Written by Gerard Albert III
blue ridge public radio
An “unnecessary” medical process is doubling costs for some rural hospital patients and worsening emergency room overcrowding at Asheville’s Mission Hospital, according to a lawsuit transferred to federal court this month. That’s what it means.
Buncombe County government leaders originally filed the lawsuit in state court against healthcare giant HCA, owner of Mission, on August 6th. But the hospital sought to move the lawsuit to federal court, as the county seeks to recover costs incurred due to the alleged ambulance transport delay. .
The county claims Mission’s emergency room is “understaffed” and that county paramedics are having to wait long hours to attend to patients.
“As we have stated numerous times, we disagree with the allegations in this lawsuit and will continue to defend ourselves through the legal process,” HCA spokeswoman Nancy Lindell said in an email to BPR. I wrote it in
Although the lawsuit focuses on wait times at Mission Hospital, it also details problems with rural health care in Western North Carolina. Most patients transferred from some area hospitals, such as Brevard and Highland, must be readmitted to the Mission ER.
Before HCA acquired Mission Hospital and several other hospitals in the region, doctors jointly decided whether to transfer patients from smaller, rural hospitals, the complaint says. If doctors determine a transfer is warranted, the patient will be admitted directly to an inpatient bed at the Mission.
However, according to the complaint, transfers are now being directed to “transfer centers,” where decisions are made by someone other than a physician. If a patient is transported, the complaint states, the patient will likely “pass through the Mission ER.”
Buncombe County attorneys argue that this process increases HCA’s profits and contributes to excessive patient wait times in the ER.
“The policy of unnecessary ER admissions as a prerequisite for inpatient hospitalization often results in medically unnecessary duplication of charges and ER overcrowding,” the complaint states.
This process, combined with ambulances being backed up and waiting for transfers to crowded ERs, could put a burden on rural counties like Transylvania, where HCA owns its only hospital, the lawsuit says. That’s what I’m claiming.
Transylvania County has two paramedics on duty, according to the mayor of the county’s largest city. The trip to Asheville takes 1.5 hours without delays. During that time, only one paramedic is available to respond to local 911 calls in the county.
“This will cause assets to flow out of the county for a significant period of time. So the longer they have to wait to be processed in the mission, the less they will be able to provide services here if needed.” ,” Brevard Mayor Maureen Kopeloff told BPR.
“The person is in a lot of pain, whatever the medical issue is, and then you add on top of that the fact that they have to go through this bureaucratic process a second time,” Kopeloff said.
When patients are brought to Mission, they are usually facing life-threatening medical emergencies that smaller hospitals in the area don’t have the resources to handle.
In 2022, the city of Brevard, led by Kopeloff, will have HCAs in seven western North Carolina counties: Buncombe, Macon, Madison, McDowell, Mitchell, Transylvania and Yancey.
“Their predatory monopolistic practices severely undermine communities’ ability to obtain affordable, accessible, and high-quality health care,” Kopelov told BPR in 2022.
HCA is one of the nation’s largest hospital systems and has been heavily criticized by communities and elected officials in Western North Carolina since 2019. The Buncom lawsuit is one of several legal actions brought against the company by local governments and North Carolina elected officials, including the attorney general. Josh Stein.
“A lot of people are starting to shift their focus to going to places like Northeast Georgia hospitals…that are comparable in size and operations to Mission Asheville, and people are relying on what they can do. , are changing to rely on these services. Go to Asheville,” Highland Mayor Patrick Taylor said.
The town of Highlands is located in Macon County on the North Carolina-Georgia border.
The county is home to two hospitals, Highlands Cashiers and Angell Medical Center, making it a somewhat unusual situation for Western North Carolina. Both are owned by HCA. Smaller facilities lack some services that only larger hospitals can provide.
There are five paramedics on duty during any given shift, but they are spread out throughout the mountain county.
Macon County Emergency Services Director Warren Cave said the county is also receiving assistance from Mission’s Mountain Regional Medical Airlift Service, which uses both helicopters and ground transportation.
Still, with so much ground to cover, paramedics have to be selective about which patients they send out of the county, Cave said.
Both county hospitals are owned by HCA, which maintains a record of prioritizing patient needs. Cave said the county typically does not use ambulances to transport low-priority patients.
“If we were to use that transportation, we would say no, and that would seriously jeopardize our resources here. We’re going to secure it,” he said.
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