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Western North Carolina
Deserves Better Healthcare


Federal data shows Mission Hospital scores lowest among the four hospital systems competing for CON beds

As part of the 2026 (CON) process, four hospital systems (Mission HCA, Novant, AdventHealth, UNC Pardee) are competing for the 92 acute care hospital beds that will be awarded by NC DHHS. Reclaim Healthcare WNC has researched and analyzed HCAHPS (Hospital Consumer Assessment of Healthcare Providers and Systems) data available from the Centers for Medicare and Medicaid Services (CMS) for the four systems. The data from federal regulators shows Mission Hospital scores lowest on patient “Likelihood to Recommend Hospital” rating among the four applicants. 

"This federally vetted 'Likelihood to Recommend' metric can be considered a good, holistic indicator of an institution's trustworthiness and the strength of its public reputation," said Nina Vinson, MPH, Data Analyst for Reclaim’s Data Team.

HCAHPS is a survey taken by hospital patients from across the country, including WNC. This survey is standardized across hospitals, national in scope, and publicly reported on “Care Compare” at Medicare.gov. Survey responses are confidential (individual patient responses are not shared with the hospital) and collected by a neutral third party.

 Key Findings

  • Consistent Bottom Ranking: Mission Hospital recorded the lowest ratings among the four regional Certificate of Need applicants (Mission HCA, Novant, AdventHealth, UNC Pardee) from 2019 through 2024.

  • Sharp Post-Acquisition Decline: The likelihood-to-recommend ratings dropped sharply, beginning the year after HCA Healthcare acquired Mission in 2019.

  • Sustained Downward Trend: While data indicate a minor performance rebound in late 2024, the overall seven-year trend line for patient experience at Mission clearly slopes downward.

  • Eroded Community Trust: More than 15 percent of patients surveyed in recent years (2022-2024) reported they would "probably not" or "definitely not" recommend Mission Hospital to loved ones, compared to just 5 percent for competing regional hospitals.

ABOUT RECLAIM

We are RECLAIM HEALTHCARE WNC, a coalition of physicians, nurses, elected officials, clergy, attorneys, business leaders, and community members. We are committed to unwavering support for staff at Mission Health and holding HCA accountable through the empowerment of our community.

Vision Statement: WNC residents again trust they will receive quality care at Mission Health. 

Mission Statement: Uniting and empowering WNC to hold HCA accountable for safe, high-quality care and positive patient experiences.

In January of 2026, Mission Hospital once was again placed in “Immediate Jeopardy” status by federal regulators. This is the third “Immediate Jeopardy” finding in two years!

Immediate Jeopardy citations of WNC hospitals owned by HCA:

  • Mission Hospital (Asheville) - 2021, 2024, 2025, 2026

  • Blue Ridge Regional Hospital (Spruce Pine) - 2023

  • Mission Hospital McDowell (Marion) - 2021

Reclaim Healthcare WNC has two goals:  

  1. Holding HCA leadership accountable to provide consistently excellent patient care and patient experiences. While many patients receive excellent care and have positive experiences at Mission, thanks to the dedicated staff, it is also true that patient care and experiences are inconsistent. We shine a continuous spotlight on these issues in order to drive change.

  2. Empowering WNC residents to be their own best healthcare advocates. We want to build an army of advocates who know what to expect and demand when they or a loved one are in the hospital.  

Defining the Problem


Since HCA purchased Mission Health in 2019, more than 200 physicians and 600 nurses have left Mission Health.

Positions vacated.

Reduced from 6.1 FTE

There has been a reduction in the ratio of full-time staff per patient bed from 6.1 FTE to 3.7 FTE. The average in North Carolina is 5.1 FTE.

Mission Health has been repeatedly investigated by NC Department of Health and Human Services (DHHS) for concerns related to patient safety and quality of care.

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