From Staff Reports

Asheville-based Mission Hospital faces two more federal violations regarding patient care, based on a letter from the Centers for Medicare and Medicaid Services, dated March 14, Asheville television station WLOS (News 13) reported on March 15.

The News 13 story was headlined: “‘Call it Strike Three:’ Mission Hospital faces 2 more federal violations for patient care.”

The CMS letter states that Mission is in violation of two requirements that fall under the requirements for patient care under the Emergency Medical Treatment and Labor Act, also known as EMTALA. 

The CMS letter stated the following:

“EMTALA is a decades-old federal law that requires Medicare hospitals provide all patients appropriate, timely emergency care.”

The News 13 report added, “The first violation regards an emergency room patient’s ‘Medical Screening Exam.’ The second violation is listed as a number — 489.20 — and doesn’t state details of the violation...

“Federal officials conducted inspections of Mission last year, but the latest violations are new information tied to the ongoing investigation and scrutiny of Mission’s Emergency Department and hospital operations by CMS and federal healthcare officials.” 

Meanwhile, the Daily Planet contacted Mission Health spokeswoman Nancy Lindell on March 21 seeking “a detailed statment”  of the hospital’s viewpoint on “the latest” developments in the challenges the local hospital system is facing, but the newspaper received an emailed response that Lindell would be “out of the office” until March 26 — well after the print deadline for this edition.

However, Lindell’s message noted that her Mission Health colleague, Katie Czerwinski, could be contacted for “an urgent matter that cannot wait for my return.” (Czerwinksi is an assistant vice president of strategic communications for HCA Healthcare, which owns Mission Health.)

Upon contacting Czerwinski on March 22, the Daily Planet — still seeking an update on Mission Health’s viewpoint on “the latest” challenges facing Mission Hospital — received the following response that, Czerwinski noted, “can be attributed to Nancy Lindell:”

“Mission Hospital received a transmittal from CMS on March 14th which was related to the initial NCDHHS survey in November 2023. 

"One finding from the initial survey was based on a medical screening examination in the Emergency Department. 

“This subsequent 90-day standard notice was an expected part of this process and means that specific elements of our approved plan of correction will also be examined and re-surveyed in tandem with the revisit to ensure that this EMTALA finding has been addressed...

“As we continue to state, we take these matters very seriously and have made significant process changes to improve our patient care experience. 

“Ongoing measurement of various indicators, including EMS offload times and patient satisfaction, validates what we are hearing from our patients, providers, and EMS partners — that our care teams are excellent and significant improvement in emergency care has been recognized.”

Also, regarding the Daily Planet’s questions about recent “certificate of need developments,” Czerwinski emailed the newspaper the following statement that she also said “can be attributed to Nancy Lindell:”

“Mission Health remains committed to providing the region’s most advanced healthcare and will continue to take our community’s evolving health needs into account as we look to the future.”

Elsewhere, News 13 quoted Erica Carbajal, an editor and reporter for Becker’s Hospital Review, which reports on the hospital industry, as saying on March 15 the following:

“They didn’t provide appropriate medical screening to an emergency patient... This includes screening, stabilizing, treatment.”

The TV station also noted, “The violations stated in the letter fall under the requirements for patient care under EMTALA.”

News 13 quoted state Sen. Julie Mayfield, D-Asheville, as saying, “What I hear from people is they don’t trust Mission Hospital anymore.” 

Mayfield told the station that she received the letter from state officials and News 13’s story noted that she “has been advocating for patients and their care for several years in light of Mission complaints, deaths cited by CMS and lawsuits.”

As for the latest set of violations, Mayfield said March 15, “You could call it ‘strike three,’” noting the following “strikes:”

• Strike one — The immediate jeopardy rating in light of patient deaths cited by CMS in deeming the hospital a danger to patients.

• Strike two — That rating was followed by another letter stating more deficiencies in care.

• Strike three — “And now we have a third letter,” Mayfield told News 13.

News 13 added, “The CMS letter requires fixes of problems in 90 days and a plan of action be submitted within two weeks.”

Mayfield was quoted as saying, “The hospital is very profitable for their company.”

Amid numerous patient complaints, a federal investigation into substandard care, coupled with Attorney General Josh Stein’s lawsuit alleging breach of care for oncology patients, Mayfield told News 13 that she “would like to see HCA sell the hospital and leave Ashville.”