County joins suit, accuses Mission of ‘parking’ patients with EMS

ASHEVILLE, N.C. (828newsNOW) – Buncombe County has filed a motion seeking to intervene in the North Carolina Attorney General’s lawsuit against HCA Healthcare’s Mission Hospital, saying county taxpayers lost more than $3 million from emergency room delays that amounted to “parking” patients in the care of Emergency Medical Services (EMS) personnel.

Attorney General Josh Stein filed suit against HCA in December 2023, accusing it of breach of contract in failing to provide emergency, trauma and oncology services at the same level that existed before the company purchased the Mission Health system in 2019.

HCA has disputed Stein’s claims from the beginning, with spokeswoman Nancy Lindell releasing a statement at the time saying, “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,” according to a report published in December by BPR News.

Lindell offered a similar, but brief, statement Wednesday in response to Buncombe County’s motion to intervene in the case.

“We’ve received the motion and we will continue to defend the lawsuit vigorously,” Lindell said in an email to 828newsNOW.com.

Buncombe County’s motion, a proposed Intervenor Complaint, was filed Wednesday in Buncombe County Superior Court.

The complaint accuses HCA of “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 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.”

In a press release, the county cited EMS wait times that increased from 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 peak times (the times when 90 percent of patient transfers typically occur), transfer times allegedly doubled, from 16 minutes to more than 32 minutes, the county alleges.

The county’s release states: “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.”

As reported earlier this week, the Department of Health and Human Services’ Centers for Medicare & Medicaid Services (CMS) has “reviewed and found acceptable” Mission Hospital’s plan of corrective action related to delays in triage and medical screening in the emergency department. However, the facility still remains in jeopardy of having its Medicare provider terminated early this summer.

“When the North Carolina State Survey Agency has determined that the noncompliance with (federal Emergency Medical Treatment and Labor Act) requirements has been corrected, CMS will withdraw its current termination action,” a notice stated. “Failure to correct the deficient practice by June 5, 2024, will result in the termination of your Medicare provider agreement.”

A related report, first obtained by Asheville Watchdog and later obtained independently by 828newsNOW, detailed a case of  “Patient #2,” a 66-year-old who was brought to the hospital by ambulance on Oct. 17, 2023, faced delays in getting evaluated and treated, and subsequently had a fatal cardiac arrest.

One Emergency Medical Service (EMS) provider told investigators that it was at least one hour and 17 minutes after arrival before EMS was able to give a hand-off report to a nurse. “Interview revealed waits had gotten more common recently and it seemed like a staffing issue,” an investigator summarized in the report.

In a statement on Monday, Lindell said the hospital was pleased that its amended plan had been accepted as of the March 26 notice.

“As we continue to state, we take these matters very seriously and have made significant process changes to improve our patient care experience,” she stated.