Report Details Shoddy Care at Hospital, "Broken Trust" with the Community
A group of local leaders issued a report based on input from residents that listed systemic problems at Transylvania Regional Hospital. Owner HCA Healthcare Inc. disputes the claims.
BREVARD — In December of 2022, a man was rushed to Transylvania Regional Hospital after a fall in his bathroom left him with severe facial injuries.
Once his wounds had been sutured, he was transported to Asheville’s Mission Hospital. He needed surgery for multiple fractures, he learned once he had arrived, but after a 22-hour wait in the emergency room, he was told the operation couldn’t be performed for another two to three weeks.
Discharged with a supply of pain medication, he traveled the next day to a South Carolina hospital, where a doctor operated immediately.
“The staff and doctors at Greenville Memorial Hospital were in disbelief of what Mission Asheville had done.”
This was one of more than a dozen harrowing stories of inadequate care included in a report released Tuesday by the Community Engagement Council for Transylvania Regional Hospital, a group of public and private county leaders formed last year.
Its report also documented “confusion and overlap in regard to billing,” and “major staffing cuts, significant turnover, and (a) toxic work environment.”
It cited the elimination of some services, such as adult daycare, and said the hospital has “struggled with staffing some foundational services such as general surgery.”
Based on these findings, the report concluded that HCA Healthcare Inc. — which in 2019 bought the hospital from then-nonprofit Mission Health — had “broken the trust and lost the confidence of this community.”
Some of the assertions in the report are “seriously and obviously inaccurate,” Nancy Lindell, Mission Health’s Director of Public and Media Relations wrote in response.
“The number of physicians on our medical staff has remained relatively constant,” she wrote, and the “rate of nurse turnover at TRH is the lowest that it has been in more than a year.”
Beyond describing problems at the hospital, the Council’s report listed three options for the HCA to repair both its claimed inadequacies and the hospital’s relationship with local residents.
The “best, most obvious approach would be for HCA to accept the validity of this report” and correct the issues it detailed, the report said. The second would be to agree to bring in a third-party consultant to “conduct a performance audit and develop workable solutions which HCA would commit to implement.”
The third option revived a suggestion that HCA CEO Sam Hazen rejected after meeting with Brevard Mayor Maureen Copelof and other community leaders last May: “Agree to sell the Transylvania Regional Hospital back to the community or to a consortium established by the community.”
That meeting sparked the formation of the Council, the members of which include Copelof, County Commission Vice Chair Jake Dalton and several leaders of local businesses and nonprofits.
Starting in August, the Council held nine “listening sessions'' throughout the county that drew more than 200 residents. Among the incidents these residents described:
On the Saturday before Labor Day, a male patient arrived at the hospital with leg pain. An emergency room doctor told him she didn’t “think” it was due to a blood clot.
Not only did he have a clot, he learned after he later followed up with another Mission doctor, it was severe enough to require surgery and a five-day hospital stay.
In July, a woman suffering from severe back pain and a full bladder in desperate need of catheterization was admitted to the Transylvania hospital. Throughout the night “no one provided her any care . . . (and) she ended up lying on the floor, the only way she could get relief.”
The Mission Health staff “looks into every concern and works diligently and quickly to address them,” Lindell wrote. “Unfortunately, because many of the examples listed in the ‘report’ lack detail or are second-hand accounts, we cannot respond to them.”
Lindell didn’t respond directly to a question about whether HCA would consider the report’s recommendations. But her email made it seem unlikely.
Hazen had pledged cooperation at the meeting last May, but soon afterwards, the “city of Brevard filed an apparently long-planned, but never disclosed, lawsuit against us,” she wrote. “For obvious reasons, we cannot participate in a group whose most vocal member (Copelof) is actively litigating against us.”
This federal, class-action, antitrust complaint claims that HCA’s large share of the healthcare market in Western North Carolina had caused skyrocketing medical costs and “dramatically worsened facility conditions and patient services.”
One of several examples of inflated costs listed in the suit was for shoulder arthroscopy: “The Mission-Asheville price for this procedure was $2,419 — nearly three times the statewide average of $897.”
In September, HCA’s lawyers moved to dismiss the suit, arguing that the city had produced no proof that its “alleged monopoly” is illegal. A judge in the case, which has been joined by the city of Asheville and Buncombe and Madison counties, has not yet ruled on this motion.
In this week’s report, the community group wrote that HCA should not cite the suit as reason to end cooperation because the “Council was not involved in the lawsuit.”
Copelof, in an interview Wednesday morning, said the two matters would remain separate and that the Council would not use the suit as leverage in any upcoming negotiations with HCA.
“We certainly don’t have the economic power that HCA has,” Copelof said, acknowledging limited ability to apply direct pressure on the company.
“But we’re speaking with the moral voice of the community.”
Email: brevardnewsbeat@gmail.com
My wife sustained a severe fracture of her femur just below the hip joint on 3 FEB. She was taken to Transylvania Regional Hospital's Emergency Department, where she received timely, compassionate, and professional care. She had very involved surgery to stabilize the fracture. The Orthopedic Surgeon communicated with me very well and did a fine job repairing the injuries and getting her on the lengthy road to recovery. The Med/Surg floor was her home for the next 3 weeks... and they treated her like she was at home. The level of care she received was on par with any other hospital we have been served by.
I have also been served by various departments of the hospital and have enjoyed the same professional, competent, and caring level of service in every encounter.
Would be interesting to know who bought HCA long before HCA bought Mission. Hint: Private Equity investment companies. And you know what they're famous for.