HCA Mission Hospital's immediate jeopardy removed

Asheville, N.C.-based HCA Mission Hospital has had its immediate jeopardy designation lifted, Blue Ridge Public Radio reported June 12.

The decision comes after a CMS revisit May 23 that found no deficiencies. CMS notified hospital leadership that it is back in compliance with Medicare conditions of participation in a June 11 letter obtained by the radio station. 

Mission Hospital was placed in immediate jeopardy after three patient deaths. The CMS report said the hospital's leadership "failed to ensure a medical provider was responsible for monitoring and ensuring the delivery of care to patients" in the emergency department, and ensure care was provided according to policy. It also described deficiencies in areas such as oncology, where a patient received expired chemotherapy, and the behavior health unit, where a child was given medication without authorization from a parent or guardian. 

On Feb. 1, CMS sent a letter to the hospital notifying leadership that the facility was in immediate jeopardy and must take action to avert the loss of federal funding. CMS had set a Feb. 6 deadline for Mission Hospital to submit a plan of correction related to its governing body, emergency services, nursing services, patients' rights, quality assurance and laboratory services. 

Since facing immediate jeopardy, the hospital has undergone increased criticism and cited for an Emergency Medical Treatment and Active Labor Act violation. 

Among the changes laid out in the hospital's plan are ensuring patients are triaged and assigned a nurse within 10 minutes of ED arrival, having lab orders collected within 30 minutes and implementing enhanced communication procedures. However, nurses alleged that the staffing levels are not consistent and that a number of steps have "already blackslid" since regulators visited the week of Feb. 20.

In March, CMS notified leadership at Mission Hospital that inspectors with the North Carolina Department of Health and Human Services had uncovered an EMTALA violation during a visit in November. At the time, CMS said Mission had failed to comply with EMTALA standards related to medical screening exams, though no other details were provided. EMTALA requires Medicare hospitals provide all patients appropriate emergency care, which includes "appropriate medical screening, examination, stabilizing treatment and transfer, if necessary." The hospital's plan of correction was approved in April.

HCA did not immediately respond to Blue Ridge Public Radio's request for comment.

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