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  • Asheville Citizen-Times

    Historic move: new group says HCA must sell Mission, Western NC's main health care system

    By Joel Burgess, Asheville Citizen Times,

    1 day ago

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    ASHEVILLE - In a historic move, elected officials, doctors and others have formed a group with the goal of compelling the sale of Mission Health by HCA Healthcare, a for-profit company and the nation's largest health care entity whose $1.9 billion purchase of the nonprofit Mission led to a serious decline in health care for Western North Carolina, said the group, Reclaim Healthcare WNC.

    “We are giving voice to the people of this region who are disappointed and angry at the degradation in the quality of care being provided in the Mission system, and particularly at Mission Hospital,” N.C. state Sen. Julie Mayfield , a founder of the coalition, said in a statement released July 24. “We are also a voice for the physicians, nurses, and staff who work at or with Mission who are not able to speak out due to the culture of fear and retaliation that HCA has created.”

    The Citizen Times reached out to Mission/HCA.

    Since the 2019 purchase, HCA's "systematic playbook-driven cuts" to staffing, services and resources along with a "rigid corporate culture" in search of profits undermined public trust and diminished a system that once provided best-in-class medical care, said a GoFundMe site that was online prior to the announcement.

    A GoFundMe page as raised $14,000 and along with $40,000 in direct donations, the group has raised some $54,000 for the effort, according to Reclaim leadership.

    Among the organizers are:

    • Dr. Clay Ballantine
    • Brevard Mayor Maureen Copelof
    • Coalition of Asheville Neighborhoods President Rick Freeman
    • Nurse Nansi Gregor-Holt
    • The Rev. Missy Harris
    • Victoria Hicks, Health Equity Coalition member
    • Dr. Scott Joslin
    • Dr. Bruce Kelly
    • Dr. Robert Kline
    • Dr. Allen Lalor
    • Geri Legeay
    • Steve Legeay
    • N.C. state Sen. Julie Mayfield
    • Dr. Mike Messino
    • John Nicolay
    • Nurse and patient advocate Karen Sanders
    • Former Western Carolina Medical Society Director Miriam Schwarz
    • Highlands Mayor Patrick Taylor

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    Move to compel sale 'unprecedented'

    The goals of the group are to replace HCA with a nonprofit owner "committed to meeting the healthcare needs of the people of WNC," as well as "holding HCA accountable for their harmful culture and practices," and restoring best in class care for the system, leaders said.

    To achieve them, the coalition plans to use public advocacy, engagement with state and federal regulators and public pressure and legislative pressure, they said.

    Mayfield told the Citizen Times the move to push out a hospital owner in such a way appeared to be unique.

    "I can tell you pretty definitively, because we've asked and looked all around the country, that there is no community that is organizing in the way that we are against HCA," said the Democratic state legislator from Asheville.

    Mark Hall, professor of law and public health at Wake Forest University, said the only similar example he knew of was in the late 1980s and early 1990s in Denver, Colorado. The nonprofit Presbyterian St. Luke's had been sold to the for-profit AMI company. A group then arranged to buy back the hospital, though the situation was different in that AMI had initiated the sale because of financial difficulties, Hall said. In contrast Mission is HCA's second most profitable hospital with $1.3 billion in net patient revenue, according to Definitive Healthcare.

    "This strikes me as fairly unprecedented," the professor said of Reclaim's effort.

    Copelof, the Brevard mayor, emphasized the issue goes beyond the main hospital in Asheville, saying it is a regional problem.

    “Our local hospital in Transylvania County has also been negatively impacted by HCA’s ownership, and the ability of our residents to receive care locally has been greatly diminished," she said.

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    More: NC Attorney General says HCA lawsuit counterclaims 'flatly contradicted' by patients

    Criticism of HCA's ownership started shortly after the 2019 purchase. By 2020, nurses had unionized and now say they might strike without increased staffing and pay. Local governments, residents and former workers have sued over claims of anti-trust activities and illegally withheld salaries.

    In one of the ongoing suits, N.C. Attorney General Josh Stein accused the company of failing to maintain levels of care in the ER and cancer treatment as promised during the purchase.

    Federal regulators, meanwhile, sanctioned HCA for nine cases of "Immediate Jeopardy," to patient safety, including four deaths. That put at risk the hospital's access to Medicare and Medicaid payments for patients relying on those forms of government health care. HCA came back into compliance June 11.

    Kelly, a retired family physician who spent 30 years at Mission, said in the statement, “HCA’s profit-driven culture and management has led to the departure of hundreds of physicians, nurses, and other staff," leading to problems such as those noted by the Immediate Jeopardy cases.

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    Messino, a retired oncologist, told the Citizen Times the practice he founded, Messino Cancer Center, ended its relationship with Mission and expanded the practice after many of the hospital's cancer care staff left.

    "They were the support people you need to take care of leukemia patients," he said. "And so the group decided it was not safe to take care of leukemia patients there anymore."

    Messino said he believed what Reclaim was doing was part of a larger movement away from corporate ownership.

    "I think people are looking at all the money that goes to shareholders and hospital administrators and realize it could be used to take care of people. I think this is the beginning of a movement to change how health care is paid for," he said.

    More: New hospital, more beds for Asheville area, Buncombe? NC officials seek public comment

    How a quick and unexamined legislative move changed the course of Western NC's health care

    Joel Burgess has lived in WNC for more than 20 years, covering politics, government and other news. He's written award-winning stories on topics ranging from gerrymandering to police use of force. Got a tip? Contact Burgess at jburgess@citizentimes.com, 828-713-1095 or on Twitter @AVLreporter. Please help support this type of journalism with a subscription to the Citizen Times.

    This article originally appeared on Asheville Citizen Times: Historic move: new group says HCA must sell Mission, Western NC's main health care system

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