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Including Mission, Transylvania in Brevard, Haywood in Waynesville, and Pardee and Advent in Hendersonville, the number of beds is closer to 1350. Still not enough to fill a void left without Mission.
It's not enough period.
Many in those rural, less affluent counties will present to EDs with conditions that are non-emergent - colds, flus, minor COVID, minor injuries, etc. - because the EDs are obligated to at least do an initial diagnosis and treatment.
If you have no insurance, or no plan on paying the bill, you just show up at the ED to get a "best guess" and "some treatment."
These people flood EDs. Is it a huge problem at Mission? My guess is that it's a "medium" problem, because anyone who can't pay for urgent care in surrounding counties presents there, as well as the typical homeless/druggie Asheville population.
Quote:
Originally Posted by Lizap
HCA is for profit - if they start losing a lot of money as a result of this acquisition, they’re likely not going to want to hang onto it. Much depends on the amount of fallout from their recent statement regarding quality. Was at Advent’s ER recently and talked with a couple of people from Asheville who were there. Also I understand Advent has been given permission to build some sort of small healthcare facility closer to Asheville. My guess is there is going to be a good bit of fallout from this, just a question of how much.
But therein lies the problem. Should HCA be forced or want to sell Mission, who would buy it if it's not profitable? It very well might be. I'm not familiar with their financials.
Quote:
Originally Posted by kyle19125
HCA has no remorse or sense of pride in its operations, so don't count on it unless the bottom line turns to red ink. Given Mission's monopoly-like status any change won't happen soon unless they somehow lose accreditation status.
Like I said previously, this won't happen because they are the only game in the immediate area, and the government would not cut off the seniors dependent on Mission services.
There will be multiple "strongly worded letters," some things will get addressed, many others will get kicked down the road, and the beat will continue indefinitely.
Many in those rural, less affluent counties will present to EDs with conditions that are non-emergent - colds, flus, minor COVID, minor injuries, etc. - because the EDs are obligated to at least do an initial diagnosis and treatment.
If you have no insurance, or no plan on paying the bill, you just show up at the ED to get a "best guess" and "some treatment."
These people flood EDs. Is it a huge problem at Mission? My guess is that it's a "medium" problem, because anyone who can't pay for urgent care in surrounding counties presents there, as well as the typical homeless/druggie Asheville population.
But therein lies the problem. Should HCA be forced or want to sell Mission, who would buy it if it's not profitable? It very well might be. I'm not familiar with their financials.
Like I said previously, this won't happen because they are the only game in the immediate area, and the government would not cut off the seniors dependent on Mission services.
There will be multiple "strongly worded letters," some things will get addressed, many others will get kicked down the road, and the beat will continue indefinitely.
Could be that another entity might feel they could turn things around. The problem for HCA is there are substitutes (e.g., Advent, Pardee) within 15-20 miles. Especially if someone lives in south Asheville, I could see them opting for one of these. We had our colonoscopies done at Mission, but after hearing their statement regarding quality, we’ll opt to go to Advent for future procedures.
Could be that another entity might feel they could turn things around. The problem for HCA is there are substitutes (e.g., Advent, Pardee) within 15-20 miles. Especially if someone lives in south Asheville, I could see them opting for one of these. We had our colonoscopies done at Mission, but after hearing their statement regarding quality, we’ll opt to go to Advent for future procedures.
When I moved all of my medical care over to WNC, my main requirement was to avoid Mission where I could because of the things that I've heard.
The issue is for people like us in Madison County who are farther away from the other options. It's also an issue for the elderly and folks who can't drive/can't get off
I would say Mission would probably be the most profitable hospital in the area. Asheville isn't poor. It's big, so the most profitable procedures would likely be done there. There's some indigent care, but there would also be a lot of gold-plated corporate plan people going there.
I don't see any reason why better management couldn't turn things around. A lot of the issues go back to staffing, which is, in large part, a pay issue. Pay to keep enough competent staff around, treat them well, and many of the issues that people are complaining about would resolve themselves.
When I moved all of my medical care over to WNC, my main requirement was to avoid Mission where I could because of the things that I've heard.
The issue is for people like us in Madison County who are farther away from the other options. It's also an issue for the elderly and folks who can't drive/can't get off
I would say Mission would probably be the most profitable hospital in the area. Asheville isn't poor. It's big, so the most profitable procedures would likely be done there. There's some indigent care, but there would also be a lot of gold-plated corporate plan people going there.
I don't see any reason why better management couldn't turn things around. A lot of the issues go back to staffing, which is, in large part, a pay issue. Pay to keep enough competent staff around, treat them well, and many of the issues that people are complaining about would resolve themselves.
A huge undiscussed issue with HCA Mission and other HCA hospitals is their tendency to staff skilled providers like RNs and diagnostic techs as independent contractors so they don't have to pay sizeable benefits packages. The end result is non-union RNs for example who are "rewarded" with patient care ratios of eight to one in many instances, versus the standard of four to one and one of the major reasons for Mission's poor performance.
A huge undiscussed issue with HCA Mission and other HCA hospitals is their tendency to staff skilled providers like RNs and diagnostic techs as independent contractors so they don't have to pay sizeable benefits packages. The end result is non-union RNs for example who are "rewarded" with patient care ratios of eight to one in many instances, versus the standard of four to one and one of the major reasons for Mission's poor performance.
Those nursing contractors also tend to make far, far more on the dollar than their FTE counterparts.
I'm in IT, but the hospital system I worked for was paying an agency $300/hr. for an IT analyst on my team. Most of our staff were in the $60k range - myself and the other senior analysts were $85k-$100k.
We were paying this kind of money for analysts and engineers all over the place. Contract labor for nurses was a huge expense. IIRC, contract labor costs were over $10m a quarter when I left.
Those nursing contractors also tend to make far, far more on the dollar than their FTE counterparts.
I'm in IT, but the hospital system I worked for was paying an agency $300/hr. for an IT analyst on my team. Most of our staff were in the $60k range - myself and the other senior analysts were $85k-$100k.
We were paying this kind of money for analysts and engineers all over the place. Contract labor for nurses was a huge expense. IIRC, contract labor costs were over $10m a quarter when I left.
There's about a $5-$6 per hour variance in the Orlando area for RN salaries between HCA and Advent for example. About $200 a week more for no benefits, no union representation and a much larger workload. Not quite a great trade-off.
It is worse than I imagined. I get the local news since we like the area and have considered a move there. An article describing the care had a link to a filed complaint. https://wlos.com/resources/pdf/7de15...Complaint1.pdf
Some details in the complaint are just unimaginable. No wonder people are dying there.
"Doctors and nurses are forced
to treat patients in the waiting room, without even the bare minimum
equipment or patient privacy protections, let alone adequate staff. Surgeons
lack sterile equipment because HCA refuses to pay staff to clean surgical
instruments.2 Local emergency management services are frustrated—and, in
one county, have stopped sending ambulances to Mission—because of how
long it takes for their patients to be transferred into the emergency
department"
"Mission
Hospital’s comprehensive cancer treatment facility, no longer employs a
single medical oncologist" so patients have to travel to the triangle or Charlotte for their cancer treatments. How do you have a cancer treatment facility with no oncologist??? And why are sick cancer patients being forced to make lengthy trips that will tire them out and damage their health?
" The longer an ambulance idles outside Mission
waiting to transfer a patient to the emergency room, the fewer paramedics
are available to respond in a timely manner to life-or-death medical
emergency calls. To get ambulance patients to a bed more quickly, some
county-employed paramedics have resorted to cleaning Mission Hospital’s emergency rooms themselves."
It really sounds like this hospital should be forcibly sold to a more responsible owner. Who would go there with the under staffing and unclean conditions?
It is worse than I imagined. I get the local news since we like the area and have considered a move there. An article describing the care had a link to a filed complaint. https://wlos.com/resources/pdf/7de15...Complaint1.pdf
It really sounds like this hospital should be forcibly sold to a more responsible owner. Who would go there with the under staffing and unclean conditions?
You go there when it's an emergency or when you can't afford/have no way to get to a better option.
The sad thing about medical care is that it's becoming increasingly necessary to live in/very near a major metro area to get quality treatment in most cases.
Being from northeast TN, in the past, more complicated cases were sometimes sent to Mission. I never hear of that now. We've been through some of the same type of situation in the Tri-Cities due to a merger, declining quality outcomes, lack of staff, well-regarded specialists bailing out, etc.
When our system was forming in 2017/2018, the IT department I was in lost an executive and quite a few of the individual contributors that he was influential in hiring to Wake Forest Baptist Health. IIRC, they merged with an additional system in the Triad, then that combined entity was bought out by Atrium a few years after that. I heard many of these same complaints from former colleagues who ended up there.
FWIW, my girlfriend's best friend worked at Mission for nearly twenty years. She ended up moving to a health system in upstate SC after she got married to a guy who lived down there and relocated. She despises it and wishes she was back at Mission.
Healthcare everywhere is a disaster. I spent years working for a hospital system, now work for a local government, and would never go back to healthcare if I had any other options.
There is hope. I’ve read Advent is building a small hospital in west Asheville. Certainly, it won’t be on the same level as Mission, but it is an excellent run operation, and will at least give people in Asheville another option. I suspect it will have an ER; Advent near Hendersonville has an excellent ER. My guess is Advent would be very interested in purchasing Mission, if they had the opportunity.
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