Dozens of people crowded into the Marion Community Building Wednesday to voice their concerns about problems they have experienced at Mission Hospital McDowell and Mission Health since the takeover by HCA Healthcare. There were also some who commended the local hospital for the job it is doing in McDowell County to care for patients.

Both critical and supportive comments were heard at the more than 90-minute meeting on Wednesday. It was the latest in a series of meetings held to gather information about the performance of the for-profit HCA since it acquired the not-for-profit Mission Health’s hospitals and physicians’ practices in western North Carolina.

The Nashville, Tenn.-based firm of Gibbins Advisors has held seven 90-minute meetings open to the public at locations across western North Carolina to provide information on its “role and scope” as independent monitor and to get feedback on HCA’s performance. Ronald Winters with Gibbins Advisors led the meeting. He said his company is an independent monitor that is not paid by HCA. The goal of the meetings is to determine if HCA is living up to its commitments and the promises that were made as part of the acquisition of Mission Health, he said.

Those commitments include retaining the existing medical services and hospitals, investing in those health care facilities and investing in the health and well-being of those communities in which they exist. Winters said his company’s goal is to gather information about what HCA is doing wrong as well as what it is doing right.

“Our most important thing is information coming from the community to see if there are any compliance issues,” Winters said. “We feel it is very important to listen to you. The purpose of this is listening. We’re not going to be able to give you answers.”

He said people can submit their comments privately. You can submit comments or questions to

On Wednesday, people at the Marion Community Building talked about the changes they have encountered with Mission Hospital McDowell and Mission Health since the HCA takeover. They voiced their concerns and frustrations over the quality of care, billing practices and lack of health care programs.

One person, whose name was not available, said that over a year ago, the hospital here started working on a disaster plan but it was put on the backburner because of the HCA acquisition. That same person said the staffing at the Emergency Room has been drastically reduced and there is no pharmacist at Mission Hospital McDowell during the night shifts.

Another person, whose name was not available, spoke about charity care that is provided when a patient doesn’t have health insurance and cannot afford to pay out of pocket. “When HCA took over, there was no charity care,” she said. “I don’t know where to turn to.”

Martha Zimmerman talked about the need for an adult day care facility especially as the local population gets older.

“McDowell County has a significant number of older adults,” she said. “McDowell County has no adult day care. We still recognize the need for an adult day care center.”

One man, whose name was not available, talked about how he waited in the Emergency Room on a gurney for five hours because no doctor was available to treat him. He talked about how emergency patients are seen at Mission Hospital McDowell in Marion and then taken to Mission in Asheville, which results in double billing.

“I am an American citizen with health insurance and this is the best I can get?” he said.

Another person, who identified herself as a retired hospital employee, talked about the security at the McDowell facility and how just about any person can wander into the building. She added the ratio of patient to health care provider needs to be improved.

“It’s so different from what I experienced,” she said.

Other people talked about the difficulties of reaching out to physicians and nurses.

“I shouldn’t have to go through a firewall to talk to my health care provider,” said one woman. “It’s the quality of care we are not receiving.”

Another woman, who is deaf and declined to give her name, talked through a sign language interpreter about her recent problems with communicating. “Before HCA bought the hospital, I had an on-site interpreter,” she said.

But after HCA took over, she had to talk through a video remote that was hard for her to see and it would often freeze up. One time, she had to go to the ER because of a kidney stone. Again, there was no on-site interpreter for sign language and she had to use that video remote. It again froze up and her husband ended up interpreting for her. She said that is a violation of the Americans with Disabilities Act.

“I’ve got a lot of anger at HCA,” she said.

Another man talked about how no one was available at the ER and a security guard had to find someone.

“I don’t think that is care,” he said. “You could get better care at the animal hospital.”

Becky Young, who is a retired nurse, spoke about the lack of charity care.

“If there is any improvement in charity care, I’d like to know where it is,” she said.

One man said he’s heard HCA plans to acquire more hospital systems in North Carolina and Mission Health was only the first.

Rose Pinkul said she was a patient at Mission Hospital in Asheville and she asked for pain medication following a surgery. It took six hours for her to get the pain medications.

“They seem to be in a big, fat hurry there and they don’t have the staff to take care of people,” said Pinkul.

Not all of the comments that were voiced on Wednesday were critical of HCA and Mission Hospital McDowell. Others were more complimentary.

“There are people who are happy with the services we are getting and that we do have a rural hospital,” said Steve Bush, executive director of the McDowell Chamber of Commerce.

City Manager Bob Boyette said Marion and McDowell County are fortunate to have a hospital. Other small towns and rural communities don’t.

“I personally wouldn’t want to live in a rural community without a hospital,” said Boyette. “We’re thrilled with the way they are going so far.”

Teresa Abernathy, who has worked at Mission Hospital McDowell for eight years, said many people don’t understand the enormous amount of work that nurses and health care providers do.

“We work so hard,” she said. “People can’t imagine what we do every day. We are very proud of our local hospital and we could not do without it. We need to look at ourselves. Diabetes, obesity is rampant.”

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