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Medicare, Medicaid funding at Asheville hospital in jeopardy

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(The Center Square) – Funding for Medicare and Medicaid at a North Carolina hospital is in jeopardy, the U.S. Centers for Medicare and Medicaid Services says.

Mission Hospital officials in Asheville have vowed to comply and submit a corrective action plan. Immediate jeopardy is when a hospital “has placed the health and safety of recipients in its care at risk for serious injury, serious harm, serious impairment or death.”

HCA Healthcare North Carolina Division President Greg Lowe acknowledged “Mission Hospital’s comprehensive survey by the Department of Health and Human Services has resulted in an Immediate Jeopardy finding by the Centers for Medicare and Medicaid Services” in a letter to staff on Friday.

The notice from federal authorities begins a 23-day countdown for Mission to craft a plan to fix the problems outlined by inspectors in a December letter to Mission CEO Chad Patrick. The letter documents nine care deficiencies over 19 months for a variety of issues, including Emergency Department staff failing to accept patients, delays for triage, assessments, monitoring, and orders for labs and telemetry.

“ED nursing staff failed to assess, monitor and evaluate patients to identify and respond to changes in patient conditions,” the letter read. “The hospital staff failed to ensure qualified staff were available to provide care and treatment for patients who arrived in the ED. The cumulative effects of these practices resulted in an unsafe environment for ED patients.”

The immediate jeopardy status is the most severe sanction possible for hospitals that have “placed the health and safety of recipients in its care at risk for serious injury, serious harm, serious impairment or death,” according to federal regulations.

Gone unresolved, federal authorities can cancel funding through Medicaid and Medicare, which Mission relies on for a majority of its funding.

Mission is integral to the mountains of North Carolina. Only seven hospitals in the state, according to the American Hospital Directory, have more than its 815 beds. The nearest two of those seven – each 130 or more miles away – are Atrium Health Carolinas Medical Center in Charlotte (1,287) and Atrium Health Wake Forest Baptist Medical Center in Winston-Salem (872).

Mission Health spokeswoman Nancy Lindell responded to a request for comment on the development in an email to The Center Square.

“There are no excuses for our patients receiving anything other than exceptional care, and Mission Health has already taken action based on the preliminary findings shared last month,” Lindell wrote. “We are pleased to hear from our EMS partners and patients that those actions are yielding positive results, including decreased wait times for care.

“We respect the process of these surveys and will submit our correction active plan to CMS by their deadline. Again, these findings are not the standard of care we expect, nor that patients deserve, and we are working diligently to improve.”

Lowe outlined some of the changes so far in his letter to staff.

“We brought in additional staff who are working in our emergency department and, on our busiest days, we have repurposed space on the Memorial Campus to accommodate additional patients,” he wrote. “Our intention has been and will continue to be to create more comfortable environments for patients who are waiting to be discharged home or admitted to the hospital, and to create more flexibility for our nurses.”

The issues detailed in the December letter from state officials largely echo growing complaints about deteriorating conditions at the hospital since HCA Healthcare purchased the facility in 2019. Those complaints, from patients, staff and contractors, eventually prompted Attorney General Josh Stein’s Department of Justice to file a lawsuit against the company in December, saying there are violations of a purchase agreement with the state in which HCA Healthcare promised to maintain emergency, trauma and cancer services at 2019 levels until 2029.

Lindell told The Center Square in December that Mission Health continues “to meet, and often exceed, the obligations under the Asset Purchase Agreement that the attorney general approved at the time of our purchase.”

Lindell said the company plans “to defend the lawsuit vigorously” and noted an independent monitor “confirmed our compliance with that agreement during its most recent review.”

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