Mission Health’s CarePartners Health Services is temporarily closed following the pressures Hurricane Helene put on Asheville’s health care system, disrupting rehabilitative care for more than 50 patients and forcing more than 250 employees to take temporary jobs elsewhere in the system, according to employees and internal emails obtained by Asheville Watchdog. 

The decision, explained to employees by CarePartners CEO Jeffrey E. Brown in an Oct. 7 email, came after the storm brought a surge of patients into the health care system and left much of Asheville without running water — even though Mission owner HCA Healthcare currently has trucks pumping water into Mission Hospital and the Federal Emergency Management Agency has helped to drill a 750-foot well there, according to Asheville Mayor Esther Manheimer, who spoke to elected officials and others about the hospital at an Oct. 8 event. 

The closing affected nearly 50 inpatient rehab patients, several long-term acute care patients, and eight hospice patients, all of whom were sent to home caregivers, skilled nursing facilities, other inpatient rehab programs, and UNC Health Caldwell in Lenoir, more than an hour’s drive to the east, according to one employee.

There was also some confusion among employees about who made the decision to transfer patients out. Multiple CarePartners employees told The Watchdog that HCA and Mission leadership told them the closure was a “state-mandated” move, and that the North Carolina Department of Health and Human Services (NCDHHS) effectively forced the transfers.

NCDHHS told Asheville Watchdog that the transfers were requested by HCA, not mandated by the state. “Patient transfers are routine following disasters like hurricanes to help better serve the medical needs in the community,” NCDHHS spokesperson Hannah Jones said.

Mission emergency rooms remain open

When asked if Mission told any employees that the closures were state-mandated, HCA Healthcare spokesperson Nancy Lindell said, “No.” She confirmed HCA had requested the transfers. She did not respond to questions about how employees would be affected by the transfers and instead issued a statement Oct. 10 about the reasoning behind the closing. 

“Our emergency rooms remain open, and we have the staff and resources to treat anyone who needs emergency care and those seeking the high levels of care available at Mission Hospital,” Lindell said. “Our biggest need at this time is for city water to be restored.”

“This is temporary and routine patient movement, and CarePartners Inpatient Rehabilitation Hospital will reopen,” Lindell wrote. “At this time, the situation is fluid as recovery efforts continue. We will evaluate capacity needs on a continuing basis and will adjust plans based on what’s in the best interest of our patients, our caregivers and our greater Western North Carolina community.”

All other CarePartners services, including outpatient rehabilitation, home health and PACE will remain open, according to a statement from Mission.

State and federal agencies stood up operations at Mission days after the disaster and have helped ease pressure on the emergency department. 

Leadership at HCA Healthcare-owned Mission Health facilities in Asheville decided to create more room for acute care patients, according to emails from Mission Hospital CEO Greg Lowe and Brown obtained by The Watchdog. Emptying out CarePartners was part of that effort.

“As recovery efforts continue, state and local emergency management teams continue to assess what is best for this area,” Brown said in his email to staff.  “Some very hard decisions are being made at this time for the good of our community.”

“[O]ne of those is the decision to de-risk facilities by discharging patients to safer settings outside of the affected area,” Brown’s memo continued. “Our inpatient leadership and case management teams (Rehab Hospital; Asheville Specialty; and Solace [hospice care]) are actively working on discharge plans for all current patients.”

Lowe, in a message to staff on Oct. 6, noted that lack of running water was the system’s “biggest concern” moving forward, and gave more details about what he called a routine transition. 

“To ensure that we can create capacity for acute care needs, we have made the decision to temporarily relocate selected stable patients from Mission Hospital to hospitals outside the area hardest hit,” Lowe wrote. “In addition, patients from Asheville Specialty Hospital and CarePartners Inpatient Rehabilitation hospital will be transferred. We anticipate these transfers to affect fewer than 100 patients across all three facilities.”

“This routine patient movement will free up resources at Mission Hospital to address the most urgent medical needs of our community, as well as ensure access for high-acuity patients including trauma, stroke and cardiovascular conditions as rescue and recovery efforts continue,” Lowe wrote. “It will also hopefully help provide additional relief for you and your teams, since we know you’ve been working around the clock.”

CarePartners ‘will reopen,’ spokesperson says

More than 250 employees were impacted by HCA’s decision to temporarily close CarePartners facilities, according to a CarePartners supervisor who spoke to The Watchdog on the condition of anonymity because they were concerned about retribution. The supervisor also estimated that more than 50 patients were offloaded from the rehab and hospice programs alone.

“We got word last Wednesday [Oct. 2] … that Greg Lowe actually came here and talked to our leadership,” the supervisor said. “I got a phone call after that meeting, and basically was told that we were given instructions to get our census to zero to offload the need for resources at Mission Hospital.”

Another employee who works in rehabilitation said employees last week were told they “were supposed to be kind of gradually whittling down our patient census,” which was already lower than normal because two units are currently under construction. 

“Then Sunday [Oct. 6], we were told all patients were meant to be evacuated by the end of the day, and it was a very quick turnaround. So at first we were told Sunday morning that we needed to offload as many patients as we could. Then several hours later, we were told that we had to be at zero by the end of the day,” the supervisor said.

Though the supervisor said “everybody understands that this was a natural disaster, and that HCA has provided the support that they have said they were going to provide up until this point,” there were still concerns over how the closures were communicated and about the future of their jobs.

“I truthfully feel like there was maybe a lack of communication amongst the division to the actual staff members,” the supervisor said. “They basically told leadership that they were the ones that needed to disseminate the information to the rest of the staff.”

According to the supervisor, administrators are trying to find different positions for CarePartner employees “for them to actually help supplement” operations that are still running. 

“What HCA told us was that certain numbers of us could apply to their Hope Fund, which is their employee support fund, if we had damage to our homes that we needed funding to pay for, or if we hadn’t met medical deductibles,” the supervisor said. 

“In addition to that, they developed a redeployment department, where they gather the information of all the employees for here at CarePartners, and have been kind of systematically redeploying them in areas that have a need,” the supervisor said. 

Mission did not respond to questions about what would happen to those employees’ jobs.

Jones, the NCDHHS spokesperson, said nursing staff and hospital leadership contacted the attending physician of each patient to tell them where the patient was transferred. 

“Both the patient and their families were involved in the decision-making process,” Jones said.

Family members who may have lost touch with patients in the Mission Health system can call the patient reunification hotline, (828) 213-1111, which is also Mission’s main line.

Asheville Watchdog is a nonprofit news team producing stories that matter to Asheville and Buncombe County. Andrew R. Jones is a Watchdog investigative reporter. Email arjones@avlwatchdog.org. The Watchdog’s local reporting during this crisis is made possible by donations from the community. To show your support for this vital public service go to avlwatchdog.org/support-our-publication/.

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