Last night, community members of Marion, North Carolina gathered to voice concerns about the takeover of Asheville-based Mission Health by Nashville-based HCA Healthcare. Mike Conley of McDowell News reports: 

Both critical and supportive comments were heard at the more than 90-minute meeting on Wednesday. It was the latest in a series of meetings held to gather information about the performance of the for-profit HCA since it acquired the not-for-profit Mission Health’s hospitals and physicians’ practices in western North Carolina.

The Nashville, Tenn.-based firm of Gibbins Advisors has held seven 90-minute meetings open to the public at locations across western North Carolina to provide information on its “role and scope” as independent monitor and to get feedback on HCA’s performance. Ronald Winters with Gibbins Advisors led the meeting. He said his company is an independent monitor that is not paid by HCA. The goal of the meetings is to determine if HCA is living up to its commitments and the promises that were made as part of the acquisition of Mission Health, he said.

In early 2019, HCA bought Mission Health for $1.5 billion. Members of the community were skeptical of the consequences stemming from the purchase of their hospital system by a for-profit entity. Federal and State regulators approved the deal upon agreement from HCA that it would set up a public health trust that would, among other things: 

  • Use the proceeds from the sale of Mission health to make investments in healthcare needs and address social determinants in North Carolina communities
  • Keeping hospitals open for at least ten years 
  • Building a 120-bed inpatient behavioral hospital 
  • Build a replacement hospital for Angel Medical center in Franklin, NC
  • Create a $25 million innovation fund dedicated to improving health care service delivery and spurring economic development 
  • Spend $232 million in capital investments on Mission facilities 

The independent monitor heard from patients on Wednesday night. Here were some of the reported complaints:

One person, whose name was not available, said that over a year ago, the hospital here started working on a disaster plan but it was put on the backburner because of the HCA acquisition. That same person said the staffing at the Emergency Room has been drastically reduced and there is no pharmacist at Mission Hospital McDowell during the night shifts.

Another person, whose name was not available, spoke about charity care that is provided when a patient doesn’t have health insurance and cannot afford to pay out of pocket. “When HCA took over, there was no charity care,” she said. “I don’t know where to turn to.”

One man, whose name was not available, talked about how he waited in the Emergency Room on a gurney for five hours because no doctor was available to treat him. He talked about how emergency patients are seen at Mission Hospital McDowell in Marion and then taken to Mission in Asheville, which results in double billing.

Another man talked about how no one was available at the ER and a security guard had to find someone. 

I have written about the impact of hospital mergers and acquisitions on patient experience and care. It’s not always great. The industry tells us that they will be able to provide better care in larger hospital systems, but the research does not support this claim. 

Check back for more updates on the on-going monitoring process of HCA-owned Mission health.