HCA Mission Hospital enacts changes in wake of CMS warning: Report

Patients triaged and assigned a nurse within 10 minutes of ED arrival. Lab orders collected within 30 minutes. These are among the policies HCA Mission Hospital in Asheville, N.C., has enacted as part of its plan of correction to address serious deficiencies the facility was cited for in January, according to internal 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

CMS previously told Becker's that submitting the correction plan initiates a multistep process to ensure the hospital has the opportunity to come into compliance and that if accepted, inspectors with the North Carolina Department of Public Health would conduct another survey to evaluate whether immediate jeopardy conditions have been removed. 

Two sources at Mission Hospital told the Watchdog that surveyors visited the facility Feb. 20, which the health department also confirmed, but added it "cannot comment on ongoing investigations." 

One of the hospital documents obtained by the publication laid out 10 action items to address deficiencies related to its ED care. Those policies included ensuring patients are assigned a nurse within 10 minutes; enhanced communication procedures; and ensuring patients experiencing alcohol withdrawal have a special assessment completed within an hour of arrival to reduce severity of withdrawal symptoms.  

The changes referenced were all related to deficiencies CMS had identified in its report on 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 the Watchdog, which also obtained the CMS report. 

"We are pleased that CMS accepted our Plan of Correction and we will continue to collaborate with the surveyors through this process," a spokesperson for the hospital told the news outlet. 

Late last year, the state health department conducted inspections at the 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. 

Earlier this month, the hospital's chief medical officer, Anthony Spensieri, MD, announced in an email to staff that he is "stepping away" from the role. He has led the hospital's medical staff as CMO since November 2019. 

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