Judge’s backing of AdventHealth over Mission Health for new Weaverville hospital keeps pressure on HCA

An administrative judge decided May 10 to uphold the state’s decision to allow AdventHealth to build a hospital in Weaverville, Buncombe County, just north of Asheville.

The management of for-profit HCA, which operates the Mission Health group of hospitals and other facilities from an Asheville base, may not be happy that the state chose AdventHealth over them.

The North Carolina Department of Health and Human Services approved AdventHealth’s Certificate of Need application to build the 67-bed facility in November 2022, and Mission Health appealed the decision, according to AdventHealth’s press release .

HCA can still appeal the most recent decision within 30 days, the judgment noted.

The decision is the latest development in a series of legal battles HCA is fighting related to North Carolina, including several over its management of Mission Health.

A former Mission Hospital employee, Sharon McRee , also sued HCA on April 25, claiming the company underpaid her, along with what could be around 1,000 other workers.

The City of Asheville, City of Brevard, Buncombe County and Madison County are also plaintiffs in a federal antitrust lawsuit against HCA filed in 2022. Lawyers on both sides filed proposed timelines for the case May 6.

Attorney General Josh Stein also sued HCA in December, claiming HCA isn’t providing the level of care that the Tennessee-based company promised when the state approved HCA’s acquisition of the Mission Health System in 2019.

Buncombe County filed a proposal to join the attorney general’s case against HCA April 3, claiming emergency room understaffing at Mission Hospital is costing taxpayers by making EMS workers wait longer to offload patients.

Weaverville hospital for AdventHealth

The administrative judge’s decision on the new hospital comes after the announcement in March that AdventHealth, a faith-based nonprofit headquartered in Florida, had purchased more than 30 acres of land in Weaverville for the planned facility.

The new hospital would serve Buncombe, Madison and Yancey counties, according to AdventHealth.

AdventHealth currently operates a hospital in Hendersonville , just south of Asheville. The new hospital would give AdventHealth a presence both north and south of Asheville.

The new facility would include 13 beds in the labor and delivery unit, 12 emergency department beds and 42 medical and surgical beds.

AdventHealth also plans to apply for an additional 26 acute care beds at the hospital by the deadline of June 17, bringing the total to 93 beds.

The health care system plans to select the architect and general contractor for the new hospital over the next few weeks, AdventHealth said.

AdventHealth expects the project to cost $254 million, Victoria Dunkle , AdventHealth spokesperson, said in an email to Carolina Public Press. Once the health care system begins site work, Dunkle said construction is expected to take 18 to 24 months.

Patrick Fitzsimmons , mayor of Weaverville, told CPP he was “really pleased” with the judge’s decision because the area in the mountains north of Asheville has “a dearth of medical services available.”

He wouldn’t be surprised if HCA appeals the decision again, he said, but is hopeful the process will move forward.

The town also signed a letter in support of AdventHealth’s application and is in favor of the addition of 26 beds, Fitzsimmons said.

The AdventHealth administration has worked with him for months on the project and communicates well about the process, he said.

AdventHealth is planning listening sessions for the community to discuss the proposal of another 26 beds.

In response to whether the organization is concerned about attracting an adequate workforce, Dunkle said while health care is a “competitive industry,” AdventHealth prides itself on its culture and promises to care for team members through competitive pay, professional development and a network of opportunity.

“We have seen a lot of excitement surrounding our new hospital from both patients and people who are interested in the opportunity to join the AdventHealth team,” Dunkle wrote.

Attorney General Josh Stein emailed a statement about the judgment to CPP, saying, “The Court’s decision will increase health care competition in Western North Carolina, which can lead to better care and lower prices. I commend the career attorneys at the Department of Justice and Department of Health and Human Services who successfully fought on patients’ behalf.”

Unpaid wages suit

A former Mission Hospital worker also filed a fair labor lawsuit against HCA on April 25, alleging HCA underpaid employees by modifying time records.

McRee brought the case on behalf of a group of employees similarly affected, who could total more than 1,000 people, the suit said.

McRee worked as a respiratory therapist in the hospital from 2002 to 2022, according to the suit. She alleged HCA underpaid her and other workers by using modified or inaccurate records.

For example, the suit claimed, McRee could clock in a few minutes before her shift time started at 6:30 a.m. and generally did, but HCA didn’t pay her for those extra minutes. When McRee worked a few minutes past her shift end of 7:00 p.m., she also wasn’t paid for those minutes.

HCA deducted a 30-minute meal break from her paycheck, despite McRee almost never being able to take a meal break during her shift, the suit claimed.

The hospital also failed to pay overtime, the suit alleged.

Antitrust suit

Plaintiffs including Buncombe County, City of Asheville, City of Brevard and Madison County, as well as the defendant HCA, filed proposed timelines for the federal antitrust case against HCA on May 6.

According to the plaintiffs’ schedule, a trial would take place in May 2027.

The proposed schedule is “truly a work in progress” and will be determined after the initial pretrial conference June 6, according to Mack McKeller , attorney for the City of Brevard.

As to the fair labor suit and attorney general’s suit, McKeller wrote over email to CPP: “it just underlines our contention of reduced service from HCA since they bought Mission.”

Maureen Copelof , mayor of Brevard, said she’s pushing to move the case as quickly as possible while still being thorough.

While the legal battle continues, HCA’s alleged monopolistic behavior also continues, she said, and monopolies mean a lesser incentive for higher quality care.

In response to other litigation around HCA, she said, “The number of lawsuits that tangentially interact shows something powerful about what’s happening.”

HCA response to AdventHealth decision

In response to the judge affirming AdventHealth’s plans to build a hospital in Weaverville, HCA spokesperson Nancy Lindell wrote over email, “We are disappointed in the Office of Administrative Hearings’ decision to uphold the awarding of 67 acute care beds to Advent Health.

“This will not solve the need to transport high-level, critical care patients out of the area when our region’s advanced care beds – only available at Mission Hospital – are full.”

As to McRee’s lawsuit, Lindell wrote, “The claims in this lawsuit are baseless and Mission Health will defend itself through the legal process.”