Opinion: Reclaiming our right to quality health care: Introducing Reclaim Healthcare WNC

The sale of Mission Health to HCA Healthcare in 2019 brought many changes to health care in Western North Carolina. Some of these are good — a new hospital in Franklin, a new and expanded mental health and wellness facility in Asheville, and new physician training programs.

But most of the changes we’ve seen cannot be characterized as good for the region or for our health care community. Examples include:

The closure of two family medicine practices with only 45 days notice, sending 9,000 people scrambling to find new physicians.
The failure of HCA to maintain long-standing relationships with well-established physician groups including Oncology, Neurology, ENT, Surgical Oncology, Urology and Hospitalists.
The departure of over 200 physicians, 600 nurses and countless other staff.
A decline in the number of staff per occupied bed at Mission Hospital from six full time equivalents pre-sale to 3.7 after the sale (average across the state is 5.1)
Declining patient satisfaction ratings, from consistent 4s and 5s (out of 5) pre-sale, to 1s and 2s in 2023
A culture of disrespect, intimidation, and fear of retaliation for speaking out against the corporate-driven changes

More generally, we have seen a broad decline in the overall quality of care at Mission Hospital due to HCA’s calculated decisions to increase profits by cutting services and staff. In so doing, they have created unsafe conditions at Mission Hospital, made Mission a difficult place to work, harmed morale, and significantly reduced the capacity of Mission-owned practices.

This decline in care was confirmed by the citation earlier this year of Mission Hospital by the federal Centers for Medicare and Medicaid Services (CMS) for nine Immediate Jeopardy (IJ) cases, including four deaths, and one violation of EMTALA, the federal law requiring hospitals to provide emergency care. IJs are the most severe sanction a hospital can receive. No other North Carolina hospital has been cited for nine at once.

That said, and this is important, you can still get good care at Mission. Where there are resources, the physicians, nurses, and other staff provide great care. We are grateful to and thankful for them. The decline in quality of care is not on them, but is due to HCA’s systemic failure to provide the resources and collaborative culture needed to ensure the best care possible is always delivered.

So, what can be done? Do we have to accept the current situation? No.

We are RECLAIM HEALTHCARE WNC, a volunteer-led, grassroots coalition that is organizing and engaging the public, health care community, elected officials, clergy and business leaders in a campaign to:

Replace HCA with a nonprofit hospital system that will better meet the needs of WNC
Hold HCA accountable for its harmful culture and practices
Restore best-in-class health care throughout the Mission system

We are employing a variety of strategies to reach these goals, including regularly communicating patient and provider stories to CMS, N.C. Department of Health and Human Services, the N.C. Attorney General, and the Dogwood Health Trust’s Independent Monitor; engaging in regulatory, legislative and shareholder advocacy; generating public pressure; and ensuring media coverage at the local, state and national levels.

In short, we are giving voice to the concerns of our community, including those who are afraid of reprisal, and creating multiple pressure points intended to move Mission to new ownership.

We are not naive. Replacing HCA is a big goal. It will not be easy and it may take awhile. But there is no other option. HCA has consistently refused to heed the calls of this community and its physicians, nurses and other staff to make needed changes. We deserve better. If HCA is not willing to invest its vast resources into making Mission Health what it has been and should be, then HCA has to go.

Reclaim Healthcare WNC will not stop our advocacy or quiet our voices until Mission Health once again provides best-in-class health care throughout the system and the public’s trust and confidence has been restored. That is what our region deserves, and that is what we demand. We invite you to join us at www.reclaimhealthcarewnc.org.

On behalf of our coalition,

Maureen Copelof, Mayor of Brevard

Missy Harris, Pastor

Scott Joslin, MD

Bruce Kelly, MD

Robert Kline, MD

Allen Lalor, MD

Julie Mayfield, N.C. State Senator

Mike Messino, MD

Karen Sanders, RN

Miriam Schwarz, MPA