HCA chased Mission doctors away and made a ‘debacle’ of emergency department, draft academic report says
Mission blasts study as “recycled news and opinion”
ASHEVILLE WATCHDOG | Reported by ANDREW R. JONES
August 15th, 2024
Mission Hospital is the subject of a 49-page academic report, “Changes in Patient Care Following HCA’s Purchase of Mission Hospital. Watchdog photo by Starr Sariego
The following article by Andrew R. Jones appeared in Asheville Watchdog on August 15th, 2024
A new working draft study out of Wake Forest University is the most comprehensive analysis of the personnel crisis at Mission Hospital to date, using hundreds of interviews, documents and media reports to tell the story of a mass exodus of doctors, a poor working environment for nurses and a dangerous situation for patients, all brought on by profit-centered management.
The 49-page report, titled “Changes in Patient Care Following HCA’s Purchase of Mission Hospital,” and its accompanying 30-page appendix of sources comprise the first academic summary of Mission’s staffing tumult since HCA Healthcare bought the Mission Health system for $1.5 billion in 2019.
It consolidates years of public information, including Asheville Watchdog’s reporting, and new interviews with dozens of unidentified individuals who work at Mission, who have previously worked there or who have inside knowledge about how the hospital is run.
The report, written by professor Mark Hall, an independent academic researcher and a member of the National Academy of Medicine, reaches three conclusions about what happened after HCA’’s purchase:
Doctors left Mission because of quality-of-care and financial issues and have been replaced by less experienced staff. Today some specialties are severely depleted or gone, including otolaryngology (ear, nose, and throat), urology, rheumatology, orthopedics and neurology, according to the report.
HCA’s management slashed staffing among nurses and other personnel vital to patient care.
Understaffing has caused “a multi-faceted debacle” in Mission’s emergency department, one that in 2024 drew federal scrutiny, which threatened the hospital’s Medicare and Medicaid funding.
“I think one question I would have as a member of the community is to what extent HCA and the hospital administration is willing to own up to this accumulation of very troubling indicators,” Hall said. “The extent and the longevity of these troubling signs I think is revealed by accumulating all this information in one place.”
Mark Hall is a member of the National Academy of Medicine and the author or editor of 20 books. // Photo credit: Wake Forest University
Mission Health spokesperson Katie Czerwinski criticized the report, saying, “This is yet another ‘study’ written by the same academic who is taking money from an out-of-state advocacy group that is currently funding litigation against Mission Health.
“It is neither serious nor impartial, and is filled with recycled news and opinion. The regulatory concerns to which it refers have been addressed and formally cleared. Once again, the author disregards that third-party independent organizations continue to rate Mission’s clinical care as best in the nation. The author unnecessarily spreads fear in the community and should stop doing so.”
Hall’s report relies on nearly 50 “key informants,” including clinicians, people management or on the board at Mission Hospital at some point, government officials and others who work in health care policy.
Comments from these sources are often scathing. One physician said hospital administration “was seemingly incapable of addressing physician concerns …. Physicians were routinely left out of any of the decision-making processes. Although physicians were given titles of medical director, service line leaders, and committee chairs, they were frankly powerless and often ignored/sidelined in the decision-making process.”
Another — Dr. Bruce Kelly — is quoted from an Asheville Citizen Times opinion column saying, “[t]here’s a deep sense of loss so many of us feel since HCA has taken over. Their corporate-driven changes are not only antithetical to our way of being, they dismantled what we’d worked so hard for. They’ve erased our institutional memory. … HCA brought with them a culture that has undermined trust, alienated many and harmed the collaboration and collegiality that’s defined who we’ve been.”
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Asheville Watchdog is a nonprofit news team producing stories that matter to Asheville and Buncombe County. Andrew R. Jones is a Watchdog investigative reporter. Email arjones@avlwatchdog.org.
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