Clinicians, local advocates decry Mission Hospital's immediate jeopardy correction plan

A group of physicians and patient advocates are criticizing HCA Mission Hospital's plan of correction to revoke its immediate jeopardy status because it makes no mention of increasing staff, local news outlets reported Feb. 22. 

The Asheville, N.C.-based hospital's plan of correction to address serious deficiencies it was cited for in January focuses on improving policies and educating staff. Among the changes are ensuring patients are triaged and assigned a nurse within 10 minutes of ED arrival and having lab results returned within 30 minutes. Those changes are related to deficiencies CMS identified in its recent report detailing what led to the immediate jeopardy sanction, including long wait times, delays in lab work and other issues that allegedly led to the deaths of four patients, according to documents obtained by The Asheville Watchdog.

On Feb. 1, CMS sent a letter to the hospital, notifying leadership that the 815-bed facility is in immediate jeopardy and must take action to avert the loss of federal funding. The agency had set a Feb. 6 deadline for Mission Hospital to submit a plan of correction indicating how it will come back into compliance. The hospital met that deadline, but a coalition of physicians and patient advocates say the plan offers "only bureaucratic solutions to what is fundamentally a workforce issue." 

In a letter to Mark Benton, chief deputy secretary for health at the North Carolina Department of Health and Human Services, seven physicians and three patient advocates called the plan "insufficient" and urged regulators to request staffing information from the hospital and assign a third party to monitor the hospital's execution of the correction plan. 

"HCA needs to increase support staff, hire more experienced nurses, place nurses in the appropriate place for their level of experience, and commit to maintain these higher staffing levels permanently," the stakeholders said in the letter. "These are the primary steps needed to ensure patient safety and high quality care over the long term, and any POC that does not include them will fail." 

All of the clinicians who sent the letter have worked at Mission in some capacity, including in leadership roles. They were joined by state Sen. Julie Mayfield at a Feb. 22 press conference sharing their concerns. 

The hospital has not said whether it will hire more staff. A spokesperson for Mission Health and HCA, Nancy Lindell, sent the following statement to Becker's

"We are pleased that CMS accepted our Plan of Correction and we will continue to collaborate with the surveyors through this process."

Late last year, the state health department conducted inspections at Mission Hospital on behalf of CMS and recommended it be placed in immediate jeopardy, noting nine deficiencies related to incidents that occurred between April 2022 and November 2023. Officials at Mission Hospital previously said they had started taking steps to address issues when they received the initial findings from the health department in January, including bringing in more staff to work in the ED. 

Once surveyors with the state's health department determine that immediate jeopardy conditions are removed, the hospital will have 90 days to complete specific corrective actions and regain compliance with regulations, according to CMS. State and federal surveyors were on site at the facility Feb. 20. 

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