Editor’s Note: As 2024 comes to a close, Asheville Watchdog staffers take you back and inside their most memorable stories and news events of the year.
I was driving down I-26 on Jan. 11 when I got the call.
The U.S. Centers for Medicare & Medicaid Services had a document I’d been hunting for months, and I would possess it within minutes.
The caller, a CMS employee, told me he had a letter from the North Carolina Department of Health and Human Services informing CMS of its investigation of Mission Hospital and its recommendation that the hospital be placed in immediate jeopardy, the most severe sanction it could face.
State and federal investigators had descended on the hospital in November and December 2023, interviewing nurses, doctors and administrators about the quality of care being provided to patients.
I knew the investigations were happening, but I didn’t know how severe their findings would be. I certainly didn’t expect a finding of immediate jeopardy, which CMS defines this way:
“Immediate Jeopardy (IJ) represents a situation in which entity noncompliance has placed the health and safety of recipients in its care at risk for serious injury, serious harm, serious impairment or death.”
Unless a hospital fixes the conditions that brought about the immediate jeopardy, it faces the loss of its Medicare and Medicaid funding, which can jeopardize its financial viability. As we have reported, the majority of patients in western North Carolina are on Medicare or Medicaid, or are uninsured.
I called my editors and we started an all-hands-on-deck session of calling sources, writing and editing.
Within a few hours of my receiving the call from CMS, we published our story, making Asheville Watchdog the first media outlet to break this major news.
“We have taken those results seriously, and there are no excuses for our patients receiving anything other than exceptional care,” Mission Health spokesperson Nancy Lindell said in the story. “This is not the standard of care we expect, nor that our patients deserve, and we will work diligently to improve.”
On Feb. 1, CMS made it official with its own letter to HCA North Carolina Division President Greg Lowe. The letter stated that the hospital had 23 days to issue a “plan of correction,” which would need to spell out how it planned to fix the conditions that brought about immediate jeopardy.
On Feb. 15, a scathing 384-page report from CMS detailing what caused the failures was released. Again, The Watchdog was the first to report the findings: 18 people had been harmed, including four who died between 2022 and 2023, all because of violations of federal standards of care. I described the report this way in my story:
It spotlights not only patient deaths and long delays in care but also a lack of available rooms, a lack of governing bodies “responsible for the conduct of the hospital,” and multiple leadership failures.
Following a Feb. 23 visit to Mission by state and federal inspectors, the immediate jeopardy finding was lifted. But a coalition of prominent physicians and patient advocates blasted Mission’s plan of correction, writing a letter to NCDHHS Chief Deputy Secretary Mark Benton in which they demanded to know why the plan didn’t require the hiring of more staff.
The Watchdog’s reporting on immediate jeopardy was just one component of our coverage of Mission Hospital in 2024. Throughout the year, we investigated numerous angles about the largest hospital in western North Carolina. Many of our stories have been grim and tough to report.
A wave of departures
Nurses and doctors have left the hospital, seeking more promising job opportunities. The Watchdog has investigated the departure of neurologists, urologists, cancer medication doctors, pharmacists, hospitalists, registered nurses and others. We’ve spoken to patients, chaplains, administrators and union leaders.
I’ve spoken with many health care workers who say they feel hamstrung by their circumstances. They say they’re unable to leave because they’ve established roots here yet at the same time don’t want to stay because they are burned out or are forced to make compromises, many related to staffing issues at the hospital.
In July, a broad coalition of physicians, patient advocates, clergy and Democratic state Sen. Julie Mayfield launched Reclaim Healthcare WNC. The initiative calls for HCA to relinquish Mission so it can become a nonprofit hospital, as it was before the Nashville company bought Mission Health in 2019 for $1.5 billion.
Ambulances line the emergency department bay at Mission Hospital days after Helene struck. // Provided photo
Our reporting shows that nurses and doctors are working hard through the tumult to give the best care possible to our community. They worked through enormous challenges following Tropical Storm Helene, with HCA supplying a high level of support.
Some still feel as if the company will continue to cut where it can.
Some of the last stories I wrote in 2024 revealed Mission’s plan to close the region’s only long term acute care hospital, Asheville Specialty Hospital, and to raze the St. Joseph’s Hospital campus, whose origins date back more than a century and which has been expensive for Mission to maintain.
About a year ago, I wrote a year-in-review piece about my investigation into the hospital’s emergency room procedures, which nurses said had endangered patients. The story included this statement about Mission:
Not everything is clear, but after two years of reporting, I believe that whatever is happening there, it’s seismic.
I didn’t realize how accurate that statement would be.
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/.
www.thecentersquare.com – By Alan Wooten | The Center Square – (The Center Square – ) 2025-04-03 14:11:00
(The Center Square) – Hurricane Helene’s death toll in North Carolina has grown to 107 and is 236 across seven states.
Gov. Josh Stein shared news of a death in the Avery County community of Newland. The wife of a couple camping was among those who died in earlier confirmations; the husband’s death was added on Thursday after his body was found.
The governor said the couple was camping on the last weekend of September when the storm hit.
This weekend marks the beginning of the 28th week of recovery. Damage is estimated at $60 billion.
Helene made landfall as a Category 4 hurricane in Dekle Beach, Fla., on Sept. 26. It was expected to come north to the Appalachian Mountains; however, the rainfall total from its dissipation there exceeded all forecasts.
Some places got more than 30 inches, most were at 24 or more. Due to terrain, water often rushed before it pooled and flooded – very unlike the flooding that happens in the coastal plains.
AccuWeather said rainfall totals were 32.51 inches in Jeter Mountain, 31.36 inches in Busick, and 26.65 inches in Hughes.
Forty-two died in Buncombe County, 11 in Yancey and 10 in Henderson.
Respective state officials say 49 were killed in South Carolina, 34 in Georgia, 25 in Florida, 18 in Tennessee, two in Virginia and one in Indiana.
Numbers were confirmed by The Center Square based on information supplied by the North Carolina Department of Health and Human Services; South Carolina Department of Public Safety; Georgia Emergency Management Agency; Florida Department of Law Enforcement; Tennessee Emergency Management Agency; Virginia Gov. Glenn Youngkin; and the Gibson County Sheriff’s Office in Indiana.
Helene is the fourth most deadly hurricane from the Atlantic Basin in the last three-quarters of a century. Only Katrina (2005, deaths 1,392), Audrey (1957, deaths 416) and Camille (1969, deaths 256) killed more people.
www.thecentersquare.com – By Alan Wooten | The Center Square – (The Center Square – ) 2025-04-02 14:21:00
(The Center Square) – Minority benefit against the majority giving up “agency, creativity, decision-making and other vital skills” in what is described as a valley of an artificial intelligence journey is likely in the next few years, says one voice among hundreds in a report from Elon University.
John M. Stuart’s full-length essay, one of 200 such responses in “Being Human in 2035: How Are We Changing in the Age of AI?,” speaks to the potential problems foreseen as artificial intelligence continues to be incorporated into everyday life by many at varying levels from professional to personal to just plain curious. The report authored by Janna Anderson and Lee Rainie of Elon’s Imagining the Digital Future Center says “the fragile future of some foundational and unique traits” found only in humans is a concern for 6 in 10.
“I fear – the time being – that while there will be a growing minority benefitting ever more significantly with these tools, most people will continue to give up agency, creativity, decision-making and other vital skills to these still-primitive AIs and the tools will remain too centralized and locked down with interfaces that are simply out of our personal control as citizens,” writes Smart, a self-billed global futurist, foresight consultant, entrepreneur and CEO of Foresight University. “I fear we’re still walking into an adaptive valley in which things continue to get worse before they get better. Looking ahead past the next decade, I can imagine a world in which open-source personal AIs are trustworthy and human-centered.
“Many political reforms will reempower our middle class and greatly improve rights and autonomy for all humans, whether or not they are going through life with PAIs. I would bet the vast majority of us will consider ourselves joined at the hip to our digital twins once they become useful enough. I hope we have the courage, vision and discipline to get through this AI valley as quickly and humanely as we can.”
Among the ideas by 2035 from the essays, Paul Saffo offered, “The first multi-trillion-dollar corporation will employ no humans except legally required executives and board, have no offices, own no property and operate entirely through AI and automated systems.”
Saffo is a futurist and technology forecaster in the Silicon Valley of California, and a consulting professor at the School of Engineering at Stanford.
In another, Vint Cerf wrote, “We may find it hard to distinguish between artificial personalities and the real ones. That may result in a search for reliable proof of humanity so that we and bots can tell the difference.”
Cerf is generally known as one of the “fathers of the internet” alongside Robert Kahn and for the internet protocol suite, colloquially known as TCP/IP.
Working alongside the well-respected Elon University Poll, the survey asked, “What might be the magnitude of overall change in the next decade in people’s native operating systems and operations as we more broadly adapt to and use advanced AIs by 2035? From five choices, 61% said considerable (deep and meaningful change 38%) and dramatic (fundamental, revolutionary change 23%) and another 31% said moderate and noticeable, meaning clear and distinct.
Only 5% said minor change and 3% no noticeable change.
“This report is a revealing and provocative declaration to the profound depth of change people are undergoing – often without really noticing at all – as we adapt to deeper uses of advancing AI technology,” Anderson said. “Collectively, these experts are calling on humanity to think intentionally and carefully, taking wise actions now, so we do not sleepwalk into an AI future that we never intended and do not want.”
In another question, respondents answered whether artificial intelligence and related technologies are likely to change the essence of being human. Fifty percent said changes were equally better and worse, 23% said mostly for the worse, and 16% said mostly for the better.
The analysis predicted change mostly negative in nine areas: social and emotional intelligence; capacity and willingness to think deeply about complex concepts; trust in widely shared values and norms; confidence in their native abilities; empathy and application of moral judgment; mental well-being; sense of agency; sense of identity and purpose; and metacognition.
Mostly positive, the report says, are curiosity and capacity to learn; decision-making and problem-solving; and innovative thinking and creativity.
Anderson and Rainie and those working on the analysis did not use large language models for writing and editing, or in analysis of the quantitative data for the qualitative essays. Authors said there was brief experimentation and human realization “there were serious flaws and inaccuracies.” The report says 223 of 301 who responded did so “fully generated out of my own mind, with no LLM assistance.”
SUMMARY: On March 14, 2025, President Donald Trump signed an executive order to dramatically reduce funding for seven federal agencies, including the Institute of Museum and Library Services (IMLS), which awarded $266.7 million in 2024. The order aims to eliminate non-essential functions and cut agency personnel to legal minimums. The move sparked backlash from library and museum organizations, warning it would severely impact early literacy programs, internet access, job assistance, and community services. Critics urged Congress to intervene, while the administration framed the cuts as part of efforts to reduce government waste under the U.S. DOGE Service initiative led by Elon Musk.
