HCA Healthcare was in potential noncompliance last year with the terms of its agreement to purchase Asheville’s Mission Hospital, according to a newly-appointed independent monitor.
The decision by Affiliated Monitors, Inc., a Boston-based firm selected for the job in April, marks the first potential noncompliance finding since HCA’s 2019 purchase of Mission.
Dogwood Health Trust, the foundation responsible for hiring the independent monitor, said in a press release Tuesday that HCA had been found in potential noncompliance with three areas of the purchase agreement.
“These concerns include the provision of Emergency and Trauma Services and Oncology Services at Mission Health; failure to remain ‘enrolled and in good standing’ in Medicare and Medicaid; and issues with Uninsured and Charity Care policies,” Dogwood said in the release.
The foundation notified the state attorney general’s office in a letter Monday and said it intends to officially notify HCA. Stein’s office has 30 days to inform Dogwood whether it agrees with its findings. The full independent monitor report is available here.
Spokespeople for HCA and Stein did not immediately respond to a request for comment.
The independent monitor’s work includes holding community meetings and issuing an annual update about compliance. For the past four years, the previous independent monitor, Gibbins Advisors, found HCA in compliance, as detailed in annual reports posted on Dogwood’s website.
The potential noncompliance finding is the latest dilemma for HCA, which has faced mounting lawsuits, an exodus of staff and heightened scrutiny from federal authorities since it purchased the previously nonprofit Mission Health System for $1.5 billion in 2019.
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, but a lengthy report by state investigators revealed the details of multiple patient safety issues, including delayed treatment and understaffing, that in some cases led to patient deaths.
HCA also faces a lawsuit from state Attorney General Josh Stein, who is the Democratic nominee for governor. On Monday, Stein’s office urged state health officials to deny Mission Hospital’s bid to add 26 more beds to the Asheville facility, citing the need for increased competition in the region and the recent spate of complaints against HCA.
Susan Mims, Dogwood’s CEO, said in a statement Tuesday that the foundation “heard requests from both the Attorney General and the communities we serve for more education and transparency regarding Dogwood’s compliance oversight of HCA.”
“We listened, which is why we are sharing this letter and report,” Mims said. “Our hope is that sharing this letter and report will help educate the public on our compliance oversight work for the 2023 reporting year and help Affiliated Monitors engage the public for the upcoming 2024 reporting year.”
Dogwood or the attorney general’s office is required to notify HCA of any potential compliance issues by October 27, the foundation said. Discussions on addressing the issues will follow, and Dogwood is expected to share a summary in early 2025 of how the issues were addressed.
