Mission Health Under Fire: Unpacking Accusations of Prioritizing Profits Over Patient Care

It’s been a tough start to 2025 for nurses at Mission Health in Asheville, North Carolina. With accusations of understaffing, cuts to weekend pay bonuses, and a tragic death in the emergency room, these healthcare workers are feeling the pressure.

Mission Health oversees the main hospital in Asheville and several smaller facilities in the region. The health system has faced scrutiny for years, especially since its acquisition by HCA Healthcare in 2019 and the unionization of its nurses in 2020. There’s an ongoing lawsuit against the health system from various Western North Carolina municipalities. Despite this, Mission Health continues to provide care under the watch of an independent monitor, ensuring compliance with regulations set in place during the HCA purchase.

Recently, the hospital has become a focal point for complaints about overcrowding in the emergency room. In February, a man died in a bathroom after calling for help. Nurses reported that overcrowding and understaffing made it impossible to reach him in time. In contrast, hospital officials attribute the incident to procedural failures by individual staff members, not a shortage of personnel. “It was not an issue of staffing levels,” said Katie Czerwinski, a spokesperson for HCA. “We are investigating the actions of specific staff.” However, nurses like Hannah Drummond argue that neglecting adequate staffing is part of a larger systemic problem, leading to serious incidents and errors in patient care.

Data from the Centers for Medicare and Medicaid Services reveals that Mission Health received critical citations for nine instances of patient harm or avoidable deaths in both 2022 and 2023. This raises a red flag about the hospital’s commitment to safety and adequate care. Drummond emphasized that HCA’s focus on profits often comes at the expense of patient care. “They’re prioritizing profits over patients, and that’s causing harm,” she stated.

Along with staffing issues, recent changes to the pay structure for weekend shifts have left nurses unsettled. The pay bonus for weekend work dropped from $40 to $25 an hour, which critics argue will exacerbate existing staffing shortages and low morale. State Senator Julie Mayfield, D-Buncombe, criticized the decision, especially given that HCA reported a net income of $5.8 billion in 2024, a 9.9% rise from the previous year. It raises the question: is the company really invested in quality care or just in boosting shareholder profits?

Complicating matters further, Mayfield is involved in a coalition called Reclaim Healthcare WNC, which aims to replace HCA with a nonprofit model in Asheville. Interestingly, she and Allen Lalor, a former emergency medicine physician at Mission Health, recently became shareholders of HCA, allowing them to propose changes at shareholder meetings. Mayfield’s involvement reflects a growing trend among healthcare professionals advocating for more nonprofit models in hospital ownership—an idea gaining traction across the country as citizens and workers demand better accountability and care standards from corporate health systems.

In today’s climate, where healthcare systems are often shaped by profit motives, it’s vital to keep the focus on safety and quality care. As discussions about hospital practices continue, the voices of healthcare workers will be crucial in shaping a better future for patients and staff alike.

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