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If this was to happen, Mission would likely have to close its doors, leaving the closest hospital Advent in Hendersonville. I have to say we've always had good experiences at Mission, but have only been there as outpatients.
That's a bit concerning because Mission ALREADY KNOWS the standards for being approved for medicare/medicaid reimbursement and obviously through they could circumvent them. What else are they fudging on?
When you are the only "ballgame" in town you have no competition so you push the limits of the rules.
I'm gonna bet they miss the deadline and get it extended. At that point, they see how many times they can get it extended by drawing out certain areas of non-compliance.
These types of "notices" sound strong, but are effectively quite toothless.
The federal government isn't going to terminate Mission's Medicare and Medicaid funding. These kinds of staffing and process problems cannot be turned around in a short amount of time.
What will realistically happen is that something will get brought into compliance, with some vague roadmap on how the remaining items will be addressed. The can will be kicked down the road as long as possible, Mission will pile up more violations, some things will be fixed here and there, others will deteriorate - meanwhile, they'll keep the funding while riding the razor's edge the entire way.
While legally the entity still might be "Mission Hospital," it is owned and operated by HCA out of Nashville. People need to get it out of their minds that it was the Mission they knew pre-merger.
The lack of competition is a huge problem. Here in northeast TN, we went through a merger of two smaller, local systems six years ago. The two systems were average at best, with some good services mixed in, but at least there was some level of competition. When those two merged, the combined unit has seen patient care quality decline drastically, services cut to the point that some previously good hospitals are now basically glorified urgent cares, specialists are bailing out to better regarded systems in more affluent areas, staffing ratios have gotten worse, and wait times in the emergency room and to see specialists have gone up. Meanwhile, executive compensation has rocketed up.
I've since moved all of my care from the Tri-Cities to Asheville. Granted, these are independent providers - one PCP and a sleep specialist - but I've been very impressed. It's been a huge upgrade of what I'm coming from.
I worked for the regional hospital system here for years. Before HCA bought Mission out, Mission posted their salaries on the job description. They often paid 30%-50% more for the same salaried IT roles that we did.
After the merger, those job openings were basically gone - anything "corporate" was likely sent to Nashville, with a handful of IT site support folks around. I interviewed with HCA in 2022. The recruiter was completely clueless, and had no idea of the role. I worked with those same technologies for years, and she couldn't even answer basic questions about the department, what the job was doing day-to-day, etc. It was one of the worst interviews I've had. Who knows - maybe if I was able to get to a hiring manager or someone technical, I'd have better thoughts, but that did not sit well with me.
Also, people need to understand hospital staffing. I have no idea what Mission pays, but there is a staffing shortage everywhere. Nursing and front line patient care positions are often thankless jobs where the workers are really overtaxed. Hospital system benefits are generally really crummy. I was there for six years, and had eighteen total days of PTO annually. That worked out to the six major holidays (which I had to take out of my PTO to "pay myself" for), one week sick, and two weeks vacation.
I now work remotely for a local government in western NC. After just a little over a year there, I have almost two weeks of sick leave accumulated, and around six vacation days in the bank. That's not even considering all the extra holidays that I get throughout the year, especially the end of the year, that I didn't get at the hospital system. I think I've had seven holidays between Veteran's Day and MLK Day. My insurance is better. We have full state benefits, which are better in all respects than the hospital system.
HCA might be a little better than what I had, but it's not going to be comparable to government benefits.
Pay/cost of living in Asheville is also going to be part of the issue, but everyone is going through that. If a nurse can make 20% more in Charlotte and buy a house for 20% less, where are they going to go?
There aren't easy answers to some of these questions. Still, better management would go a long in fixing them.
Recently a family member of mine was in Advent near Hendersonville. She said this was, by far, the best hospital experience she’s ever had, and she’s been in multiple hospitals over the years. Staff were efficient and friendly. The staff/patient ratio was relatively high. She had a couple of former Mission nurses who did not speak very well of their former employer. We are fortunate to have a hospital of this caliber in the area.
The issue is HCA and this is how they often operate, regardless of level of competition. In Sanford FL where I used to live their facility there (Central Florida Regional Hospital) does not employ RNs directly (they're all on contract) and pay below market rate, with heavy competition from much larger/nicer hospitals belonging to Orlando Health and Advent Health within a 15-20 minute drive. They run larger patient loads as well with patient to RN ratios above standard, with no fear of strikes from an organized union.
In my opinion given Mission is the only hospital in Asheville (a city with a population closing in on 100K with over 10 million visitors per year) another hospital is needed and warranted for reasons already discussed regarding competition-driven quality of care.
Western Carolina University has established a campus in Asheville near Biltmore Park that offers health education for RNs and might be inclined to delve into a teaching hospital for not only RNs, but MDs as well. It's a departure for WCU but in a rapidly growing section of the state, care is sorely needed like as provided at East Carolina University's facility in Greenville operated by Vidant.
Recently a family member of mine was in Advent near Hendersonville. She said this was, by far, the best hospital experience she’s ever had, and she’s been in multiple hospitals over the years. Staff were efficient and friendly. The staff/patient ratio was relatively high. She had a couple of former Mission nurses who did not speak very well of their former employer. We are fortunate to have a hospital of this caliber in the area.
I have heard good things about them, but aren't they out of FL as well? Personally, I would prefer local leadership that understands and is connected to the region, but quality care is quality care.
I had a sleep study done a few months ago. The technician and his wise lived in Old Fort. Both previously worked at Mission. She was a nurse at Blue Ridge Hospital in Morganton. They had lots of horror stories.
You can shop around for doctors in non-Mission groups, but the problem is the acute care, which you don't have any choice in during an emergency.
The federal government isn't going to terminate Mission's Medicare and Medicaid funding. These kinds of staffing and process problems cannot be turned around in a short amount of time.
Maybe, maybe not. It HAS happened many times. Haywood Medical Center in Clyde lost medicaid/medicare reimbursement from August 2008 to May 2008. They barely stayed in business. Many other hospitals failed due to losing reimbursement. You act as if it can't happen, but it does.
And since it is often death penalty, so to speak, its not invoked often, and the hospital is given great leeway to correct the issues.
Maybe, maybe not. It HAS happened many times. Haywood Medical Center in Clyde lost medicaid/medicare reimbursement from August 2008 to May 2008. They barely stayed in business. Many other hospitals failed due to losing reimbursement. You act as if it can't happen, but it does.
And since it is often death penalty, so to speak, its not invoked often, and the hospital is given great leeway to correct the issues.
Mission is the only hospital in the immediate Asheville area. There really aren't any options here - pulling the funding means the Medicare-reliant seniors in the immediate area don't have an emergency, inpatient option. That's not going to happen in a city that size.
HCA is a giant organization. Even if Mission lost funding, theoretically they could shift funds from profitable hospitals to Mission to keep it open.
Mission is the only hospital in the immediate Asheville area. There really aren't any options here - pulling the funding means the Medicare-reliant seniors in the immediate area don't have an emergency, inpatient option. That's not going to happen in a city that size.
HCA is a giant organization. Even if Mission lost funding, theoretically they could shift funds from profitable hospitals to Mission to keep it open.
Advent, near Hendersonville, is only 15 miles from Mission. This is closer than many people are to a hospital. When we lived in previous states, it was always further than this to a hospital. With that said, I doubt Advent has the capacity to handle the overflow from Asheville.
Advent, near Hendersonville, is only 15 miles from Mission. This is closer than many people are to a hospital. When we lived in previous states, it was always further than this to a hospital. With that said, I doubt Advent has the capacity to handle the overflow from Asheville.
The whole area is seriously underserved for hospital beds as it is now. The Asheville MSA which includes Hendersonville and Waynesville has just around 1100 hospital beds for a population of close to 500K, which is about 2/3 the number required for that size and especially so given the population dynamic of 45% over the age of 50. Of the 1100 beds in the MSA. HCA Mission has 850 of them so it's especially dire for those outside a 15-20 minute trip from that facility.
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