'Critically understaffed': Asheville crowd vents frustrations with Mission Health and HCA

ASHEVILLE - “We're critically understaffed," the Mission Hospital nurse said, her crying causing her to cut sentences short.

Amid residents, former patients and politicians who gathered Feb. 10 for a meeting with the firm hired as watchdogs over the local health system's sale, Jennifer Kirby described her typical work days, her voice wavering and eyes iwith tears.

She was among about 150 people who gathered for a meeting held by the independent monitor of the $1.5 billion hospital sale, which closed in February 2019.

As with others in the series of meetings around Western North Carolina, it opened with a brief introduction by Ron Winters, founder of the firm Gibbins Advisors, the firm hired as required by the NC attorney general-approved purchase by HCA Healthcare of Mission Health.

Then, for most of the next two hours, more than 15 people seated in the Mountain Area Health Education Center stood up and voiced a litany of concerns about their local hospital.

'Time for patience' is over

The comments began with state Sen. Terry Van Duyn, standing at the front of the room to read a letter co-signed by WNC state Reps. John Ager, Susan Fisher and Brian Turner, Buncombe County Commission Chair Brownie Newman and Asheville Mayor Esther Manheimer.

“The time for patience in the transition has passed,” Van Duyn read aloud after expounding on constituent concerns regarding charity care, patient safety and physician disenfranchisement.

As she concluded the letter, the crowd broke into applause, with around 20 standing to cheer. An indignant message, followed by clapping, became a pattern throughout the evening.

Concerns for patients and staff

Once the politicians returned to the front few rows, microphones were passed throughout the room as various stakeholders highlighted health care issues they’d seen and heard. Worries ranged from overworked staff to delays in patient care to claims of inaccurate billing to the cutting of services like the wheelchair clinic.

Gwen Straub, of McDowell County, told the crowd of her partner, Carol Sue Sweet, whose death Straub linked to Sweet's early discharge from Mission Hospital last year.

Alexandra Kiefer, of Henderson County, detailed her November stay for back surgery at Mission Hospital. Over 11 nights Kiefer recalled “harried and hurried” nurses seemingly too short staffed to address her needs — including going to the bathroom and receiving pain medication — in a manner she found adequate. Kiefer estimated the typical response time from nurses and nursing assistants was 25 minutes. She said the last time she spent an extended period at Mission, six years ago, staff would respond to her calls within five minutes.

"My husband ended up having to do a lot of the things that a nurse or CNA (certified nursing assistant) would do,” Kiefer told the Citizen Times. “I even ended up hiring a private duty nurse on top of that for the night my husband couldn’t be there.”

The most visibly emotional speaker of the night was Kirby, a bedside nurse at Mission Hospital with almost 15 years of experience at the hospital.

She listed hospital positions where she saw shortages: registered nurses, CNAs, phlebotomists, housekeepers, radiologists, respiratory therapists and physical therapists, among others.

“Every single department in the hospital that is designed to help the patient get out and toward wellness is critical and unethically and inhumanely understaffed,” Kirby said with tears welling in her eyes. “I used to be really proud of where I work, and I'm not anymore.”

She later told the Citizen Times she was not afraid to speak out publicly.

Related:

'We have no doctor here': Rural residents voice concerns at HCA compliance meeting

Public meetings set to discuss HCA's compliance in Mission Health purchase agreement

Messaging frustrations to HCA

Several speakers took time to distinguish their fury at HCA from their appreciation of Mission staff, who speakers said they felt were performing the best they could in difficult circumstances.

“If you want to get the minimum, go to Mission,” said Chris Jennings, who spent time at Mission when her great-aunt was at the hospital last fall. “We had one nurse that told us she cries every single night because she knows she is not giving appropriate, competent patient care."

Instead of personal stories, several speakers asked Winters how he would convey community recommendations to HCA management. While his firm’s specific purview pertains to 15 commitments within the Asset Purchase Agreement — including maintaining charity care and rural hospitals — Winters has previously stated he would pass along other concerns he hears to HCA managers.

Gibbins Advisors will communicate with six regional advisory boards on HCA's compliance with the agreement. Those boards, one for each Mission hospital in Western North Carolina, will be comprised of eight members, four selected by HCA and four selected by the Dogwood Health Trust, the foundation formed from the sale of Mission Health.

Remaining HCA compliance meetings

Transylvania County: Transylvania Regional Hospital: 5:30-7 p.m. Feb. 11, Unitarian Universalists of Transylvania County (UUTC), 24 Varsity St., Brevard.

Transylvania Regional Hospital: 5:30-7 p.m. Feb. 11, Unitarian Universalists of Transylvania County (UUTC), 24 Varsity St., Brevard. McDowell County: Mission Hospital McDowell: 11:30 a.m.-1 p.m. Feb. 12, Marion Community Building, 191 N. Main St., Marion.

Mission Hospital McDowell: 11:30 a.m.-1 p.m. Feb. 12, Marion Community Building, 191 N. Main St., Marion. Mitchell County: Blue Ridge Regional Hospital: 5:30-7 p.m. Feb. 13, Auditorium, Burnsville Town Center, 6 S. Main St., Burnsville.

Brian Gordon is the education and social issues reporter for The Asheville Citizen Times. He can be reached at bgordon@citizentimes.com, at 828-232-5851, or on Twitter at @briansamuel92.