuck in Mission another day and a half. He was mercifully transferred to Solace Hospice on the evening of the 15th and administered anxiety meds and sedatives. I was contacted by a doctor there who essentially asked permission to euthanize my father who passed away early Tuesday morning. He had been at Mission from his entry to the ED the previous Tuesday to a room on Friday the 13th, the 14th, the 15th… May you have some peace and closure one day

37. I am not one to go to the emergency room but, recently circumstances came about that landed me there. I went to the front desk where I wasn’t asked to present identification but was asked why I was there. I explained the situation and events that lead me to the hospital. ( I have spent a lot of time at Duke hospital so, I’m aware of how things should flow, aside from just basic common sense.) I was triaged after waiting for at least 4 hours but, it wasn’t until AFTER imaging and labs that I was checked into the system! Nobody seemed to know what was going on and the lack of communication is insane. I understand that things happen and I’m aware that you aren’t seen as soon as you walk in the door. I’m not being unrealistic. There were people wheeling around their computers, to check patients in and get insurance information as well as to have them sign consent to treat AFTER being there for hours and hours or already receiving some form of care. I witnessed a woman in a wheelchair, with an IV in, slumped over the side of her wheelchair with her head and arm dangling for over an hour. I saw people with decent lacerations having to wait way too long to be triaged. Prioritize your patients… Those that are ” frequent flyers” could wait until you get through the steps of getting the emergent patients checked in and triaged. Everything I experienced that trip was like being in the Twilight zone. This hospital isn’t a pop up store, it’s a hospital that’s been operating for a long time, regardless of changing ownership. It was as though it was day 1 of opening and everybody was trying to figure out what their role was. My opinion is that you won’t see the real issues there, as long as they know they’re going to be monitored. It’s like DSS calling you to say they’re on the way to your home and will be there within the hour…. That gives you time to clean up and do whatever to present a different picture than what you would see if you just showed up. There’s a reason people are willing to drive out of town and out of their way to go to another hospital. Hopefully they get it together… They should have never sold out… Money isn’t everything

38. I’m in home health and saw the patient of mine be transported and after arrival due to COPD sit hours in waiting room not getting the needs met after admission. Seeing how understaffed or unorganized. Baths/ sponge baths are never given which lead to UTI arriving home.communication was never satisfied

39. I have had some of the same experiences expressed here. I went to The ER for what was thought to be a kidney infection only to have a nurse give me an IV with a penicillin based antibiotic after I had specifically said I was allergic to penicillin, this took place in The ER waiting room. Within seconds after receiving the IV, my face became red and I threw up , someone passing by said urgently, “ she’s in anaphylactic shock !”
    I was only then that I was rushed into triage. This happened in September 2023.. And yet again, in November when an Urgent Care location misdiagnosed me and called an ambulance.,being concerned, I naturally agreed to go to The ER, though, in hindsight, it was a mistake. Once in The ER I stated again I was allergic to penicillin and yet I was given a penicillin based IV, immediately again I wet into anaphylaxis , this time to be given three painful EPI injection jammed into my thigh. After this horrid experience , I wouldn’t go to this hospital for a bandage let alone any medical procedure. Recently, my PCP requested I had some tests done at the hospital, my response is too impolite to repeat here. Now I know that I live in a Tort Reform state it explains why so many lawyers I contacted refused to take my case.

40. My father was admitted to Mission Hospital with a traumatic brain injury in October 2023. He spent three days in the emergency room before being transferred to a room October 13th. I received calls from the attending doctor and two caseworkers prior to my visit that Friday. I mentioned hospice. The doctor later attempted to upgrade a terminal condition to stable mentioning “In house hospice”. Translation: For-profit nursing home for as long as they could keep him alive. I told the staff that he was a Veteran. Nobody has that information on file. Dad’s care was minimal and he was afraid and in lots of pain. I ended up having a coming to Jesus with the doctor and demanded he be transferred to the VA. He wasn’t, but papers were signed on behalf of Care Partners to move him to Solace Hospice. That was on Saturday the 14th. My father was not moved out of Mission Hospital until the following evening on Sunday the 15th. On Tuesday evening the 16th, I received a call from a doctor at Solace Hospice essentially asking me if he could put my father down as he was in a lot of pain and experiencing acute anxiety. I gave him the go-ahead. My story is one of so many….

41. This is a humanitarian crisis. How on earth are they allowed to remain open and accept patients into this hellscape? The national guard medical fleet should be deployed there immediately. Where is the Gov in all of this? For NCDHHS to wait 2 years to respond to the Nurses pleas is inexcusable.

42. We need to get ahead of the curve and consider the future. Let’s say that we somehow get our hospital back. What can our community and local leaders do right now for the top-notch health care professionals who still remain and whom we wish to retain? As we know from watching the depletion of the APD and the ranks of UNCA, retention of talent is far less costly than recruitment and retrofitting (and hiring a parade of consultants). We need to stop lurching from one crisis to the next.

43. I spent 36 hours in spruce pine hospital. Chest pains that went away in a few hours. They gave me medicine for acid reflux or something I don’t have. They sent me a bill for $60,000. My insurance paid for it,have A,B,D,G. My bill said 0 due. They did nothing. Going to Tennessee next time!

    1. Nah, go to Advent. I’ve had to use them and they’re truly amazing.

44. One local group who seem to be absent/silent in all these discussions, maybe from the very beginning of the sale, seems to be our elected city and county officials – as a big chunk of Mission is in their backyard. “How come?” Have they been doing their Sargent Schultz impersonations? Why didn’t anything seem to happen until the Watchdog and the “staties” stepped up? Questions to consider in an election year?

45. I’ve been a nurse for 36 years, and worked EMS for years prior to that. As I was coming to in an ambulance after a motor vehicle accident (someone ran a stop sign), the paramedic apologized to me that they had to take me to Mission. That said volumes. It’s still incredible to me that the citizens of Western North Carolina allowed their homegrown regional charity to become a for-profit entity, and very few still seem to be wondering just how that happened.

46. I took my son to FastMed Urgent Care in mid September. They diagnosed home with3 broken bones in his foot and recommended we go to Mission Hospital ER. We arrived at the ER shortly after 1 PM and left at 9:15 PM.
    What I witnessed during those hours was horrifying. All the waiting room chairs and floor were filled with people crying out in pain, receiving IVs, and personal information was being discussed in front of others. Paramedics brought in people on gurneys and had to fit them into the waiting area. After 3:00 I requested my son’s blood sugar level be tested as he has Juvenile Diabetes. There was nothing to eat or drink and I was getting worried about his listlessness. I continued to ask until finally at 8 PM his blood sugar level was tested. At this point, he was passing out. His reading was 28! He was brought apple juice and was revived. After that he got an MRI and was released. We happily left. It felt like a disaster had happened in Asheville and all these people were left to fend for themselves. I can’t believe this is our Asheville hospital.

47. A few years ago I was sitting with a friend in the emergency department, the EMTs wheeled in a girl with a MASSIVE head wound. The nurses directed the EMTs to leave her in the hallway, I kept a close eye on her the whole three hours I was there, I didn’t move, I didn’t even go to the bathroom, and not one person checked on her by the time we left. I said something to a nurse but don’t know what happened after that. Then years later but about two years ago, a few days after I had my cochlear implant surgery I went in with such bad vertigo I couldn’t stand and felt like puking so bad that any time I spoke I was gonna puke, the nurse at the check in refused to talk to my partner only me. He explained things to her but she kept cutting him off and wouldn’t let him finish, then we find out that it was gonna be a 5 hour wait. We left and went to Advent where I got seen immediately and they were happy to talk to my partner only asking me to thumbs up for yes and thumbs down for no any time they wanted to check what he was saying. I know so many people that have BEGGED the EMS to take them anywhere but Mission, unfortunately all the ambulances in the area is under missions power and have to take them there. Many people refuse the ambulance ride. From the actions of this “hospital” you’d think Mission’s mission is to kill as many people as possible.

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