State attorney general, doctors and nurses criticize HCA over patient care at North Carolina's Mission Hospital
The attorney general's office says HCA is not living up to its purchase agreement and may face a lawsuit if it does not make fixes within 40 days.
NBC News | Reported by Gretchen Morgenson
November 13, 2023
Brevard Mayor Maureen Copelof
The following story was reported by NBC News on November 13th, 2023
Four years after it bought Mission Hospital, an 815-bed facility in Asheville, North Carolina, HCA Healthcare is under fire in the region, threatened with a lawsuit by the state attorney general and facing criticism from nurses and at least 124 current and former Mission doctors who say HCA, the nation’s largest for-profit hospital chain, is imperiling patient care at the facility in its pursuit of profits.
“Profits over people is not an ethic, model, or aspiration that can deliver the quality of care we all expect and deserve,” the doctors wrote in a letter to the independent monitor watching over management of the hospital. “We ask that hospital leadership look at economics as if people mattered.”
On Oct. 31, the office of North Carolina Attorney General Josh Stein wrote a letter to a foundation called Dogwood Health Trust, contending that HCA had violated the terms of the agreement it struck in 2019 when it bought Mission, a formerly nonprofit facility. Under that agreement, HCA had promised to continue providing an array of specific services for a decade at the hospital, including those involving behavioral health, emergency and trauma, oncology and pediatrics. Dogwood Health Trust was created when HCA bought Mission and works to improve the health of people in Western North Carolina.
The attorney general’s office noted a breach of that agreement at Mission, citing diminished care in the hospital’s oncology unit and its emergency department. The letter warned that if HCA does not cure the violations within 40 days, Stein “is authorized to file suit.”
A Mission spokeswoman said in a statement that the hospital is proud of the health care it provides and is disappointed by the attorney general’s statements. “We continue to meet, and often exceed, the obligations under the asset purchase agreement,” she said. “The independent monitor has confirmed compliance every year since the agreement was signed in 2019.” The spokeswoman also provided a letter signed by 75 Mission practitioners who say patients continue to receive great care at the facility.
Dr. Martin Palmeri, an oncologist who practices at Mission Hospital.Messino Cancer Centers
Dr. Martin Palmeri, an oncologist who practiced at Mission before HCA took over and has continued to practice there, has a different view. Before the HCA buyout, he said in an interview with NBC News, local oncologists had developed excellent clinical programs to treat patients in the region. But after HCA acquired Mission, he said, nursing staff declined precipitously, the number of chemotherapy-trained pharmacists went from four to one, and the HCA labs services and turnaround times declined significantly. These deficiencies made it difficult to treat the full array of cancer patients coming to the hospital, he said.
After years of trying unsuccessfully to resolve these problems, Palmeri said the only choice he and his colleagues had was to stop offering three oncology services at which he said Mission had previously excelled. They were treatments for acute myelogenous leukemia, acute lymphocytic leukemia and primary central nervous system lymphoma. “We felt it would be best for our patients to get their complex hematology care somewhere else,” he said.
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