Buncombe County seeks $3 million in damages from Mission/HCA

Press release from Buncombe County:

On Wednesday, April 3, Buncombe County filed a Motion to Intervene and proposed Intervenor Complaint in Attorney General Josh Stein’s lawsuit against HCA for breach of contract requesting a permanent injunction and compliance with its obligations to provide emergency and trauma services and oncology services at the same level of quality provided at Mission prior to HCA’s purchase of the hospital. While the County is supportive of the attorney general’s suit against Mission/HCA, the motion seeks damages for the extensive wall times the County’s emergency services staff has experienced while transporting patients to the emergency room.

In part, the proposed complaint states: “In the years following their acquisition of the previously nonprofit Mission hospital system in early 2019, Defendants have disregarded their statutory, contractual, and common-law obligations, allowing emergency services at the Emergency Department at Mission Hospital (the “Mission ER”) to deteriorate dramatically. In particular, during relevant times, Defendants intentionally understaffed the Mission ER so that Buncombe County’s EMS crews often experienced excessive wait times to transfer patients to the Mission ER, requiring EMS personnel to attend to emergency room patients long after arriving at the Mission ER.”

Central to the motion are EMS wait times at Mission, which increased from approximately 9:41 minutes in the first quarter of 2020 to 17:41 minutes in the third quarter of 2023, despite numerous requests and demands from County staff and management to expedite care in the ER. At the same time, “90th percentile times” – the time in which 90% of EMS-to-ER patient transfers occur – increased from approximately 16 minutes to more than 32 minutes. These 90th percentile times far exceed the 20-minute national standard reported by the National Emergency Medical Services Information System.

As a result of Mission “parking” ER patients with Buncombe County EMS, taxpayers have provided a benefit to HCA of more than $3 million since the beginning of 2020, and the County seeks damages in that amount as outlined in the proposed complaint.

The proposed complaint maintains that Mission continued to shirk responsibility to patients at the expense of the County until:

• The Attorney General filed this action on December 14, 2023, and
• The U.S. Centers for Medicare and Medicaid Services identified the Mission ER as a candidate for “immediate jeopardy” classification on December 9, 2023 and, after an intensive investigation, issued notice that Mission Hospital was in “immediate jeopardy” of losing CMS funding due to its disregard of ER patients’ health and safety.

The County maintains that only after such action by the Attorney General and CMS did Mission begin to take action to adequately staff its ER rather than deliberately relying on the County’s EMS to treat Mission’s ER patients. However, at any time Mission may choose to revert to previous practices, which both endanger patient safety in emergency situations and run up costs incurred by the County.

The County’s proposed Intervenor Complaint was filed just before noon today in Buncombe County Superior Court and will be assigned to the NC Business Court.