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by Grace Vitaglione, Carolina Public Press
December 14, 2023

N.C. Attorney General Josh Stein sued HCA Healthcare on Dec. 14 over allegations that the hospital company is not providing the care it agreed to when the state approved its acquisition of the Asheville-based Mission Health System in 2019. 

At a press conference about the lawsuit, Stein said the company is failing to provide emergency and cancer care for Western North Carolina residents. He referenced allegations that the emergency department at HCA’s facility in Asheville was “frequently filthy” and had well above average wait times.

Stein also singled out the lack of any medical oncologists on Mission’s staff. 

“Patients in Western North Carolina deserve quality health care and that is exactly why I am taking this action today,” he said. 

Staff around him at the conference held signs reading “Staff Up! For Safe Care. End Crisis Care Now.” Hannah Drummond, a nurse in the emergency room department at Mission, said at the press conference that “the front waiting room often resembles a warzone” because of the staffing crisis. 

Other allegations against HCA include understaffing, creating bed shortages, and impeding ground and air medical transport services in the region. Cancer patients are also allegedly unable to begin chemotherapy treatments because no medical oncologist is available, according to the state Department of Justice.

Sen. Julie Mayfield, D-Buncombe, said at the conference that she and two other representatives introduced the “Preserving Competition in Health Care Act” to increase transparency about health care transactions and in part authorize the Attorney General to determine how the transaction might impact the “cost, availability, accessibility and quality of care.”

According to Stein, HCA agreed to continue providing emergency and trauma services and oncology services at Mission Hospital until at least 2029, when the Tennessee-based for-profit health care company purchased nonprofit Mission. 

Stein said he asked the court to order HCA to restore emergency and trauma services and oncology services to the previous level at Mission Hospital before HCA’s purchase.

The suit follows a years-long saga of worries over how care would be affected by the HCA’s purchase and ensuing complaints over services and staffing. 

In 2020, Stein issued a letter to the president of the North Carolina division of HCA Healthcare asking for answers in regards to four key concerns: quality of care, sexual assault nurse examiner staffing, charity care and nursing issues. 
Nurses at Mission Hospital in Asheville voted in 2020 to approve a union, and union leaders said it was a contentious process.

HCA’s Mission Health responds

Aske about the lawsuit, Nancy Lindell, Director of Media and Public Relations for Mission Health, issued a statement later on Dec. 14, saying that the company was aware of the lawsuit and pointedly identifying Stein as gubernatorial candidate.

“We remain confident that we continue to meet, and often exceed, the obligations under the Asset Purchase Agreement that the Attorney General approved at the time of our purchase, and we intend to defend the lawsuit vigorously,” Lindell said.

She also noted that the independent monitor appointed as part of the HCA acquisition oversight “confirmed our compliance with that agreement during its most recent review.”

“Though there have been challenges, some of which we are continuing to address as we work to expand our capacity, we remain committed to serving our community,” Lindell said.

“Despite the state not allowing important expansions at Mission Hospital, we will continue to fight for critical access to health care services for the people of Western North Carolina.”

Editor’s note: This article was updated on Dec. 15, 2023, to include additional information from HCA that became available.

This article first appeared on Carolina Public Press and is republished here under a Creative Commons license.