Mission Hospital faces renewed federal scrutiny over patient safety worries

Mission Hospital has been cited four times in five years for immediate jeopardy, the Centers for Medicare & Medicaid Services’ most serious safety warning. For Asheville families who rely on the only Level I trauma center in Western North Carolina, the question is immediate: what harm could still reach patients if repeated scrutiny has not produced a lasting fix?

The most recent citation, in October 2025, involved a preventable patient death, unsafe patient transport, patient misidentification and a harmful infection protocol. CMS later lifted that designation after Mission submitted a plan of correction, but the hospital was still required to hire Bryant Healthcare Consultants and file monthly progress reports, with a deadline of July 26. CMS uses immediate jeopardy when a facility’s noncompliance places patients at risk of serious injury, serious harm, serious impairment or death, and it can impose the harshest penalties in federal nursing and hospital oversight.

Mission serves 18 counties and handles regional emergency, maternal, surgical and trauma care. Understaffing, 10 preventable deaths in the past 18 months and a lack of security have drawn concern around a hospital that is also the only one in North Carolina with a nurse’s union, formed in 2020 after HCA Healthcare bought Mission Health in 2019. Before that sale, Mission operated as a nonprofit.

State Sen. Julie Mayfield, a Buncombe County Democrat, has pressed HCA and regulators for years over staffing and patient-care problems at the hospital. Mission cardiology nurse Kerri Wilson has said she no longer feels comfortable having loved ones treated there, and she has described staying with her father around the clock during his care because her family did not feel he was safe alone. Wilson has also said Mission remains the region’s go-to hospital for cardiac traumas, which makes the staffing and safety questions harder to ignore.

In July 2025, Dogwood Health Trust said HCA was potentially out of compliance with its Mission purchase agreement for the second year in a row, pointing to diminished emergency and trauma services, CMS standing issues and charity-care policy concerns. North Carolina Attorney General Josh Stein sued HCA in 2023, alleging that staffing cuts had made care inadequate or unavailable and that doctors and nurses were forced to treat patients in waiting rooms without adequate sterile equipment.

CMS can terminate Mission’s Medicare and Medicaid agreement if problems persist.