Understaffing Issues at Mission Hospital Prompt Federal Complaint from Buncombe County

Understaffing Issues at Mission Hospital: Buncombe County Files Federal Complaint

In Asheville, North Carolina, recent challenges facing Mission Hospital have come to light following a federal complaint filed by Buncombe County. This complaint, lodged on September 4, 2024, highlights a substantial financial burden on local taxpayers, amounting to an eye-popping $3 million, all while patients find themselves facing longer waits in the hospital’s Emergency Department.

A Shift in Policy

The crux of the complaint revolves around a change in policy by HCA, the parent company of Mission Hospital. Initially, when patients needed to be transferred from rural hospitals, they could go directly to an inpatient bed with a physician’s request. However, the new policy now mandates that these patients must first be admitted to the Emergency Department. This shift, according to the county’s filing, not only inflates medical bills but also leads to additional charges that the patients would not have encountered previously.

In their complaint, Buncombe County asserts that this new requirement allows the Emergency Department to function as a profit center, keeping patient volumes high, albeit at the expense of timely care. The complaint points out that making decisions regarding patient admissions now involves a transfer center and non-physician staff, raising concerns about the quality of care being provided.

Waiting Times on the Rise

Worryingly, the complaint goes on to detail how the average wait times for patients coming from Buncombe County Emergency Medical Services (BCEMS) have spiked dramatically. From a manageable average of just 9 minutes and 41 seconds in early 2020, the wait has ballooned to a concerning 17 minutes and 41 seconds by late 2023. Moreover, the ’90th percentile time’—which tracks how quickly 90% of EMS-to-ER patient transfers occur—has climbed from 16 minutes to over 32 minutes, making a significant jump that far exceeds the nationally recommended 20-minute standard.

In 2018, prior to HCA’s acquisition of the hospital, nearly 96% of ER patient handoffs were completed within the ideal 20-minute mark. Fast forward to the third quarter of 2023, and this efficiency plummeted to about 72%. Such a significant drop raises serious concerns about the hospital’s operational effectiveness and its ability to promptly care for patients.

Legal Actions and Community Impact

The complaint also states that Buncombe County has been compelled to step in and provide additional services to manage the overwhelmed Emergency Department, including supervision, housekeeping, and patient care. Despite sending a request for reimbursement to HCA for these costs, the county claims it has received no response, further complicating the situation.

Moreover, the staffing issues have not gone unnoticed by the staff at Mission Hospital. Many nurses have expressed their frustrations, leading to an overwhelming vote to authorize a strike as morale has dropped due to the increasing challenges. This development underscores the strain not only on the patients but also on those who work tirelessly at the hospital.

What’s Next?

As the legal proceedings unfold, HCA has been granted additional time until October 11, 2024, to respond to the allegations. This situation opens up broader discussions about healthcare staffing, patient care, and the responsibilities of hospital administrations to ensure adequate service delivery.

As Asheville continues to face these pressing healthcare challenges, the community is left watching closely, hoping for swift resolutions that prioritize patient safety and well-being. With the county taking action, perhaps there is a silver lining in shedding light on the complexities and demands faced by the local healthcare system.