Nurses Demand Accountability as Mission Hospital Faces Sanctions

Nurses at Mission Hospital in Asheville, North Carolina, are calling for accountability as the health system confronts another round of sanctions from state and federal health agencies. The North Carolina Department of Health and Human Services (NCDHHS) has recommended that Mission Hospital be designated as experiencing immediate jeopardy due to practices that have created an unsafe environment for patients.

This recent recommendation marks the third time since the acquisition of the hospital by HCA Healthcare in 2019 that Mission Health has faced such a designation. According to an investigation by NCDHHS, the hospital’s practices resulted in significant patient harm, including four deaths between 2022 and 2023. Past incidents, such as a female patient found dying on the floor of her hospital room in 2021, have raised serious concerns about patient safety.

Kerri Wilson, a registered nurse at Mission Hospital since 2016, expressed her hope that the health system will finally take accountability for its actions. “This is the hospital and town I was born in, I grew up in, and I love it, but I’m glad to see that they’re being held accountable,” Wilson stated in an interview. She believes that HCA has the resources to improve the hospital significantly, provided they listen to nurses and community concerns.

Immediate Jeopardy Designation Explained

The concept of immediate jeopardy, as defined by the Centers for Medicare and Medicaid Services (CMS), is the most severe deficiency classification for a hospital. It occurs when noncompliance jeopardizes the health and safety of patients, leading to serious injury or death. On October 10, 2023, NCDHHS informed Greg Lowe, CEO of Mission Hospital, that a survey conducted in September resulted in the immediate jeopardy declaration on September 25, 2023.

The notification cited failures in patient safety protocols, including insufficient systems to prevent misidentification and inadequate monitoring of patients during transport. Specific incidents highlighted by NCDHHS included lapses in responding to telemetry patients and failures to communicate infection-prevention measures effectively.

In response to the recommendation, HCA Healthcare expressed disappointment, stating that the hospital has implemented extensive corrective action plans. The company emphasized its commitment to providing high-quality care and ongoing improvements in patient safety.

Nurses Rally for Change

On September 30, nurses at Mission Hospital rallied to bring attention to long-standing staffing and safety issues. Wilson noted that despite raising these concerns to hospital leadership, their warnings have often gone unheeded. “They don’t want to hear it,” she remarked, expressing frustration over management’s dismissive attitude towards the nurses’ attempts to highlight dangerous conditions.

According to National Nurses United, the largest nursing union in the United States, the hospital employed 1,692 bedside nurses as of March 2024, a number significantly below the estimated requirement of approximately 2,200 nurses for safe operations. By August 2025, that number had further declined to 1,523, raising alarms about the potential for further patient harm.

Nurses have also criticized HCA for eliminating a crucial meal and rest break program, which had previously been linked to improved patient satisfaction. Wilson recounted how the hospital’s attempts to keep the previous immediate jeopardy designation “very secretive” led to a rally and subsequent unionization efforts by the nursing staff.

In light of the recent events, Wilson and her colleagues are demanding meaningful action to address staffing shortages and improve working conditions. “What we hope to see is that there actually be some action and then put the resources into getting staff into the hospital so that we can fix the broken system,” she asserted.

As the situation evolves, NCDHHS has forwarded its findings to the CMS regional office in Atlanta. CMS will determine compliance and inform Lowe of any necessary actions. Wilson remains committed to advocating for staff and patient safety, emphasizing the need for HCA to leverage its resources to enhance care conditions.

“Our patients are going to suffer until HCA leadership is willing to invest in the necessary changes,” she warned. The nurses at Mission Hospital are prepared to continue their efforts, collaborating with regulatory agencies and the community to ensure a safer environment for all.