Western North Carolina
Deserves Better Healthcare

Data from federal regulators shows Mission Hospital scores lowest on patient experience ratings of the four hospital systems applying for CON beds

Reclaim Healthcare WNC has researched and analyzed data available from the Centers for Medicare and Medicaid (CMS) for the four hospital systems applying for beds as part of this year’s upcoming Certificate of Need (CON) process.

The HCAHPS (Hospital Consumer Assessment of Healthcare Providers and Systems) is a survey taken by hospital patients from across the country, including WNC. The survey measures patient experiences with specific, valued aspects of their hospital care, such as responsiveness of hospital staff, communication with doctors, whether the patient would recommend the hospital to others, communication about medication, cleanliness of environment, and clear discharge information. The results are then combined and summarized into a single one-to-five star rating scale that is produced annually. 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.

The Reclaim Board of Directors determined that it would be informative to research the scores of the four CON applicants– Advent Health, Novant, UNC Health and HCA/Mission-- given the upcoming NC DHHS CON hearing in August to award 92 hospital beds. 

"Healthcare experts and federal regulators support use of these data to achieve fair comparisons between hospital systems, incentivize quality, and enhance accountability and transparency. We agree and want to do our part, by sharing these results," says Nina Vinson, data analyst on Reclaim's Data Team.

“These data represent the patients’ own experiences here in NC. We think it is critically important to amplify the patients’ voices by sharing these data,” says Miriam Schwarz, vice chair for the Reclaim Board of Directors. 

The chart below shows the HCAHPS summary star ratings for Advent Health, Novant, UNC Pardee and HCA Mission hospitals from 2018-2024, with star scores of one-to-five listed on the left hand side of the graph and the years across the bottom of the graph. Each hospital is color-coded (see the legend), with Mission always the last bar in each yearly grouping and in bright yellow.

Compared with the other CON applicants, Mission had the worst ratings (two stars out of five) from 2020-2024. (Complete 2025 data is not yet available.) HCA purchased Mission Hospital in 2019. 

Among CON applicants, Advent saw the highest and most consistent ratings over time (four stars out of five across all seven years) and UNC Pardee and Novant saw ratings of three and four stars out of five over the seven years.

Despite being a Fortune 100 company with record profits, HCA has reduced staffing levels at Mission since purchasing the Western North Carolina hospital system in 2019. The Centers for Medicare and Medicaid Services (CMS) have placed Mission Hospital in Immediate Jeopardy status four different times that we know of since HCA’s purchase of the hospital in 2019 and three times in the past three years. Immediate jeopardy is the most severe citation a hospital can receive from regulators.

“In recent years, Mission had the lowest experience ratings by patients, among the four CON applicants,” says Julie Mayfield, Chair of Reclaim Board of Directors. “Our community needs alternatives to Mission, and NC DHHS should award these beds to HCA’s competitors.”

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 can trust that they will receive quality care at Mission Hospital.

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 less than 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.