Monitor again finds possible non-compliance at Mission Hospital deal
Mission Hospital’s watchdog found two more possible compliance lapses in 2025, extending a three-year streak of concern over HCA’s deal obligations.
An independent monitor found two instances of potential non-compliance in 2025, keeping HCA Healthcare’s Mission Health purchase under scrutiny for the third straight year. The latest findings put renewed attention on Mission Hospital in Asheville, where emergency care and oncology services remain among the most sensitive issues for Buncombe County patients.
Affiliated Monitors and Dogwood Health Trust released the report on July 24 as part of the oversight tied to HCA’s $1.5 billion purchase of Mission Health, which closed on Feb. 1, 2019. HCA announced the acquisition agreement in 2018, and the monitoring structure that followed was designed to track whether the company was living up to the terms of the sale and the commitments that came with it.
Dogwood Health Trust says its role includes ensuring HCA remains in compliance with the Mission asset purchase agreement. Dogwood engaged Affiliated Monitors, Inc. as the current independent monitor in April 2024, making the review process a continuing feature of post-sale oversight rather than a one-time check.
The latest report comes after a July 11 monitoring review for calendar year 2024 found three areas of potential non-compliance and said two issues had been resolved. That earlier review also kept attention on Mission’s emergency room and oncology care, two areas that carry immediate consequences for patients in Asheville and across Western North Carolina when access or reliability slips.
The monitor also met with community members in May to discuss HCA’s compliance and said it was closely tracking charity care and Medicare and Medicaid compliance. Those topics matter in Buncombe County because Mission Hospital remains one of the region’s main entry points for emergency treatment, inpatient care and specialty services.
The recurring findings have turned the Mission sale into an ongoing local accountability test. When a hospital system promises continuity during an acquisition, the question for patients, workers and nearby communities is whether the promise holds up in practice, especially when possible problems keep surfacing in the same system year after year.
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