Mission Hospital Faces New Immediate Jeopardy Recommendation As State Agency Flags Major Safety Risks

By Jack Evans & Jeremy B. Jones

The Asheville Watchdog

Mission Hospital should again beryllium put successful contiguous jeopardy, nan worst punishment a infirmary tin face, nan North Carolina Department of Health and Human Services has recommended.

The finding, made by NCDHHS and reported to nan U.S. Centers for Medicare & Medicaid Services (CMS), is simply a devastating rustle to nan largest healthcare supplier successful occidental North Carolina: For nan 2nd clip successful 2 years, and nan 3rd since for-profit HCA Healthcare bought nan nonprofit Mission Health strategy successful 2019, nan infirmary risks losing Medicare and Medicaid backing because of deficiencies successful attraction truthful terrible that authorities inspectors judge they airs imminent consequence of superior injuries aliases decease to patients.

NCDHHS notified Mission CEO Greg Lowe of its uncovering successful a missive dated Oct. 10 and obtained Friday by Asheville Watchdog. In an email Friday afternoon, Mission spokesperson Katie Czerwinski said nan infirmary was disappointed pinch nan recommendation.

“While we respect nan surveyors’ role, nan authorities regulators person not articulated what insufficiencies beryllium coming fixed nan extended corrective action plans we person implemented and provided to them,” she said. “Because of that we proactively shared our plans pinch CMS. We judge we person addressed nan issues and invited an expedited follow-up survey.”

MH COP Facility Letter (003)_RedactedDownload

In nan letter, NCDHHS alleged that Mission grounded to correct aliases mitigate risks concerning diligent misidentification, telemetry monitoring and patient-transportation safety. 

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The agency, which conducted its investigation connected behalf of CMS past month, flagged a bid of incidents connected July 26, Aug. 19, and Sept. 4. The first of those dates aligns pinch an incident successful which a cardiac diligent died aft becoming disconnected from telemetry equipment, which off-site technicians usage to show patients’ captious signs, for astatine slightest an hour. The Watchdog first reported news of nan death, on pinch nan truth that infirmary management many times turned down nurses’ requests for an emergency gathering pursuing nan incident, successful September.

In nan different incidents, nurses “failed to guarantee safe and due carrier and continuous beat oximetry monitoring for a patient” and “failed to forestall and power infections by not accurately implementing and communicating infection prevention precautions,” according to nan NCDHHS missive to Lowe. The agency besides investigated a Sept. 18 incident related to infection prevention practices but wished that nan infirmary took corrective action that prevented it from rising to nan level of contiguous jeopardy.

“For months, bedside nurses, on pinch our union’s Staffing and Professional Practice Committees, person been calling connected Mission Hospital to prioritize safe staffing,” said Kerri Wilson, a registered caregiver successful Mission’s telemetry portion and chair of nan master believe committee, successful a connection provided by National Nurses United. “Instead, our concerns person been ignored while nan infirmary continues to put profits complete diligent care. The tragedies that led to this contiguous jeopardy uncovering could person been prevented if guidance had listened to nurses and invested successful diligent safety.”

Mission’s adjacent early now rests successful nan hands of nan CMS’s location agency successful Atlanta, which will determine whether to spot nan infirmary successful contiguous jeopardy. The CMS determination could return weeks aliases months: When nan agency placed Mission successful contiguous jeopardy successful 2024, it did truthful astir six weeks aft NCDHHS’s missive to then-CEO Chad Patrick.

If placed successful contiguous jeopardy, Mission would person 23 days to rumor a scheme of correction aliases look nonaccomplishment of its Medicare and Medicaid funding, which would beryllium disastrous for nan hospital, which is financially limited connected that funding.

Previous contiguous jeopardy findings

In early 2024, Mission was placed successful contiguous jeopardy after an NCDHHS inspection revealed 18 patients were harmed betwixt 2022-2023, 4 of whom died, each arsenic a consequence of violations of national standards of attraction related to nan hospital’s emergency and oncology services. The punishment was lifted aft Mission provided a scheme of correction wrong nan mandated 23 days.

In 2021, Mission faced another contiguous jeopardy punishment aft a female diligent – referred to arsenic Patient #6 successful nan investigation study – was recovered dying connected nan level of her infirmary room connected March 1, her IV disconnected, and saline flush syringes successful her bed.

In a missive dated June 2, 2021, to Patrick, NCDHSS wrote that “the infirmary grounded to support a safe situation for a medical/surgical diligent pinch a history of constituent maltreatment and forestall diligent entree to unsecured flushes, grounded to travel a expert bid for liquid symptom medication, and grounded to pass and escalate diligent attraction concerns for safety.” 

Two different hospitals acquired by HCA successful nan region person received contiguous jeopardy citations pursuing nan 2019 waste – Blue Ridge Regional Hospital successful Spruce Pine successful 2023 and Mission Hospital McDowell successful Marion successful 2021.

“Today’s news from NC DHHS puts to remainder immoderate mobility that nan value of attraction astatine Mission Hospital has dramatically declined since HCA’s purchase,” authorities Sen. Julie Mayfield said Friday via matter message. “Despite their immense resources, HCA appears incapable of moving this infirmary successful a measurement that champion serves its patients and supports its staff. Instead, they proceed to make choices designed chiefly to service their shareholders. That needs to extremity now. HCA must make imperishable improvements successful staffing, alternatively than nan impermanent changes they person made previously, to guarantee that we do not find ourselves present again and again.”

Earlier this year, CMS besides investigated an Emergency Medical Treatment and Labor Act usurpation astatine Mission aft a patient died successful an emergency section bathroom in February after calling for thief for 29 minutes earlier unit responded. That investigation wished that Mission violated its work to supply emergency services. But by nan clip of nan investigation, nan infirmary had taken capable steps to remedy nan problems that led to nan decease and avoided an contiguous jeopardy finding.

CMS regulations specify contiguous jeopardy arsenic noncompliance that “has placed nan wellness and information of recipients successful its attraction astatine consequence for superior injury, superior harm, superior impairment aliases death.

“[It] is nan astir superior deficiency type, and carries nan astir superior sanctions,” according to nan regulations. “An contiguous jeopardy business is 1 that is intelligibly identifiable owed to nan severity of its harm aliases likelihood for superior harm and nan contiguous request for it to beryllium corrected to debar further aliases early superior harm.”

Immediate jeopardy is rare, according to a 2021 study from nan National Library of Medicine, which reviewed 30,808 infirmary deficiencies betwixt 2007-2017. Only 2.4 percent aliases 730 of those resulted successful contiguous jeopardy, according to nan study.

With 682 licensed acute attraction beds, Mission is nan state’s largest infirmary westbound of Charlotte, serves tens of thousands of patients a year, and is nan region’s only Level 2 trauma center. It has applied to go occidental North Carolina’s only Level 1 trauma center and is awaiting a determination from NCDHHS.

[Editor’s note: This communicative was updated astatine 4:57 p.m. Oct. 17 to see remark from Mission Hospital.]

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Asheville Watchdog is a nonprofit news squad producing stories that matter to Asheville and Buncombe County. Jack Evans is an investigative newsman who antecedently worked astatine nan Tampa Bay Times.  You tin scope him via email astatine jevans@avlwatchdog.org. Andrew R. Jones is simply a Watchdog investigative reporter. The Watchdog’s reporting is made imaginable by donations from nan community. To show your support for this captious nationalist work spell to avlwatchdog.org/support-our-publication/.

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