This story was originally published in the Asheville Watchdog.
Mission Hospital to Expand Amid Safety Scrutiny
Despite current investigations into safety issues, Mission Hospital in Buncombe County has been granted state approval to increase its capacity by 95 acute-care beds. This decision comes as the hospital, owned by HCA Healthcare, faces scrutiny from state and federal bodies over repeated safety violations associated with multiple patient deaths.
The North Carolina Department of Health and Human Services (NCDHHS) chose Mission over proposals from AdventHealth Asheville and UNC Health West Medical Center, both seeking to add 129 beds to new facilities in the area. The decision was made on March 27, following the 2025 State Medical Facilities Plan, which determined a need for 129 additional beds across four counties, including Buncombe.
In related developments, Novant Health Asheville Medical Center has received approval to build a new 34-bed hospital in Arden, further expanding healthcare options in the region.
The choice to award additional beds to Mission Hospital has raised questions, particularly given its history of sanctions. State Sen. Julie Mayfield voiced concerns, saying, “I was shocked, and then puzzled, why the state would award [Mission] 95 more beds when they can’t seem to safely manage the beds that they have.”
Mission Hospital has been placed in Immediate Jeopardy, a severe federal warning, four times since HCA Healthcare’s acquisition in 2019. Although a citation from January was lifted in February, the facility remains out of compliance with certain federal standards, risking Medicaid and Medicare reimbursement without corrective action by July 29.
AdventHealth and UNC Health West have until April 27 to appeal the NCDHHS decision. AdventHealth spokesperson Victoria Dunkle expressed disappointment, stating that the decision might not serve the community’s best interests and is reviewing appeal options.
Mission’s expansion proposal, initially seeking 129 beds, was scaled down without explanation. Barring appeals, the hospital will grow to 828 beds from 733, with a $198.5 million expansion set for 2031 completion.
Legislative responses are underway, with Sen. Mayfield planning to propose laws linking bed awards to compliance with CMS regulations. U.S. Rep. Chuck Edwards is also pursuing federal legislation to enhance CMS’s authority over noncompliant hospitals.
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