A recent lawsuit filed against HCA Healthcare, the owner of Asheville’s Mission Hospital, highlights issues with emergency room wait times and the burden on rural patients. Buncombe County officials initially brought the case against HCA in state court, alleging that ambulance transport delays have resulted in unnecessary medical processes that double costs for patients and worsen emergency room overcrowding. HCA requested to move the lawsuit to federal court.
County leaders argue that Mission Hospital’s emergency room is understaffed, causing delays for ambulance crews who must wait with patients for lengthy periods. HCA, through spokesperson Nancy Lindell, maintains their disagreement with the lawsuit’s claims and emphasizes their intention to defend against it.
The lawsuit also sheds light on the challenges faced by rural healthcare in Western North Carolina. Patients transferred from smaller facilities, such as those in Brevard and Highlands, must now be rerouted to Mission’s emergency room instead of being directly admitted to inpatient beds, a process that changed following HCA’s acquisition of the hospital. Previously, a joint decision made by physicians determined the appropriateness of transferring a patient.
Under the new process, transfers are handled through a “transfer center,” where non-physicians decide on patient routing, typically leading to a visit to the emergency room even when it may be unnecessary. The lawsuit alleges that this procedure not only delays patient care but also serves to increase HCA’s profits while contributing to emergency room congestion.
The repercussions of these policies extend to rural areas such as Transylvania County, where the only local hospital is also owned by HCA. Mayor Maureen Copelof of Brevard stated that delays in emergency room processing greatly hinder local emergency medical service capabilities, leaving the community vulnerable during critical times.
In 2022, the city of Brevard, led by Mayor Copelof, had filed a separate lawsuit against HCA for allegedly monopolizing healthcare in several counties in Western North Carolina. Copelof highlighted the detrimental effects of HCA’s practices on access to quality health care in the region.
HCA, one of the largest hospital systems in the United States, has faced increasing scrutiny from local communities and elected officials in Western North Carolina since 2019. The Buncombe County lawsuit is part of a broader pattern of legal challenges facing the organization, including actions initiated by local and state officials.
Patients are beginning to seek alternatives, turning to facilities in Georgia rather than relying solely on services offered in Asheville. Residents in Highlands, located in Macon County, report that while HCA operates two hospitals in the area, neither offers a full array of services that larger hospitals provide.
In Macon County, emergency services are limited due to the vast mountainous terrain, which complicates transport options. Director of Macon County Emergency Services, Warren Cabe, indicated that crew decisions are made judiciously with patient priority in mind, ensuring local resources remain available.
With these ongoing legal battles and growing community concerns over healthcare access, the situation in Western North Carolina continues to evolve.