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Lawsuit filed against HCA by local municipalities can proceed, judge rules

A sign outside Mission Hospital in Asheville.
Felicia Sonmez
A sign outside Mission Hospital in Asheville.

The legal battles involving HCA Healthcare, the owner of Asheville’s Mission Hospital, took another twist this week.

On Wednesday, a federal judge ruled that a June 2022 lawsuit filed against HCA by the city of Brevard can go forward. Buncombe and Madison Counties and the City of Asheville joined the lawsuit shortly after it was filed.

In the lawsuit, the plaintiffs alleged that HCA engaged in a scheme to monopolize health care markets in seven Western North Carolina counties, resulting in higher prices and a lower quality of care. HCA responded by filing a motion to dismiss the case.

Chief U.S. District Judge Martin Reidinger ruled Wednesday that the plaintiffs had “plausibly stated a claim” that HCA has monopolized power and harmed competition in the Western North Carolina market.

In his ruling, Reidinger said the lawsuit “sufficiently alleges” that HCA has “monopoly power over the Outpatient Market.”

“Specifically, the Consolidated Complaint alleges that, in large part due to the Defendants’ alleged scheme to maintain and enhance monopoly power, the HCA Defendants have reduced the availability and quality of Outpatient Services in the Outlying Region, in turn compelling patients to travel to HCA Defendants’ Asheville facilities, and have caused prices for Outpatient Services in the Outlying Region to substantially increase relative to other providers in North Carolina,” Reidinger said.

State Sen. Julie Mayfield (D) praised the ruling at a press conference in Asheville Thursday.

“After many months of waiting, finally yesterday the judge issued a clean and complete denial of HCA’s motion,” she said. “This means that the lawsuit can proceed and the parties will enter into a period of discovery.”

Mayfield added that the plaintiffs are also seeking to certify the case as a class-action lawsuit “on behalf of all local entities who are self-insured.”

Nancy Lindell, a spokeswoman for HCA, said the company will “vigorously defend the lawsuit, while continuing to provide excellent healthcare to the citizens of Western North Carolina.”

HCA has faced numerous lawsuits since its 2019 purchase of the previously-nonprofit Mission Health System. State Attorney General Josh Stein (D) sued the for-profit hospital giant in December, alleging that it had breached the terms of its purchase agreement by failing to provide adequate emergency and oncology care at its facilities. HCA has filed a motion to dismiss that lawsuit as well.

Additionally, federal authorities recently declared that conditions at HCA’s Mission Hospital put patients in “immediate jeopardy,” the most serious warning a hospital can receive. State inspectors have been making regular visits to the facility, including as recently as this week.

A 384-page report by the Centers for Medicare and Medicaid Services detailed the multiple patient safety issues – including delayed treatment and failures to provide timely care – that led to the designation.

Federal authorities accepted a “Plan of Correction” from HCA and will decide by Feb. 24 whether Mission Hospital is in compliance with the plan.

At Thursday’s press conference in Asheville, current and former Mission Hospital staff sharply criticized HCA’s “Plan of Correction,” which they said did not go far enough in addressing the main force behind the hospital’s problems: chronic understaffing.

"I can give you a solution in one sentence: Hire and retain staff,” nurse Molly Zenker said.

At one point, Zenker teared up as she described the efforts Mission Hospital nurses are making on behalf of patients.

“The nurses at Mission are not fooled by the paltry efforts HCA has made to remove the hospital from immediate jeopardy,” she said. “But I promise, the nurses at Mission will not stop fighting for this community. We will not lie down. We will not be bullied.”

The Rev. Missy Harris, a minister who worked for nearly six years as a Mission Hospital chaplain, also spoke with emotion about the CMS report’s findings.

“Things weren’t perfect before HCA arrived,” Harris said. “That said, Mission Health has never received a 384-page report outlining a litany of systemic failures that have caused widespread harm and, most regrettably, loss of life.”

Felicia Sonmez is a reporter covering growth and development for Blue Ridge Public Radio.