Mission criticized on staff shortages, patient care

LOW MORALE: Black Mountain resident Kitty Kelly said that when a relative was at Mission Hospital recently, she found that staffing levels are so low that, “Nurses are in tears. Nurses are covering way too many patients.” Photo by Mark Barrett

Finding a nurse to answer a patient’s call, someone to prepare equipment for surgery or even to clean a room at Mission Health is often an exercise in futility, speakers said at a Feb. 10 meeting to get public input on the performance of the system since it was taken over by for-profit owners.

Local elected officials, ordinary citizens and even a Mission nurse all blasted the stewardship of Nashville, Tenn.-based HCA Healthcare, which bought the collection of hospitals and other health care institutions for $1.5 billion and began running it in February 2019.

“Patients are screaming into the hallways: ‘Please help! Help!’” Dr. Carole Saltzman, a retired physician, told consultants hired to monitor HCA’s adherence to the terms of the purchase from the nonprofit that had owned and run the system.

NO CLEANUP: Dr. Carole Saltzman, now retired, said janitorial services at Mission Hospital have dwindled to the point that “patients are having to clean their own rooms, or their family members [are.]” Photo by Mark Barrett

Jennifer Kirby, a Candler resident who is a nurse at Mission’s main hospital in Asheville, tearfully told the crowd, “Every single department in that hospital that is designed to help the patient … is critically and unethically and inhumanely understaffed.

“I used to be really proud of where I worked. I’m not anymore,” she said.

Almost everyone who spoke was strongly critical of changes made under HCA. Worries about a shortage of workers and patient care dominated the discussion, but speakers also raised concerns about HCA’s charity care policy, relationships with physicians, services for deaf patients and other issues.

State Sen. Terry Van Duyn, D-Buncombe, read a letter from herself, Mayor Esther Manheimer, county Board of Commissioners Chair Brownie Newman and Buncombe County’s three state House members that called for changes in what the letter says are “unacceptable” outcomes of the sale. The co-authors stood beside Van Duyn.

The letter notes predictions Mission officials made before the sale that HCA would turn a profit at Mission by making purchasing and back office functions more efficient.

“It is clear now that this was a lie,” the letter says. “Instead, HCA has chosen to make its money by reducing charity care, eliminating medical and unit administrative staff to the detriment of patient care and safety, and sacrificing entire physician practice groups with long-standing contractual relationships by demanding significant reductions in pay.”

A shortage of staffers is “putting patient safety at risk,” the officials said.

Several people said it is also harming employee morale.

“I have lots and lots of friends who work for Mission,” said Fairview resident Barbara de Loache. “They are miserable.”

NOT ENOUGH: Candler resident Jennifer Kirby, who has been a Mission Health nurse for nearly 15 years, said its main hospital is “critically and unethically and inhumanely understaffed.” Photo by Mark Barrett

The meeting is one of several being held around Western North Carolina by Gibbins Advisors, a consulting firm hired by Dogwood Health Trust, the nonprofit that received proceeds from the Mission sale. The legal requirements Gibbins is monitoring generally have to do with provision of specific services rather than quality of care, but a Gibbins official told the crowd it would relay all of the concerns to Dogwood and HCA.

Mission spokeswoman Nancy Lindell said Feb. 11 that system officials “heard the passionate voices of our community. This feedback is important to us and, as such, we have been and continue to actively work with both our local and corporate leaders to identify opportunities for improvement.”

She said the past year “has been a time of enormous transition for our organization and … we have sometimes created confusion by not effectively communicating about changes.” The system will evaluate next steps once the current round of similar meetings around WNC is complete, Lindell said.


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18 thoughts on “Mission criticized on staff shortages, patient care

    • C-Law

      Your instincts are in the right place Jay, but it really isn’t about “for-profit” vs. ‘non-profit.” It is much bigger than that…

      As I pointed out to my late parents a number of years ago The Democrat Party they were aligned with since my youth no longer exists and has become an existential threat to the nation.

      My late father and I had a number of “spirited” debates, including his staunch support of policies that included financially raping people, specifically through the medical monopolists. He strongly supported being able to “get what was his” when it came to Medicare, even though he was a CPA and knew damn well what the math looked like when it came to the spending growth rates. He also knew it was all a scam too; as I’ve repeatedly pointed out, and he was well aware of, while it is true there are more old people today over the last 25 or so years that number has increased by 30% while Medicare and Medicaid spending has gone up by a factor of FIVE.

      Was Medicare an actual contractual promise? Yep. For you, I, and everyone else. Offer, Acceptance, Consideration, Performance. The basic elements are all there. If Congress deems it otherwise we have a right of enforcement via whatever means are necessary; if you cannot find recourse in the law then lawless it shall be.

      The claim of force majure is illegitimate. If a population increases by 30% then it’s reasonable for the cost of same to go up by 30%. This is a temporary increase, since of course everyone dies, and the “pig in the python” problem was not only known it was explicitly designed for in both Social Security and Medicare.

      You cannot claim “force majure” and thus the ability to abrogate said agreement if you not only knowingly let people rob the bank, as has occurred here with the medical scammers, but you knowingly, on both sides of the aisle, allow blatantly illegal acts to take place that increase the cost of said program by 500%, bankrupting it.

      Worse, these acts have created a class of citizens rapidly approaching one in five that personally benefit from these scams in the form of “jobs.” Those people are all co-conspirators whether they recognize their role in the scheme or not.

      You want the ingredients for a Civil War? The former one was over tax, trade and slavery. This one will be over those who rip the people off for $3 trillion a year, cause the collapse of government finance and the 536 jackasses in DC who not only refuse to put a stop to it but who cheer it on. And no, those who are tired of that crap are not going to give up any of their guns — except when they’re hot, dirty and empty. That’s a check you can cash.

      The people have had it with the effects but have been lied to for 30+ years about the cause, and since we now live in a Facesucker generation where nobody can manage to spend 10 minutes on their own research (it’s not like the Treasury’s financial statements are hidden or something; you can trivially verify everything I said up above) so what you get is a population squeezed, a roaring stock market while at the same time 90+% of the people are being dispossessed of everything they have. Keep it up and you get violence. That’s not a wish, it’s not a desire, it’s a historical fact that has repeated time and time again throughout history.

      There is no political party left for those who don’t care who you **** but do care about fiscal sanity. As I pointed out when the Tea Party was co-opted about 10 years ago and I stuck up my middle finger in their direction The Republicans are now the party of Guns, Gays and God; one against and two for. What if you’re not Christian and believe in the 2nd Amendment? The Republicans are not for you. What if you’re gay and believe in the 2nd Amendment? Ditto. Where do you go if you’re in that group in a political context? Nowhere.

      When I got involved in the Libertarian Party I pointed out to the state party leadership (as part of it) that this was a ripe field and were the party to take strong platform stands on putting an immediate and total stop to the******job in the medical system while at the same time fully supporting the 1st and 2nd Amendments, never mind the 4th, it could become relevant in national politics OVERNIGHT. I was blown off and, after repeatedly banging my head against the wall trying to change minds without success, subsequently resigned.

      Last night Sanders, just as in Iowa, showed exactly what happens when you cheer this crap on. The proletariat gets tired of it at some point and if you lie often and hard enough they’ll even vote for a Communist. They now have — twice.

      As I’ve pointed out I challenge you to name a billionaire who didn’t get the money by violating anti-monopoly laws in some form or fashion — that is, someone who didn’t cheat.

      Bloomberg certainly did. He got most of his money through the lease of his terminals. Why are they basically the “only choice”? How do you get the data on an exclusive basis to become the only choice? That’s supposed to be illegal but just like the medical center that breaks Robinson-Patman along with Sherman and Clayton daily “if there’s no indictment there’s no crime”, right? The only real difference is that almost nobody has to do business with Bloomberg’s terminal salesfolk. How many people evade ever doing business with the medical rapists?

    • Lulz

      No, one of the many problems of a non profit allowed to buy up competing doctors and land with their profits. And you think more government is the solution? Government is the root of all that is bad now. People scam the system with the laws on their side.

  1. Beverly Wright

    Tennessee based HCA? Ok…we’ve got their name and where they are… They should be ashamed of themselves, but this scenario was predictable at the get-go. Had this been a hotel or brewery, certain money would have been no prob. Shame on you, Tennessee HCA.

    • Lulz

      No you should wake up. All those years of being a non profit allowed Mission to accumulate prime real estate. Which they just turned around and sold.

  2. C-Law

    But, but, but…!!!!

    Asheville City Council and the Sunrise Red Guards Movement have declared a CLIMATE CRISIS-EMERGENCY-APOCALYPSE!!!

    Issues like Mission/HCA are merely window dressing and can not be a priority or compete for resources or attention when we are in a CLIMATE CATASTROPHY!!!

    Ha, ha! How rich…I’ve said it before and I’ll say it again, the residents of Asheville and Buncombe County have gotten EXACTLY the government they DESERVE! ha ha!

    PS–to the staffing issue at Mission. A close friend was an RN at Mission from 2012-2017. Worked Neurosciences, ER, and Float Pool. Day Shift. Best wage earned was as Float Pool RN, earned $27.15/hr in 2017. Got wise to the unlivable quality-of-life conditions in Asheville and GTFO in 2017. Moved to Lincoln County, NC. Able to build a brand new home for minimum 30% less than Buncombe County (the home they wanted to build in Buncombe would have cost $325,000 on .27 ac lot, property taxes over $2,000 annual with SECU First-time buyer financing…same home was built on 3.13 acre lot in Lincoln County for $217,700 through the SECU, property taxes approx. $1,080 annual. ) Works for Atrium Health (formerly Carolinas Health System) as a day shift Float Pool RN…works in Lincolnton, Shelby, and Charlotte as needed. Earns $44.85/hr. If they wanted, they could move over to Novant-Presbyterian Health and earn an additional $2/hr, but haven’t decided to yet. They earn $33,000 more a year, pay less taxes, and live in a nicer home and larger property simply by moving 80 miles southeast of Asheville…hmm, struggle with all the BS in AVL/Buncombe earn scrape by on $50,000 a year, or live in Lincoln County, a solid middle-class lifestyle making $85,000 a year without even needing to work a single OT shift. Easy call.

    Case closed…let the “progressives” keep reaping what they’ve sowed in Asheville and Buncombe County.

    • Lulz

      You can’t battle a group of thieves who look at those with something as a way to fleece them. They either are kicked out or they run out of other peoples willingness to play by their rules and laws. Increasingly and as I get older I’m coming to the conclusion that playing in their rigged game is stupid.

      All of the issues people have with HCA can be attributed to one thing. And that’s the non profit scheme Mission took advantage of and the city was in cahoots with.

    • Lulz

      Again, Mission was a non-profit that used their profits to monopolize, capitalize, and buy.

      The only people to blame are the ones who support the scam that is 504c. How can you have a non-profit that is buying up all the prime real estate that pays no taxes? Mission isn’t the only one around here but the theme is the same. Big non-profits and big tourism own this town. Period.

      • Mike

        While it is true that there is no such thing as a “non-profit,” the difference is where does the revenue go- into the pockets of a few elite or back into the local community by supporting personnel, offering good benefits and, yes, purchasing real estate and expanding to hire more people into a positive work climate and culture?

        **Note: Not claiming Mission was perfect and I don’t see where any of the good (but overdue) reporting on this has. The point is it’s gotten worse, not better or even neutral, under HCA.

        • Lulz

          Mission did good? How? They bought out competition leaving you all with a monopoly to deal with. Paid no property taxes that others had to make up. Oh and go try and compete. See how quickly big corp puts their attack dogs in council on you with some BS law. Big tourism does the same with the private property rights of homeowners with Airbnbs.

          Wake the hell up. The scam of big corp and big government is merely a way to exploit others for their own gain. It’s disgusting.

  3. Gary Purvis

    I had numerous surgeries through April 2018, and was quite impressed with the services and staff in all areas. Then, when I had to have 5 surgeries on my knee from February-November 2018, I was quite distressed by the lack of decent service and the staff. It wasn’t necessarily their fault because they were being taxed to the limit. The food was not adequate or good. I couldn’t follow the command to wait before getting up to go to the bathroom because I couldn’t get anyone to help me and I didn’t want to pee or poop the bed. Surgery and pain is difficult the way it is, but then to have such inadequate service during my recovery was distressful. I don’t look forward to being in the hospital any longer. What a shame that for-profit hospitalization equals poor staffing/service so that the business can line their pockets. My wife has experienced the same thing with the oncology ward needing to pull out after so many years of providing good service. Please, is there not any kind of regulatory means to require the business to fulfill their responsibilities to meet the healthcare needs of the community?

  4. Beverly Wright

    Tourists! Read this…and if you, family, and friends plan to visit Aville, warn them not to get sick or have an emergency!!!!! Bad news in this city.

  5. MG Massey

    Told ya so..
    Criminal medical neglect
    When money is placed as more important than life, this is what you get.

  6. Barry

    The scam of non profit status is a joke and has been for a very long time giving a huge advantage to health care systems. So now the rubber has to meet the road and to no surprise a profit on this network is required. This is going to be difficult because too much was paid for Mission in the first place. Expect to see a further reduction in services as non-profitable components will be closed or sold off. The good news is there is some competition from other hospitals and service providers. Let’s hope they step up and fill the gap’s.

  7. Camille

    In the middle of January I had a very serious surgery. My sister stayed with me from start to finish and heard-as did I- my surgeon say that he wanted me to be sent to a rehab hospital until I recovered fully and then home health and physical therapy once I was home. I had no idea how these things work out and my sister took me home. I had no idea what I was supposed to do while I waited for their call. Nothing happened. A month into this the pain was so bad and my incision was draining profusely so I called the surgeons office crying, terrified, threatening to make a formal complaint to Medicare. I got a call the same day from my local home health and an RN and Physical Therapist showed up the next day. After they had examined my hospital records we found that the ball was dropped at Mission and they explained to me that the Paperwork that one person is responsible for comes at him/her like a tsunami; more than is humanly possible to handle without error. I’m better now 6 weeks later. I’m able to walk through my house and my incision is healing decently. I know the staff needs to work and I have no complaints about my inpatient care. I hope there will be some honest resolutions that will benefit the staff and draw more people to work there. This will automatically trickle down to the patient and the care will be better.

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