From Staff Reports

ASHEVILLE, N.C. — Despite facing multiple serious federal citations, including “immediate jeopardy” findings, and intense scrutiny over staffing and patient care under Nashville-based HCA Healthcare, Mission Hospital in Asheville won approval for a $198 million, 95-bed expansion. 

And while Mission Hospital received approval to expand, “new hospital proposals from nonprofits AdventHealth and UNC Health West have been denied, though with the opportunity to appeal,” the Asheville Citizen Times reported on April 2.

“In a letter sent to Mission Hospital dated March 27, the North Carolina Department of Health and Human Services approved Mission Hospital to receive no more than 95 additional acute care beds, bringing the hospital to 828 acute care beds,” the ACT noted.

“In another letter the same day, the agency approved Novant Health to build a 34-bed hospital

“Competing health systems presented their visions for the future of Western North Carolina health care in December,” the ACT stated, with Mission, Advent and UNC Health each vying to build a new, 129-bed hospital for the region.

Novant Health proposed an “intentionally modest” hospital that would be in Arden.

The ACT added, “The agency also outright found that UNC Health West’s proposal was ‘not conforming,’ stating that the health system’s failed to “adequately demonstrate that the need it has for the proposed project, including patient origin, projected utilization, and access to medically underserved groups is based on reasonable and adequately supported assumptions.” 

In finding its application to be “non-conforming, NCDHHS stated that determined that it could not legally approve the application, according to the document.

“Mission’s proposed expansion would cost more than $198 million and is scheduled for completion in 2031 while Novant Health’s proposal is estimated to cost $322 million and is scheduled for completion in 2030, according to NCDHHS documents,” the ACT stated.

Meanwhile, HCA Healthcare spokeswoman Katie Czerwinski wrote the following in an email to the ACT April 2:

“We are pleased that the North Carolina Department of Health and Human Services Division of Health Service Regulation approved Mission Hospital to add 95 inpatient beds to its Asheville campus, affirming the essential and critical care we continue to provide to western North Carolina. We look forward to alleviating bed capacity constraints so that patients can get the high-quality, advanced care services only Mission can provide.” 

“The CON approval is likely to face legal opposition from the health care companies seeking a larger share of awarded beds,” the ACT noted. “Over the past seven years, Mission Hospital has faced protests, lawsuits and citations amid what federal, state and regional lawmakers have said are a result of understaffing at the hospital and perceived divestment from its owner, the Nashville-based HCA Healthcare.

“The hospital has been cited with immediate jeopardy four times since its $1.5 billion 2019 purchase. It is the worst federal sanction the Centers for Medicare and Medicaid Services can levy on a hospital. The hospital is currently under an “enhanced plan of correction,” of which it has a deadline of July 26 to implement or otherwise potentially face losing Medicare and Medicaid funding.”

Meanwhile, AI Overview noted, “Lawmakers and local health care advocates worry the decision could reduce competition to Mission Hospital.”