NC investigators cite 9 'Immediate Jeopardy' incidents at Mission Hospital
ASHEVILLE – State investigators identified nine "Immediate Jeopardy" incidents at Mission Hospital following a fall survey, the most serious deficiency regulators can assign.
Regulators from the North Carolina Department of Health and Human Services notified Mission Hospital Chief Executive Officer Chad Patrick of the declaration in a Dec. 19 letter, obtained and first reported by the Asheville Watchdog. The Citizen Times verified the letter.
State officials found that hospital nursing staff did not quickly accept and monitor emergency department patients, leading to delays in care, and preventing nurses from identifying and responding to changes in patient conditions.
The letter also indicated that staffing deficiencies led to delays in treatment for patients.
“The cumulative effects of these practices resulted in an unsafe environment for ED patients,” the letter read.
"Immediate jeopardy" is the most serious designation regulators can give for an inspection. According to the federal Centers for Medicare and Medicaid Services, an immediate jeopardy situation occurs when facility noncompliance with regulations creates risk for serious injury, harm, impairment or death. These deficiencies lead regulators to impose the harshest sanctions on providers.
“Mission Hospital has received preliminary survey results from CMS regarding its emergency department,” Mission Hospital spokesperson Nancy Lindell said in a Jan. 12 statement. “We have taken those results seriously, and there are no excuses for our patients receiving anything other than exceptional care. This is not the standard of care we expect, nor that our patients deserve, and we will work diligently to improve.”
A CMS spokesperson told the Citizen Times in a Jan. 12 email that the agency is reviewing the findings and will issue a statement of deficiency, which will describe how the hospital is not complying with federal regulations. The hospital will have 23 days to submit their plan of correction or remove the immediate jeopardy situations. If CMS does not approve, the agency will give the hospital at least 15 days of notice before it revokes the hospital's Medicare payments.
The agency will make the statement of deficiencies publicly available within 30 days of delivering it to the hospital or once CMS receives an acceptable plan of corrections, whichever comes first, the spokesperson said.
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An NCDHHS spokesperson pointed to federal law that forbids state officials from commenting on whether Mission has been put in immediate jeopardy.
Mark Klein, a nurse at Mission Hospital, said in a Jan. 12 email to the Citizen Times that the immediate jeopardy designations are products of HCA understaffing.
"Without adequate staff, monitoring patients to a reasonable standard of care is physically impossible, which is why the HCA business model harmed patients," he said.
Klein, 58, said that HCA leadership has not communicated about the immediate jeopardy incidents to hospital nurses. He said that HCA added full-time and temporary nurses as a short-term solution to staffing deficiencies at the hospital.
HCA Healthcare, a for-profit, publicly traded company, bought the Mission Health system for $1.5 billion in 2019.
The immediate jeopardy notification came days after North Carolina Attorney General Josh Stein sued Mission and HCA for not complying with the level of emergency and cancer care it agreed to following the 2019 acquisition. That lawsuit asked the court to demand HCA restore emergency and cancer services to its pre-sale conditions.
“Today’s news is extremely alarming and reinforces my deep concerns about the quality of care people in western North Carolina are receiving at HCA,” Stein said in a Jan. 12 statement to the Citizen Times. “I appreciate CMS and DHHS for their hard work to improve the situation for patients. I will continue to do everything in my power to protect people’s health care – including continuing to vigorously pursue my lawsuit against HCA.”
Mission’s emergency department posed patient safety and emergency service issues for months.
In July, the Citizen Times reported that ambulance patients arriving at the Mission Hospital emergency department can wait hours to receive care. Hospital staff and emergency service leaders blamed an overtaxed and understaffed emergency department for the delays. These delays prevented emergency service personnel from responding to 911 calls in their jurisdictions.
More: Mission Hospital to implement new ambulance patient handoff policy. HCA gives no details.
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Mitchell Black covers Buncombe County and health care for the Citizen Times. Email him at mblack@citizentimes.com or follow him on Twitter @MitchABlack. Please help support local journalism with a subscription to the Citizen Times.
This article originally appeared on Asheville Citizen Times: NC finds 9 'Immediate Jeopardy' incidents at Mission Hospital
