HCA-owned Mission Hospital in Asheville received an "A" grade for safety in the Spring 2023 ratings by the Leapfrog Group. // Graphic courtesy HCA Mission Hospital

Earlier this year Mission Hospital of Asheville was named one of the “50 Best Hospitals” in the United States. That award, given by Healthgrades, a for-profit hospital rating company, in effect designated HCA-owned Mission as the best hospital in North Carolina. No other hospital in the state was listed.

Mission has touted this award in its marketing materials, citing it as proof of the high performance of the hospital’s staff and management.  

“We are grateful to Healthgrades for their independent evaluation of our clinical excellence,” Chad Patrick, CEO of Mission Hospital, said in a news release announcing the award.

Healthgrades is owned by Red Ventures, a giant media company based in Indian Land, South Carolina, that also owns Bankrate, The Points Guy (a ratings system for airline mileage programs and credit cards), CNET, and the Lonely Planet travel guides. 

According to an article this year by The Verge, “Red Ventures’ business model is straightforward and explicit: It publishes content designed to rank highly in Google search for “high-intent” queries and then monetizes that traffic with lucrative affiliate links.”

Red Ventures is one of several organizations that publish consumer-facing evaluations of hospitals, and whose ratings are used by Mission — and other local hospitals — in their marketing materials.

Paul Keckley

Because hospital raters like Healthgrades charge hospitals a fee to use their ratings in their marketing materials, the ratings are “more a marketing ploy than a way to evaluate performance,” Paul Keckley, a Nashville-based healthcare policy analyst and industry expert, who produces an industry newsletter called The Keckley Report, told Asheville Watchdog.  

Keckley called the ratings unhelpful for consumers. “It’s almost buyer beware,” he said.

Leapfrog, another organization whose ratings are touted by Mission, is a nonprofit founded and supported by an employer coalition. It focuses on patient safety and issues semi-annual grades for hospitals, like a report card’s A, B, C, D and F. It has given Mission an “A” for much of the last few years under HCA.

Mission also received a “Best Regional Hospitals” award from US News & World Report for 2022-2023, though it places 17th in the magazine’s North Carolina list of regional bests. 

Healthgrades gave AdventHealth Hendersonville two awards in 2023 and 2021 for “Patient Safety Excellence” and “Outstanding Patient Experience.” It also named UNC Health Pardee — formerly Margaret R. Pardee Memorial Hospital in Hendersonville — one of “America’s 100 Best Hospitals” in 2023 and 2022. 

Leapfrog also gave AdventHealth Hendersonville an “A” and Pardee a “B” in its latest ratings.

Rating the Raters

Such consumer-facing ratings are meant to inform patients of where to go for the best care. But medical experts doubt they truly inform patients. 

In a 2019 article, the New England Journal of Medicine’s NEJM Catalyst turned the tables. The authors of the article, “Rating the Raters: An Evaluation of Publicly Reported Hospital Quality Rating Systems,” found that the various hospital rankings and ratings — often producing different results — can be confusing for consumers. 

“The numerous currently available public hospital quality rating systems frequently offer conflicting results, which may mislead stakeholders relying on the ratings to identify top-performing hospitals,” according to the report (paid subscription required).

Of the four groups analyzed by the New England Journal of Medicine, U.S. News & World Report got the highest grade, a B — none of the ratings companies got an A — followed by the government’s own rating system, Hospital Compare by the Centers for Medicaid & Medicare Services (CMS) with a C. 

Mission Hospital, located in Asheville, North Carolina, is Mission Health’s flagship hospital, licensed for 815 beds. Healthgrades named Mission Hospital as of one America’s 50 Best Hospitals from 2020-2023, identifying the top 1% of hospitals in the nation for providing the highest clinical quality year over year. Leapfrog Hospital Safety Grade recognized Mission Hospital with an “A,” nationally recognizing Mission Hospital’s achievements in protecting patients and providing safer healthcare.

— From Mission Hospital’s website

Healthgrades and Leapfrog received the lowest grades. Leapfrog, which awarded Mission Hospital an “A,” itself got a C- in the 2019 NEJM ratings. Healthgrades, which named Mission the highest-rated hospital in North Carolina, received the lowest grade, a D+.

Overall, ratings systems should be used cautiously, the NEJM report said, as “they likely often misclassify hospital performance and mislead.” The report noted that insurance companies use the ratings data to steer patients to certain facilities, and hospitals use the data as a way to identify areas for improvement.

They also noted that publishing companies like private equity-backed Red Ventures perform these ratings with a profit motive. 

“[H]aving hospitals pay the rating systems to be able to display their performance or to allow use of their ratings for hospital marketing or advertising — may create unfortunate incentives. Specifically, there is a concern that the business of selling these ratings leads to a model that encourages multiple rating systems to intentionally identify different ‘best hospitals.’ ” the authors wrote. 

“Close to Meaningless”

“I think they’re [the hospital ratings] close to meaningless,” said Dr. Eric Thomas, a nationally known patient safety expert who is a professor of medicine at the McGovern Medical School at the University of Texas Health Science Center in Houston. 

Dr. Eric Thomas, professor of medicine at the McGovern Medical School at the University of Texas Health Science Center in Houston. 

“It’s really not very helpful to use these kinds of measures to rank hospitals on safety because it just doesn’t give you a full picture of safety,” Thomas said.

Thomas said that the safety measures that go into the scores do not find enough of the harmful events that can occur in a hospital, and “there are a huge number of safety events that harm patients,” he said. A study of the safety monitoring system for Medicare beneficiaries a few years ago, he said, detected only about 2 percent of the safety events.

“A hospital could be performing very well on a limited number of safety measures,” Thomas said, “yet at the same time, people could be coming into that hospital every day and being harmed by horrible errors.”

Complicating the ratings, Thomas said, is that hospitals may focus only on what is publicly reported instead of “focusing on the things that could potentially improve safety across the board, like nurse staffing.”

Unionized nurses at Mission have repeatedly protested in the streets about the safety risks they say are posed for patients because of inadequate staffing, a topic previously reported on by Asheville Watchdog

Legislation to limit the number of patients for each registered nurse is now under consideration in Congress. “Numerous studies have shown that safe nurse-to-patient staffing ratios result in higher quality care for patients, lower healthcare costs, and an overall better workplace for nurses,” said Rep. Jan Schakowsky (D- IL) said in a press release when the legislation was re-introduced March 30.

Nurses at Mission Hospital in Asheville protest what they say are unsafe staffing levels // Watchdog photo by Barbara Durr

“Staffing is a way of addressing all the safety problems that are happening in a hospital at the same time,” Thomas said. “What you need to do is create a culture and train clinicians to have the ability to communicate well as teams, to identify risky situations and be able to respond appropriately in those moments.”

“And that gets into the bigger issue of the safety culture of an organization,” said Thomas.

Dr. Matt Austin, associate professor of anesthesiology and critical care medicine at the Johns Hopkins University School of Medicine, said that the ratings systems have divergent results because they look at different aspects of care. He is a paid consultant for Leapfrog through his work for the Johns Hopkins Armstrong Institute for Patient Safety and Quality, and advises on the scientific methodology behind Leapfrog’s safety grades. 

Terms like best hospital don’t tell you a lot

Austin said that the hospital ratings attempt to boil down complicated and multi-factor care in a hospital into a single assessment. “So using terms like ‘best hospital’ doesn’t really tell you a whole lot,” he said. 

Dr. Matt Austin, associate professor of anesthesiology and critical care medicine at the Johns Hopkins University School of Medicine

Because the rating organizations look at different things, Austin said, “I think consumers, unfortunately, do have to look under the hood a little to really understand what each rating system is trained to tell them.”

The Hospital Safety Grade’s methodology is peer‐reviewed and fully transparent, according to Leapfrog, and is available to the public at www.hospitalsafetygrade.org/your-hospitals-safety-grade.

Austin said the ratings “have utility as a jumping off point for conversations” with one’s physician. While hospital choice can be limited to where a patient’s physician has admitting privileges, he said, “You try to educate yourself and make good decisions.”

“Am I going in for bypass surgery? I’m probably going to dig into how the hospital does on that versus other hospitals,” Austin said. It really doesn’t matter to a heart patient that the hospital is highly rated for knee replacements, he said.

Healthgrades looks strictly at clinical outcomes — Did the patient die? How many patients have complications from common conditions and procedures, and have to be readmitted? — using data from Medicare. It evaluates nearly 4,500 hospitals a year, or nearly three quarters of the 2022 total of 6,093 hospitals in the United States. 

The results of its evaluations are compared with its proprietary risk methodology, according to Dr. Brad Bowman, Healthgrades Chief Medical Officer and Head of Data Science.

Healthgrades has also awarded top ratings to Mission since 2021, including a 2022 “Patient Safety Excellence Award,” though notably Mission did not win the 2023 Healthgrades award for “Outstanding Patient Experience.”

Bowman told Asheville Watchdog in an email that while there are other strong hospitals in North Carolina, Mission was recognized by Healthgrades for the eighth year in a row “as one America’s 50 Best Hospitals — the only one in North Carolina.”

Bowman declined to say how much it charges hospitals such as Mission for a licensing agreement to use its ratings in marketing materials. Healthgrades also does not make its full methodology and risk adjustment models public, said other medical researchers. 

US News said in its 2022-2023 rankings that Mission rated as “high performing” in eight adult health procedures, including colon cancer surgery, heart bypass surgery, heart attacks, heart failure, strokes, hip and knee replacements, and chronic obstructive pulmonary disease (COPD). Multiple other procedures scored “average” and three scored “below average,” including ovarian cancer surgery, hip fracture, and transcatheter aortic valve replacement. 

US News evaluates more than 5,000 hospitals. Its ratings rely most heavily on clinical outcomes, such as survival rate, using Medicare data, but it also uses data on the nurse-to-patients ratio that reflects the quality of care, and conducts a survey of physicians, according to its website. It also includes patient experience data from Medicare, but this accounts for just 5 percent of the score.

Leah Binder, CEO of Leapfrog

Leapfrog uses 30 different measures in five dimensions, Leah Binder, the CEO of Leapfrog, told Asheville Watchdog. It looks at such things as complications and infections after surgery, pressure ulcers, practices to prevent errors, and medications safety. It will be adding data on nurse-to-patient ratios later this year, Binder said.

“Safety should come first,” Binder said, “because nothing else matters if you’re not safe in the hospital, no matter how good your surgeon is.”

“Hospitals are complex and dangerous places” where “some horrible things happen,” Binder said. “Sadly, it is a very common problem in this country.”

Binder said that a study by BMJ, the weekly medical journal of the British Medical Association, suggested that hospital errors, injuries, and accidents are “the third leading cause of death in the United States, with 250,000 people a year dying.” Others don’t die, she said, but they “just get egregiously harmed.”

The dangers of hospitals rose last year, according to a recent report by The Joint Commission, which accredits hospitals. It said that reports of adverse events, called sentinel events, that killed or severely harmed patients rose to 1,441 in 2022, a 19 percent increase from 2021.

Leapfrog graded nearly 2,900 hospitals last fall, or close to half of the total hospitals in the nation, and generally gives about 35 percent of those an “A”  rating, Austin said. “It’s a fairly generous grading curve,” he said.

Hospitals rated “A” are more likely to pay the ratings companies to license use of the ratings in marketing material. 

Patient experience differs from patient safety

Patient safety measures, such as death and complications, predominate for the hospital ratings, but Leapfrog integrates some patient experience measures from the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS), a survey conducted by the federal Centers of Medicare and Medicaid Services (CMS). 

Leapfrog uses the HCAHPS data on nurse communication with patients, doctor communication with patients, the responsiveness of hospital staff, and communications about medications, Austin told Asheville Watchdog. 

Mission’s scores by Leapfrog on the responsiveness of hospital staff, communications with nurses and communication about medications are all in red (indicating poor), with communication with doctors in yellow. “So, they don’t actually do all that great,” he said.

Medicare’s website includes a Hospital Compare function, and Mission Hospital scores just two stars out of five for patient experience, though it rates four stars overall. The fours stars rating is based on the performance of the hospital in treating heart attacks and pneumonia, general safety, and its readmission rates, according to Hospital Compare. 

The two-star rating for patient experience “would be a big red flag,” said Carol Cronin, executive director of the Informed Patient Institute. That rating “says there’s a problem,” she said.

The breadth of the problem is detailed in Mission’s scores for the two-star patient experience. Mission scores lower than the national average on every one of the 10 issues covered in the HCAHPS survey. Some were notably larger deviations from the national averages, according to information from CMS.

Only 46 percent of Mission patients reported that they “always” got help as soon as they wanted, compared to a national average of 66 percent. Only 53 percent of patients reported that their room and bathroom were “always” clean, compared to 72 percent of the national average. And only 50 percent of patients reported that they would definitely recommend the hospital, compared to a national average of 70 percent.

“Do I feel safe?”

The rating organizations emphasize patient safety, while paying less attention to the patient experience.

Thomas said patient experience is an “evolving topic.” It was once assumed that patients thought of safety in the same way medical professionals do, by looking at the possibility of harmful events, he said. But“when you talk to patients and families and ask them in a more open ended way what does safety mean to you, it’s a lot about emotional safety. Do I feel safe?”

This sense of safety is about how hospital staff are communicating with the patient and treating the patient with respect, said Thomas. “Right now, there are no patient-centered measurements. All the surveys don’t really get at that (emotional safety) very directly.”

“You could have a successful surgery in terms of no complications, but the experience could have been miserable for all kinds of reasons,” Thomas said.

“Rankings are not based on patient experiences,” said Caitlin Donovan, a senior director at the National Patient Advocacy Foundation in Washington, DC. The rankings “should be looked at with great suspicion,” she said.

Cost is not covered in ratings

Keckley also said prices would be a key factor in how a consumer evaluates a hospital, but costs are not addressed in any ratings. In a January Gallup poll, 38 percent of Americans said they delayed medical treatment in 2022 because of cost. Another poll last May by HealthSparq found that 44 percent of respondents avoided getting care in the last year because they were not sure about costs, and 68 percent of respondents said they’d be more likely to book a medical appointment if they knew the estimated out of pocket costs.

In 2023, for the second year in a row, Mission was out of compliance with a federal rule on price transparency, the Patient Rights Advocate, a national nonprofit focused on price transparency, reported in February. The report was endorsed by North Carolina Treasurer Dale Folwell. 

Nancy Lindell, Division Director for Public and Media Relations for Mission, said the hospital has complied by providing on its website “a consumer-friendly Patient Payment Estimator tool” that helps patients understand their out-of-pocket costs, as required by the federal regulation. 

Inflated prices are a key issue in the two federal antitrust lawsuits that Mission faces.  One of those lawsuits was filed by the cities of Asheville and Brevard, as well as the counties of Buncombe and Madison, and the other was filed by private citizens and local businesses.

Mission’s pricing was also part of a report released April 11 by the Community Engagement Council for Transylvania Regional Hospital and sent to Sam Hazen, the CEO of HCA. It said HCA had “broken the trust and lost the confidence of this community.”

The new report used an example of exorbitant pricing for a shoulder arthroscopy from the original Brevard antitrust lawsuit: “The Mission-Asheville price for this procedure was $2,419 — nearly three times the statewide average of $897.”

Kaiser Healthcare News researchers zeroed in on trauma-team activation charges in 2020, and found that for North Carolina HCA Mission charged an average of $9,187 compared to the non-HCA fee of $5,175.

At the end of the day, said Donovan of the National Patient Advocacy Foundation, “There is no correlation between what a hospital charges and the value of what was done.” 

Asheville Watchdog is a nonprofit news team producing stories that matter to Asheville and Buncombe County. Barbara Durr is a former correspondent for The Financial Times of London. Contact her at bdurr@avlwatchdog.org.

27 replies on “Ratings Company Says Asheville’s Mission Is the Best Hospital in North Carolina. We Seek a Second Opinion.”

  1. From my experiences over the years, I’d say Pardee Hospital in Hendersonville is far superior to Mission.
    I thought you did a good job pointing out the correlation between money and ratings.
    Thank you, Mike Forward

  2. my experience with Mission last year was positive. it was obvious that staff worked too long hours, but they were responsive and professional.
    i needed to go on a payment plan having no insurance and they were helpful and were not rude nor did they make me feel embarassed at that.

  3. Medical care, especially Mission in Asheville, is a huge issue. We moved here to retire in 2017 and now we’re moving back to where we came from. Retirees considering Asheville for retirement need to know: Asheville is definitely not the place to retire.

  4. Two stories.
    Some years back a friend in Maryland had liver cancer. The woman with whom he lived and his friends undertook an effort to educate ourselves about what hospitals had best outcomes. What we learned was that outcomes varied right down to the doctor performing the procedure. Even within a department, outcomes varied. The idea of a hospital getting some kind of a grade as a whole is ridiculous, especially in light of the questionable financial relationships between rating organizations and the hospitals. Buyer beware.

    My son, in the spring of 2020, underwent surgery at Mission for a pilonidal cyst. It never healed. The surgeon would see him every other week and clean the wound. Pain and bloody sheets for months. Finally we requested he be seen by a wound care specialist. This was not suggested by the surgeon after months of no real progress. The specialist pretty rapidly determined that another surgery would be required and suggested we see a surgeon at Wake Med in Raleigh. That surgeon came about as close as I’ve ever heard a doctor criticize the work of another. His first attempt to resolve the situation wasn’t radical enough. Early this January he performed another more radical procedure, which I’ll spare you the details of. After nearly two years of living with an open and stalled wound the situation is now resolved. He was and is a college student who was in pain and found it difficult to sit in class and through remote classes for two years and in fact last fall had to drop two classes because the pain and bleeding from sitting for 1 1/2 hours at a stretch were too great. Buyer beware.

    1. i am glad to hear your son is ok now WCB, no one should have to endure he went through. thank you for your story. Bob H.

  5. In the year and a half we have lived in Asheville, my husband has had 4 procedures at Mission. We were concerned because of all the articles about their problems. All 4 times his experience was very good. My husband has multiple issues with his heart, lungs and previous cancers. The nurses were attentive and so kind. The doctors were also attentive and willing to listen to our concerns. All asked questions and answered any questions we had. Some nurses said they learned something from his TEP prosthesis. It’s not common and they had never seen one. I was expecting a shortage of staff but didn’t feel like it. I know it’s a problem nationwide. Our daughter is a nurse in Las Vegas and they have the same problems. All areas we were in were very clean and believe me I check. Also, the “saving grace” for me (the care giver) the breakfast and tacos in the cafeteria are excellent. Mission is good for us.

  6. Thank you, as Barbara Durr certainly pulls the curtain back on the ratings groups. I prefer YELP , Google, Indeed and Glassdoor platform reviews which share patient and employer experiences. Sure, some of those reviews are too picture perfect to believe but many seem helpful to an understanding of staffing, quality of care, billing, etc…. Of course, I really wish that the US had fast acting scientific panels (like Denmark) to improve healthcare for clinicians and patients. The US medical boards are a conflicted hot mess too, in my opinion.

  7. To control against cynical hyperfocus of administrators on metrics that lead to a leafrog score, one could use something not measured like hospital cleanliness or ER wait time as a denominator. For example, changing the A-F scale to integers 1-6, if an institution received an A (1) from leapfrog and an A (1) in cleanliness, the ratio would be 1/1 = 1. On the other hand, if an institution ranked A (1) from leapfrog and an F (6) in cleanliness, the ratio would be 1/6; in this way any ratio <1 would indicate data tampering to meet prespecified metrics with cynical intent rather than the uncontrolled conclusion that leapfrog A = great.

  8. I have had several in-hospital experiences with Mission. The treatment has always been thorough and professional. My interactions with nurses have been very nice giving me a lot of comfort and confidence in the ability and performance of them. Cleanliness is always a major concern of mine because most of my time in Mission has been is a surgical and/or ICU situation. I have never felt uneasy with thelevel of cleanliness. I’ve spent much time at Shands hospital at the University of Florida; at the Villages Regional Hospital; at the UPenn hospital and at the UVA hospital. Mission is as good or better than any of those.

    I am a subscribing member of Watchdog and feel that this article falls short of their usual superb objectivity standards. It projects a feeling of anti-profit and anti-Mission without directly saying so. The value of a hospital rests with the feelings of the patient and patient experiences should be published for accuracy in ratings. In my case, I have found reliance on the choice of my doctor works best.

  9. Dr. Peter Gentling has told us what needs to happens. Are any responsible citizens ever going to organize to heed his advice? Asheville Watchdog, your reports on HCA’s malfeasances tell us what we already know. Can you advocate instead, and advocate relentlessly, for citizen action?

    “Here is what must be done. First, Attorney General Stein and the U.S Department of Justice must investigate: When was the first contact made between HCA and the Mission leadership? Who was involved? Is there a paper trail? Were any payments made from HCA? To whom? When and how much? If and when was the civilian Mission Board informed of HCA’s interest? What were Mission’s liquid assets before and after the merger? What happened to the assets? Was there any competitive bidding? If not, why not? How completely was the Mission Board informed, all along the way? Are there minutes from Board meetings, and are its members allowed to speak? If Attorney General Stein cannot access this data, then the U.S Department of Justice, with all its resources, must investigate.
    We all want our fine nonprofit hospital back with private physicians and adequate staff. Reverse, nullify, the purchase. Return the Dogwood Trust funds to HCA. If this cannot take place, then HCA owes the Dogwood Trust an additional $3.5 billion it should have paid in the first place.
    Peter Gentling, MD FACS”

  10. Excellent article Barbara Durr!! Purchased ratings…. shocking not one bit.. Mission is far below the national average across the board regarding all things with the exception of exorbitant costs- asheville citizens know this.. and speaking to averages…. the current national average is not the quality of healthcare that it once was. Is the current average healthcare for our loved ones acceptable? Do we value “just” average healthcare in this country? how low is the current national standard and how much lower is Missions standard of care..i stand firm to never work for, be treated by an HCA facility

  11. I had to take my husband to the emergency room a few months ago in fear he was having a heart attack. We got there a little after 1 am and it was 9 PM the next evening before he was able to get a room. While in the ER, he was moved to different sections, in the ER, 3 times. As we were finally wheeled up to the cardiac wing, an employee told us we were lucky, the heart wing is the only one HCA had not “touched” and it was the same as when it was Mission but it was still understaffed. That is why he could not get a room. Not because they were full but because the have cut staff so badly there were not enough people to get a room ready. It is not nurses alone that are under staffed, HCA has drastically cut the support staff that did things like clean and prepare rooms. It is insane that they require highly trained nurses to do this work on top of caring for patients.

  12. Perfect subject to explore! During a college course titled
    ‘Statistics’ I learned how to run and graph studies. Most important were the months spent discussing the questions and wording. Lesson learned: statistics can easily be manipulated to provide the answer wanted by the commissioner of the question. For-Profit rating companies could be just that . . . For profit!

  13. This rating is an absolute joke. Last July, I had to bring my elderly mother to the ER at Mission. She had pneumonia. We got there at 9 pm and didn’t get called back to a room at the ER until about 3 pm the following day! Yes, it took that long to see a doctor. Well, a PA, anyway. We were stuck all night long in the ER. People made beds on the floor in an attempt to get some sleep. It was a nightmare. And she had to wait additional hours in the ER to get a room. It was close to 24 hours of waiting time total. How on earth can anyone rate Mission that high when their ER is such a mess? And on a previous hospital visit, my mom had to wait an hour to get help using the bathroom pretty much every time she had to go. I’m sorry. I would drive down to Advent Health or Pardee before using Mission again!

    1. Thank you Barbara Durr for an excellent article. About time someone exposes these ratings shams. Also Mission doesn’t even report for many categories of safety. They hide data. They only have to report in so many areas to be included in the ratings. It’s voluntary and not required by Leapfrog. Now focus on actual patient safety horror stories at Mission. I have one and I have receipts. You may have to do a whole Watchdog series on patient harm at Mission. Just look at Mission Google reviews to get started, that’s the truest hospital rating system we have. Hint: they’re really bad. AVL watchdog to the rescue, please.

  14. Frankly, it’s frightening.
    We got sold down the river when HCA was allowed to buy Mission.
    I had surgery to remove a tumor that went like clock work at Mission in 2017, before HCA bought it. All the pre-op team were wonderful, as we the surgical team, and the post-op team on my floor. Professional, skilled, thoughtful, timely, throughout.
    Now, from reports online by current patients which match with those reported in this article, you’d be lucky to come through it unscathed.
    I’d be afraid to go there for care these days. Wouldn’t you?
    It’s time somebody did something about it, the longer HCA is allowed to run our healthcare into the ground, the worse it will only get, and result in more of us ending up in the ground sooner than we should be.
    Yet, our Republican legislature worries more about drag queens and taxpayer paid school vouchers for kids to go to private schools instead of putting more money into supporting our public schools.
    How different is HCA Mission from the thieves running Raleigh, who most assuredly, will not stand up and make HCA change.

  15. An excellent job presenting the different ratings and how they work.
    I also enjoyed reading many very good comments, indicating people are paying attention. Thanks so much

  16. I spent 7 excruciating hours waiting in the ER for a doctor to examine me. It turned out I had kidney stones and I was finally given morphine. It was hell, I would never go there again.

  17. This rating, just like polls, surveys and consultancy studies can be and often are skewed, incorrect, misleading, and myopically off-kilter, incorrect–even to the detriment of citizens’ lives and well-being. Somewhat related to another article published today: just look at some of the vague, ludicrous and misleading ‘surveys’ the BCTDA tries to pawn off on our citizens…

  18. Mission Hospital has a horrible reputation among almost everyone I know here in Asheville.

    1. The problem is when you are in an emergency type situation you don’t pull up the leapfrog. You quickly go to the nearest hospital which for many of us is Mission. It used to be tradition around here, “if it’s serious go to Mission.” That is no longer safe or sound advice. Buncombe and Madison EMS will take you to Mission and will not haul you to Pardee or another hospital of your choosing. So we don’t always have a choice. Planning a surgery ahead of time for a specific procedure at a carefully researched facility and specific doctor is one thing but emergencies are a wildcard and the odds are not good at Mission ER and if you get admitted the odds might even be worse. There’s a whole lot more than a nursing shortage going on there.

  19. I spent 8 days at Mission last August after an auto accident. The nurses and CNAs were great, but overworked – not enough of them in a TRAUMA floor! My room was NEVER swept or mopped in 8 days. I had ONE bath in 8 days. The nurse dropped a glove on the floor on day three; when I left on day eight, it was still on the floor. The lavatory and bathroom were never cleaned. The floors in the hall had dirty spots from spills- the same spots for 8 days – noticed them every day as I walked with the physical therapist down the hall. The nurses and CNAs are trying, but they need help!!!

  20. In February of this year, my 88 year old husband was told that his blood count was “critically low” and I should take him to Mission ER for transfusions. We arrived at the ER at approx. 2:30 p.m. At 10:45 p.m. WE HAD STILL NOT BEEN SEEN. BY ANYONE. We waited 8+ hours. EIGHT HOURS. I finally left to take him home as we were both exhausted. Exiting the car he fell and broke his hip. Don’t tell me how great Mission is. We are still struggling with the after effects of this horrific experience.

  21. Informative article. I have been a patient there, and so has my spouse….surgeries and strokes. Always felt like they could have done better, but each time, there is just not the staff to do better. Many people in our area know that going to Mission does not feel like an option that is conducive to a good outcome. One might say that an incentive to stay healthy is so you will not have to go to Mission.

  22. Newsweek allows payment from all participants in their surveys. This is hardly a true accounting of quality.

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