North Carolina Attorney General Josh Stein announced on Dec. 14 that he is suing the Nashville-based, 182-hospital HCA Healthcare system for allegedly reneging on its promise to maintain consistent emergency and cancer care delivery in western North Carolina, following its 2019 purchase of the Asheville, N.C.-based Mission Health System.
The Winston-Salem Journal’s Richard Craver reported on Thursday afternoon that “HCA Healthcare, the for-profit owner of Mission Health System in Asheville, is being sued by N.C. Attorney General Josh Stein for failing to meet obligations in its 2019 purchase agreement. The attorney general’s office conducts anti-trust reviews of hospital merger applications. The complaint, filed Thursday in Buncombe County Superior Court, includes a fact sheet on how the AG's office has determined HCA is not meeting its contract obligations. Stein claims HCA ‘is not providing the quality, consistent emergency and cancer care for western North Carolinians it committed to deliver.’”
Attorney General Stein made the following statement in announcing the lawsuit on Thursday: “For-profit HCA has broken its promise to the people of western North Carolina and to my office. Quality health care is too important – in some cases, a matter of life and death. But HCA apparently cares more about its profits than its patients. The doctors, nurses, and medical staff at Mission HCA have worn themselves to the bone trying to care for patients without the necessary resources or support. They deserve our gratitude, but they and their patients also deserve better. I’m taking HCA to court to make sure it lives up to the agreement it made when it bought non-profit Mission in 2019. That’s what the people of western North Carolina deserve.”
In the announcement, AG Stein’s office added that, “When HCA purchased Mission, Attorney General Stein negotiated additional health care protections for patients because he was concerned that HCA would cut critical services that the community needs. HCA promised not to discontinue emergency and trauma services or oncology services at Mission Hospital until at least 2029. Over the last several years, the North Carolina Department of Justice has heard from hundreds of North Carolinians about the issues at HCA and received more than 500 complaints. Patients specifically have raised concerns about emergency and trauma services and oncology services. Attorney General Stein is asking the court to order HCA to restore emergency and trauma services and oncology services to the level Mission Hospital provided before HCA took over.”
A copy of the complaint can be found here.
The Winston-Salem Journal’s Craver reported that “HCA Healthcare's N.C. Division deferred comment to Nancy Lindell, Mission's director of media and public relations, who cited Stein's bid for 2024 Democratic governor nomination in her remarks. ‘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,’ Lindell said. ‘Importantly, the independent monitor confirmed our compliance with that agreement during its most recent review. This lawsuit will not have any impact on our commitment to the community we are proud to serve.’”
As Craver noted, “The complaint comes as Stein has become more vocal regarding the ripple effects of health-care system acquisitions and mergers. Local high-profile examples that Stein approved include: Atrium Health’s acquisition of Wake Forest Baptist Medical Center in October 2020; the merger of Atrium and Advocate Aurora in December 2022 that formed the nation’s fifth-largest health-care system; and Novant Health Inc.’s acquisition of New Hanover Regional Medical Center in February 2021.”
As Mitchell Black of the Asheville Citizen-Times explained it on Thursday afternoon, “North Carolina Attorney General Josh Stein filed a momentous lawsuit that accused HCA Healthcare of failing to provide the level of emergency services and cancer care it agreed to when it purchased the Mission Health system in 2019. Stein, who is running for governor, announced the filing at a Dec. 14 news conference in Downtown Asheville. The lawsuit Stein filed in the General Court of Justice’s Superior Court Division is asking the court to demand HCA restore the emergency and oncology services to its pre-sale conditions. Stein’s office notified Dogwood Health Trust in a late October letter that HCA violated the commitments it made when it bought the Mission Health system in 2019. Dogwood is the nonprofit entity that received the proceeds of the $1.5 billion purchase. It is responsible for overseeing HCA’s compliance with those commitments and delivers grants to Western North Carolina organizations,” he noted.
Stein’s lawsuit, filed in Buncombe County Superior Court, asks the court to declare that HCA has breached its asset purchase agreement, issue a permanent injunction to restrain HCA from committing such breaches, and require HCA to provide emergency and cancer services at the level they were prior to 2019.
In response to an inquiry by Stat News’s Tara Bonow on Thursday, Mission’s Lindell emphasized the fact that Stein is currently running for governor, leading with, “We are aware of the announcement Gubernatorial Candidate Stein made in Asheville today.” Lindell wrote that HCA is confident it continues to meet the obligations under the purchase agreement. She pointed out that the independent monitor appointed to oversee HCA’s compliance found no problems during its most recent review. “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,” Lindell said. “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.”
