This is a developing story and will be updated.
North Carolina’s attorney general wants state health officials to deny Mission Hospital’s bid to add 26 more beds to the Asheville facility, according to a letter sent Monday and shared with BPR News. The AG’s office cited the need for increased competition in the region and the recent spate of complaints against Mission’s owner, HCA Healthcare.
The letter comes as Nashville-based HCA, Florida-based AdventHealth and Winston-Salem-based Novant Health are competing for a “Certificate of Need” – just as they did two years ago.
Attorney General Josh Stein, who is also the Democratic nominee for governor, has been among the most outspoken critics of HCA. Last year Stein sued the for-profit hospital company, alleging that it had breached the terms of its 2019 purchase of Mission Health System.
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In Monday’s letter, Kevin Anderson, senior counsel for consumer protection and multi-state litigation, said that the granting of any Certificate of Need “should promote competition and advance the State Medical Facility Plan’s basic principles of safety, quality, access, and value.” Anderson wrote: “...Granting Mission’s application would do neither.”
North Carolina law requires that health care providers obtain a "Certificate of Need" from state health authorities in order to add to their facilities or equipment.
“The large market share for acute care services that Mission already enjoys in western North Carolina makes it a poor candidate to promote competition in that region,” Anderson wrote. “And Mission is failing to provide safe, quality, accessible, and affordable care in the region at its existing facilities.”
Nancy Lindell, a spokeswoman for HCA Healthcare, said Mission Hospital "remains committed to providing the region’s most advanced healthcare" and that HCA believes the hospital "can best meet Western North Carolina’s growing need for complex medical and surgical care services."
"The current utilization of Mission Hospital’s services is very high, including services related to the ICU and adult medical and surgical beds," Lindell said in a statement. "Currently, Mission Hospital accepts thousands of patient transfers from other hospitals across the region. These transfers reflect a need for the addition of higher acuity beds and services offered by Mission which will meet the needs of patients in Western North Carolina. Additionally, if approved, Mission believes that it can make these beds available on a more expedited timeline than other applicants."
In the years since HCA’s purchase of Mission Health System, the company has faced an exodus of staff, mounting legal troubles and heightened federal scrutiny. Late last year, federal authorities declared that conditions at Mission Hospital put patients in “immediate jeopardy,” which temporarily put the facility at risk of losing its Medicare and Medicaid funding.
The designation was lifted in June. Even so, the letter from the attorney general’s office is the latest signal that HCA’s critics are continuing to exert pressure on the company over its management of Mission Hospital.
Last week, a group of local elected officials, health care workers and others launched a coalition, Reclaim Healthcare WNC, centered on pushing HCA to sell Mission Health System.
As far as HCA’s desire to expand, two years ago, Stein’s office sent a similar letter to NCDHHS opposing Mission’s bid for a Certificate of Need for 67 additional acute care beds serving residents of Buncombe, Graham, Madison and Yancey counties. The certificate was eventually awarded to AdventHealth. Mission appealed the decision, leading to more than a year of legal wrangling. An administrative judge upheld the decision in May.
AdventHealth owns a hospital in Hendersonville and recently announced the purchase of 25 acres of land for a future Weaverville facility, which will include the 67 beds. If AdventHealth succeeds in its latest Certificate of Need application, the 26 beds would be added to that facility, for a total of 93 beds.
Novant Health's application for the Certificate of Need states that, if approved, the company plans to build a 26-bed acute care center, Novant Health Asheville Medical Center. The facility would focus on cancer care.
