The North Carolina attorney general's office is asking the state health department to deny HCA Healthcare's certificate-of-need application to add 26 acute care beds to its Asheville-based Mission Hospital.
The move follows a recent effort to push Nashville, Tenn.-based HCA Healthcare, one of the largest ASC operators, to give up control of the system.
HCA, however, maintains that it can meet the growing need for complex medical and surgical services in the region.
"The current utilization of Mission Hospital's services is very high, including services related to the ICU and adult medical and surgical beds. Currently, Mission Hospital accepts thousands of patient transfers from other hospitals across the region," A spokesperson for Mission told Becker's. "These transfers reflect a need for the addition of higher acuity beds and services offered by Mission, which will meet the needs of patients in western North Carolina. Additionally, if approved, Mission believes that it can make these beds available on a more expedited timeline than other applicants."
Here are five more things to know:
1. HCA isn't the only health system looking to expand in the region. Altamonte Springs, Fla.-based AdventHealth and Winston-Salem, N.C.-based Novant Health have both submitted CON in the area.
2. Reclaim Healthcare WNC, a group of physicians, nurses, elected officials and community advocates, have criticized HCA's alleged "harmful culture and practices" and launched a campaign to replace HCA with a nonprofit organization.
3. Leaders at Reclaim have criticized several changes at HCA, including the closure of two family medicine practices with only 45 days notice, the failure of HCA to maintain relationships with physician groups and the departure of more than 200 physicians and 600 nurses, among other allegations, according to a July 28 editorial published in The Citizen Times.
4. "Any grant of a certificate of need should promote competition and advance the state medical facility plan's basic principles of safety, quality, access and value. Granting Mission's application would do neither," North Carolina Attorney General Josh Stein wrote in the July 29 letter.. "The large market share for acute care services that Mission already enjoys in western North Carolina makes it a poor candidate to promote competition in that region. And Mission is failing to provide safe, quality, accessible and affordable care in the region at its existing facilities."
5. The health system is also facing a lawsuit from the North Carolina attorney general's office alleging it cut emergency and cancer care at Mission Health, lapsing on its 2019 purchase agreement.
"Though there have been challenges, some of which we are continuing to address as we work to expand our capacity, we remain committed to serving our community," Mission said in a statement after the complaint was filed. "Despite the state not allowing important expansions at Mission Hospital, we will continue to fight for critical access to healthcare services for the people of Western North Carolina. As the Attorney General acknowledged, this lawsuit is no reflection on the dedication of our doctors, nurses and colleagues who serve our patients every day. This lawsuit will not have any impact on our commitment to the community we are proud to serve."