Mayfield pushes HCA for Mission Hospital impact report, proposal fails

Julie Mayfield took Buncombe County’s Mission Hospital fight straight to HCA Healthcare’s owners, pressing the company’s shareholders for a broader report on how its hospital acquisitions have affected care. The proposal failed, leaving Asheville with the same core questions about staffing, emergency-room waits, physician departures and whether a distant corporate parent will ever fully answer for what has happened at Mission.

At HCA’s annual stockholder meeting on April 23, the North Carolina senator asked the company to prepare an impact report covering its hospital acquisitions over the last decade. She wanted the report to show how many physicians had left, what patients were saying about their experiences and what nurse-to-patient ratios looked like across the system. WLOS reported that Mayfield said Mission Hospital had been flagged with four Immediate Jeopardy findings in the seven years since HCA bought it, a statistic that underscored why the issue remains so raw in western North Carolina.

HCA completed its purchase of Mission Health on February 1, 2019, for about $1.5 billion. The deal covered a six-hospital system in Asheville and western North Carolina, and at the time HCA said it operated 185 hospitals and about 1,800 sites of care in 21 states and the United Kingdom. For Buncombe County, that transaction shifted control of the region’s largest hospital from a local health system to a national corporation based in Nashville, Tennessee, narrowing the leverage available to local patients and elected officials when problems surface.

Dogwood Health Trust says its independent monitor is responsible for assessing whether HCA is complying with the purchase agreement, and in April 2024 it engaged Affiliated Monitors, Inc. as the current Independent Monitor. But the continuing scrutiny has not eased concerns inside the community. A Wake Forest University study published in 2025 concluded that the sale of Mission Health to HCA did not lead to lasting improvements at Mission Hospital, reinforcing why Mayfield and other local voices continue to push for more transparency.

Aaron Sarver of Reclaim Healthcare WNC attended the meeting as a shareholder and said the goal was to keep pressure on HCA for accountability and transparency. Mission Health spokesperson Nancy Lindell said the preliminary voting report showed significant shareholder support for HCA’s position and that the proposal was not approved. Mayfield said she had made the same proposal last year and planned to bring it again next year, or something similar, if conditions did not improve. For Asheville residents still watching staffing, service changes and patient safety at Mission, the vote settled nothing.