HCA Healthcare
April 05, 2019

John Boyle, Asheville Citizen Times

Asheville's Mission Health was acquired in February by HCA Healthcare for $1.5 billion

Today’s batch of burning questions, my smart-aleck answers and the real deal:

Question: I don't work at Mission Hospital and never have. But I have numerous friends who do. Several of them have independently shared with me that the culture there has changed just in the few weeks since Hospital Corporation of America purchased and started running it. From what I am told, HCA's emphasis on "productivity efficiency goals" has not been done in a prudent way and has created great stress on employees and supervisors. Apparently, there's an emphasis on staffing efficiency that leads to people being sent home hours before their shift is over. One friend suffered a 10% pay-loss for that week. I am told that employees can use their "accumulated personal time" to offset the hours lost. But, that "personal time" is vacation and sick leave etc., so not a very appealing way to cover one's shortage of hours, especially when you earned that personal time. Doubly so when one has immediate bills to pay and food to put on the table. I realize HCA wants to make the hospital more efficient. That's good. But it seems to me they are hurting the very asset that makes Mission a great hospital: its people. Moreover, I was told HCA may be negatively affecting patient safety as some departments end up having fewer people working than needed at times. By hurting morale and effectiveness through shortsighted and poorly implemented "efficiency," is HCA cutting off its corporate nose to spite its face? And Western North Carolina's citizens' health may be the victim. Is this culture change really happening, and can HCA/Mission change course?

My answer: On a positive note, Mission is right there to help with nose replacement cosmetic surgery after spite removals.

Real answer: "Mission has in the past and continues to flex staff to volumes, much like many other health care organizations," said Mission Hospital spokeswoman Nancy Lindell. "At the heart of everything we do is applying the same compassion and commitment we have for our patients to our co-workers and colleagues."

More: Mission-HCA deal gets key regulatory OK from state Attorney General Stein

Nashville-based HCA and Mission, formerly a not-for-profit health care system, consummated their $1.5 billion deal in February. HCA now owns the Mission Health system, while the money HCA paid allowed for the creation of the Dogwood Health Trust, a private nonprofit dedicated to health improvement in the region.

As a corporation, HCA has had issues with staffing levels, particularly with nurses. The New York Times carried an article March 30 titled, "Nurses Strike in New York: Threat Increases Over ‘Safe Staffing’ Levels."

"Last year, staffing disputes were a central topic when nurses in five states picketed and threatened to strike hospitals operated by HCA, one of the country’s largest health care providers," the article states.

You can find the entire article here: www.nytimes.com/2019/03/30/nyregion/nyc-nurses-strike.html

Last September, the Tampa Bay Times published an article titled, "Nurses at many HCA hospitals say they are willing to strike over pay, staffing, security." You can find that article here: https://bit.ly/2LZlwAT

So clearly, staffing and efficiency is big concern at HCA hospitals.

I'm not taking a deep dive into the issue in Answer Man, but I'm sure it's something the paper will keep tabs on as the HCA ownership of Mission progresses, and we're glad to talk to employees about their experiences.

For now, Mission kept its remarks pretty short and sweet. Lindell stressed that Mission wants to be a good place to work, and a top-notch health care system.

"We work hard to create a place where employees feel empowered to provide the best care possible while experiencing a rewarding career and balanced life," Lindell said. "We care like family and take seriously our responsibility for the health and well-being of our patients and our colleagues."