Mission Hospital in ‘substantial compliance’ after CMS scrutiny

ASHEVILLE, N.C. (828newsNOW) — Mission Hospital says it is in substantial compliance with federal requirements after the Centers for Medicare & Medicaid Services completed its review of the hospital’s corrective action plan following months of scrutiny over patient safety and care.

Mission Health President Greg Lowe told employees Wednesday that CMS completed its review of the hospital’s Enhanced Plan of Correction and determined that Mission is operating in substantial compliance with CMS requirements.

As a result, CMS will not require any additional surveys related to the agency’s January 2026 inspection, Lowe said.

“This is an important milestone for Mission,” Lowe wrote in an email to staff. “It is the result of your work over the past several months to strengthen the care we provide to our patients every day.”

The finding marks a significant change from earlier this year, when CMS placed Mission Hospital in “immediate jeopardy” following a January inspection. Immediate jeopardy is the most serious deficiency designation used by federal regulators and indicates conditions that could place patients at risk of serious harm, impairment or death.

Mission has faced multiple federal sanctions in recent years, including four immediate-jeopardy findings since HCA Healthcare acquired Mission Health in 2019.

In February, CMS required Mission to implement an Enhanced Plan of Correction and bring in an independent consultant to help oversee improvements after the January findings.

Lowe said Mission has spent the past several months focusing on staffing, training, communication, accountability and the hospital’s care environment.

He cited daily operational reviews, additional staff training, increased leadership and Environment of Care rounding, a 24/7 Patient Care Line and other measures as part of the effort.

“While we should take pride in reaching this milestone, our work is not finished,” Lowe wrote.

Mission will continue working with Bryant Healthcare Consultants through the end of the year, even though CMS no longer requires the hospital to do so, Lowe said. The hospital also will continue working with CMS as it focuses on maintaining the changes.

Independent monitor raises separate concerns

The latest CMS finding comes as Mission remains under scrutiny from state officials, community advocates and the independent monitor overseeing HCA’s compliance with the 2019 purchase agreement.

During an Aug. 4 public Q&A hosted by Dogwood Health Trust and Affiliated Monitors Inc., the independent monitor discussed two areas of potential noncompliance identified in its 2025 annual monitoring report: reductions in certain health care services and Mission Hospital’s federal regulatory standing.

The monitor cited the closure of Industrial Rehabilitation at CarePartners and service changes at Mission Hospital and Mission Children’s Hospital as examples of potential reductions in access to services covered by HCA’s commitments.

The report also raised concerns about Mission Hospital’s temporary loss of what the monitor described as “good standing” with federal regulators as it went through CMS immediate-jeopardy compliance cycles.

Those findings are separate from Wednesday’s CMS announcement that Mission is now in substantial compliance with federal hospital requirements.

The monitor’s findings have been turned over for review, giving the North Carolina Attorney General’s Office an opportunity to evaluate HCA’s response and determine whether further action is warranted under the 2019 Asset Purchase Agreement.

HCA representatives have maintained that the company is operating in full compliance with its commitments under the purchase agreement.

Lawsuit continues

The CMS finding and independent monitoring process come as a lawsuit filed by North Carolina Attorney General Jeff Jackson against HCA over its obligations under the 2019 purchase agreement moves toward trial.

North Carolina Business Court Judge Julianna Earp recently rejected most of HCA’s arguments seeking to end the case early. The lawsuit alleges HCA failed to meet commitments to maintain emergency, trauma and oncology services at Mission Hospital.

Earp ruled that the purchase agreement requires HCA to take the steps necessary to actually provide those services and allowed claims related to emergency department staffing and patient care to continue.

The ruling did not determine that HCA violated the agreement. HCA has denied the allegations and argued that it has met its obligations.

The Medicare and Medicaid concern identified by the independent monitor stems in part from a 23-day notice CMS issued to Mission in October 2025 warning that its provider agreement could be terminated. Mission submitted a corrective action plan, and CMS approved the Enhanced Plan of Correction that followed.

Mission then received another immediate-jeopardy finding during the January 2026 inspection before addressing the concerns.

The CMS finding addresses Mission’s compliance with federal hospital requirements following the January inspection. It does not resolve the separate questions surrounding HCA’s obligations under the 2019 purchase agreement, which remain under review and are the subject of ongoing litigation.

Lowe told employees the hospital’s focus now is on maintaining the progress.

“Every patient and family should be able to rely on Mission for safe, compassionate, high-quality care they can trust,” Lowe wrote. “Together, we can make this happen.”