Mission Hospital in Asheville Faces Third “Immediate jeopardy” sanction Since 2019
The U.S. Centers for Medicare & Medicaid Services (CMS) has placed Asheville’s Mission Hospital in “immediate jeopardy,” marking the third time since 2019 the facility has received the most severe sanction available to healthcare regulators. This designation puts the hospital at risk of losing critical Medicare and Medicaid funding.
Mission Hospital CEO Greg Lowe announced the sanction in a letter to staff on Friday, October 27, 2023, and subsequently obtained by Asheville Watchdog. According to the letter, CMS acted on a advice from the North Carolina Department of Health and Human Services (NCDHHS) to place the HCA Healthcare-owned hospital in immediate jeopardy.
A spokesperson for Mission Hospital, Nancy lindell, deferred to a previous statement regarding the NCDHHS recommendation when reached for comment.
The sanction stems from an on-site NCDHHS inspection conducted last month at the request of CMS. The state agency’s recommendation to CMS cited incidents occurring on July 26, August 19, and September 4.
One incident on July 26 involved the death of a cardiac patient who was disconnected from telemetry equipment – used by off-site technicians to monitor vital signs – for at least one hour. Asheville Watchdog initially reported on this death last month.
Additional concerns raised by NCDHHS included safety issues during patient transport and failures in proper infection prevention protocols, as detailed in a letter sent to Lowe on October 10.
“CMS has taken appropriate action to hold HCA accountable,” stated Aaron Sarver,a spokesperson for Reclaim Healthcare WNC,a coalition advocating for improved conditions at Mission Hospital or a change in ownership. “Unfortunately, this is not the first time ‘Immediate Jeopardy’ has been invoked due to staffing levels that continue to endanger patients.” sarver emphasized that restoring staffing to safe levels is the primary step, noting that nurses, technicians, and support staff are consistently overburdened, hindering their ability to provide quality care.
Mission Hospital has 23 days – untill November 9 – to submit a plan of correction acceptable to CMS.
The latest sanction follows a similar incident earlier this year. A sanction was issued after a female patient was discovered dying on the floor of her hospital room on March 1, with her IV disconnected and saline flush syringes nearby. NCDHHS inspectors found that the hospital had failed to maintain a safe habitat for a patient with a history of substance abuse, prevent access to unsecured medical supplies, follow physician orders for pain medication, and effectively communicate and escalate patient safety concerns.
Earlier this year, CMS investigated an Emergency Medical Treatment and Labor Act (EMTALA) violation at Mission Hospital after a patient died in an emergency department bathroom in February after calling for help for 29 minutes without a response. While the inquiry determined a violation of the hospital’s responsibility to provide emergency services, CMS ultimately found that Mission had taken sufficient corrective measures, avoiding an immediate jeopardy finding.
As HCA acquired Mission Hospital in 2019, two other regional hospitals under HCA ownership have also been placed in immediate jeopardy: Blue Ridge Regional Hospital in Spruce Pine in 2023 and Mission Hospital McDowell in Marion in 2021.
“The pattern we now can see clearly since HCA purchased Mission in 2019, is after being sanctioned by regulators, HCA surges resources to the hospital for a period of time to have an IJ lifted,” Sarver said. “Than, they return to a baseline of unsafe staffing levels. That can be fixed tomorrow by bringing in more staff,but it must be a permanent fix.”
[Correction: An earlier version of this story misstated the timing of an emergency Medical Treatment and Labor Act investigation that took place earlier this year.]
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Asheville Watchdog is a nonprofit news institution dedicated to reporting on issues impacting Asheville and Buncombe County. Keith Campbell serves as the managing editor ([email protected]), Jack Evans is an investigative reporter ([email protected]), and Andrew R. Jones is a watchdog investigative reporter. Their reporting is supported by community donations; contributions can be made at avlwatchdog.org/support-our-publication/.
