Mission Hospital nurses applaud AG’s lawsuit

RNs’ complaints resulted in state investigation, immediate jeopardy finding

By Chuleenan Svetvilas

National Nurse magazine - Jan | Feb | March 2024 Issue

In December, Mission RNs applauded North Carolina Attorney General Josh Stein for filing a lawsuit against HCA for violating the asset purchase agreement it made when it acquired Mission Health in 2019. The lawsuit alleges that HCA is not providing the quality, consistent emergency and cancer care it committed to deliver. 

Hannah Drummond, RN in the emergency department at Mission Hospital in Asheville, spoke at the attorney general's press conference, stating in part, “Just this week, when I worked a shift in triage, we had more than 10 patients per nurse, patients being admitted to the floor straight from the waiting room without ever being assessed by a nurse, patients who were unstable not being monitored on cardiac monitoring, and ambulances stuck waiting to offload patients in the back — meaning emergency services and ambulances were unavailable in Buncombe and surrounding counties to respond to 911 calls because they were stuck. All the while, to make more money, HCA kept its doors open to transfers even though we had 140-plus patients in our 96-bed ER already.”

Since HCA took over Mission Hospital, nurses say staffing and working conditions have deteriorated. In response to the decline in patient care conditions and resources at Mission Hospital, the nurses voted to join NNOC in September 2020 to use their voice to fight for better patient care and staffing.

Since they unionized, the RNs have filed hundreds of assignment despite objection forms (ADOs) documenting unsafe staffing and working conditions affecting patient care. Mission nurses have held numerous protests and rallies about patient safety and chronic short staffing. Since June 2022, the RNs have also been filing complaints with the state’s Occupational Safety and Health Division and the Department of Health and Human Services (NCDHHS). 

The Mission RNs’ complaints eventually resulted in the state sending investigators to conduct inspections at the hospital in November and December 2023, culminating in a Dec. 19 letter sent to hospital administration, warning that the delays in care and lack of care for patients in the emergency department placed the facility in “immediate jeopardy,” meaning that Mission Hospital was at risk of losing its federal funding from the Centers for Medicare and Medicaid (CMS).

“We have patients on life-supporting medications in hallway beds, unmonitored,” said Drummond. “We have had patients die in hallway beds. We have had near misses. We have reported this to management and they have done nothing. Only when DHHS or Joint Commission is in town do they make efforts to adequately staff this ER, not just with nurses, but techs, housekeeping, transporters, and more.”

“HCA not only promised to uphold a safe standard of care in the ER and this hospital, it also signed a contractual agreement. It’s time for this evil corporation to be held accountable.”

In February, Mission Hospital administration sent a plan of correction to CMS, without soliciting any frontline nurses’ input. 

Chuleenan Svetvilas is a communications specialist at National Nurses United.