The North Carolina Department of Health and Human Services (NCDHHS) has proposed Mission Hospital to be placed under immediate jeopardy, considered the highest level of sanction a hospital can endure. The U.S. Centers for Medicare & Medicaid Services (CMS) received this recommendation regarding the largest healthcare provider in western North Carolina. This would be the third instance of such a sanction for the hospital since its acquisition by for-profit HCA Healthcare in 2019. Cause for such measures stems from severe care deficiencies that might expose patients to serious injuries or even the risk of death. These shortcomings were relayed to the Hospital’s CEO, Greg Lowe, in a letter dated October 10, procured by Asheville Watchdog.
In an official response, Mission spokesperson, Katie Czerwinski, indicated their disappointment with the recommendation, arguing the inspectors have failed to identify currently existing inefficiencies given the comprehensive corrective action plans the hospital has implemented and shared with them. She further stated they were open for an expedited subsequent survey.
In the letter, NCDHHS highlighted Mission’s failure to amend or lessen risks related to patient misidentification, telemetry monitoring, and patient transportation safety. Several incidents were detected in July, August, and September, sparking an investigation conducted by the agency on behalf of CMS. One such reported incident detailed a cardiac patient’s death because of disconnection from telemetry equipment for more than an hour. This incident was previously reported by the Watchdog, also mentioning the administration’s denial of nurses’ petition for an emergency meeting.
In other instances, it has been alleged that nurses failed to ensure safe transportation and comprehensive pulse oximetry monitoring for a patient. They also failed to regulate and manage infections through accurate implementation and communication of infection prevention precautions.
However, the fate of the hospital now awaits decision from the CMS regional office based in Atlanta which will decide whether to place the hospital under immediate jeopardy or not. During a similar sanction in 2024, the agency took approximately six weeks to settle post the receipt of NCDHHS’s letter. If the jeopardization materializes, Mission Hospital would be required to present a plan of correction within 23 days or it runs the risk of forfeiting its Medicare and Medicaid funding, a financial backbone for the hospital.
Previously, the hospital faced a similar sanction in 2021 when a patient was found in a critical condition in her room. The conditions pointed towards negligence in maintaining a safe environment for the patient, disregard of a physician’s order for liquid pain medication as well as unsafe access to unsecured flushes among others.
Concerns and condemnation also comes from political quarters. State Senator, Julie Mayfield, argued that the deterioration of care quality at Mission Hospital since their acquisition by HCA is inexcusable. She urges permanent improvements in staffing and other areas of concern to evade repetitive instances of this nature.
Regulations by CMS define ‘immediate jeopardy’ as a state of non-compliance which puts the health and safety of patients under the risk of serious damage, impairment or even death. An analytical study from the National Library of Medicine categorizes such jeopardization as rare, with just 2.4% of 30,808 hospital deficiencies resulting in immediate jeopardy according to their research. With its 682 licensed acute care beds, Mission serves tens of thousands of patients annually and is the exclusive Level 2 trauma center in the region. It has an application pending to be the sole Level 1 trauma center in western North Carolina.