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North Carolina attorney general sues HCA for neglecting hospital emergency, cancer service quality

by John R. Fischer, Senior Reporter | December 20, 2023
Business Affairs
North Carolina Attorney General Josh Stein is suing HCA Healthcare for allegedly creating a poor care environment at Mission Health.
North Carolina’s Attorney General is taking HCA Healthcare, the largest health system in the U.S., to court for allegedly failing to provide quality emergency and cancer care at Mission Health System, as it promised to do when it acquired the nonprofit in 2019.

According to NC Attorney General Josh Stein, HCA promised to not discontinue trauma or oncology services at Mission Health until at least 2029. But concerns about these services are among the more than 500 complaints that hundreds of state residents have submitted to the North Carolina Department of Justice over the last several years.

Among them are reports of patients being treated in hallways, waiting nearly a day to be seen, not being fed, sleeping in soiled beds, leaving the hospital without being seen, and more. Cancer patients have said they waited months to be seen or have had to find other care sites due to the mass number of physicians and nurse practitioners leaving Mission Health. The hospital also shut down its retail pharmacy and stopped offering treatments for leukemia and lymphoma, according to the complaints.

“The doctors, nurses, and medical staff at Mission HCA have worn themselves to the bone trying to care for patients without the necessary resources or support. They deserve our gratitude, but they and their patients also deserve better,” said Stein in a statement.

Stein is asking the court to order HCA to restore emergency, trauma, and oncology services to the level Mission Hospital provided before HCA took over. He previously warned the healthcare system in a notice sent on October 31 to Dogwood Health Trust, a nonprofit set up to receive the proceeds from the $1.5 billion acquisition in 2019, that gave HCA 40 days to correct the alleged violations of the purchasing agreement it signed.

"We remain confident that we continue to meet, and often exceed, the obligations under the Asset Purchase Agreement that the Attorney General approved at the time of our purchase, and we intend to defend the lawsuit vigorously," Nancy Lindell, director of media and public relations for Mission Health, told HCB News.

She added that the state is not "allowing important expansions at Mission Hospital" and that the lawsuit "is no reflection on the dedication of our doctors, nurses and colleagues," as acknowledged by Stein.

In his complaint to the court, Stein says he had reservations before the deal was made that HCA’s “profit-driven business model” would lead to essential medical services being cut in western North Carolina and “demanded” that HCA agree to additional protections, including a 10-year agreement not to cut emergency, oncology, and other critical services.

Instead, he says that doctors and nurses have ended up treating patients without proper or sterile equipment and with limited staff. Additionally, emergency management services in one county have stopped sending ambulances due to long waits to transfer patients, and there is not one single medical oncologist left at the Mission Cancer Center.

“These breaches, moreover, have inflicted significant harm on medical professionals, patients, and citizens throughout the region. HCA’s gross mismanagement of the emergency and trauma and oncology departments is putting the medical professionals who work in those departments in an impossible position,” wrote Stein in his complaint.

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