On August 19th, NC DHHS will hold an administrative hearing here in WNC regarding the four hospital systems applying for this year’s Certificate of Need (CON) process. DHHS will award 92 hospital beds to one of four applicants – Advent Health, Novant, UNC Health and HCA/Mission.
Reclaim Healthcare WNC thought it would be informative to the public to analyze data available from the Centers for Medicare and Medicaid (CMS) regarding patient experiences in the three hospitals based in WNC (Advent Health Hendersonville, UNC Pardee, HCA/Mission) plus Novant Presbyterian, located in Charlotte.
The HCAHPS (Hospital Consumer Assessment of Healthcare Providers and Systems) is a survey taken by hospital patients from across the country, including WNC. The survey measures
patient experiences with specific, valued aspects of their hospital care, such as responsiveness of hospital staff, communication with doctors, whether the patient would recommend the hospital to others, communication about medication, cleanliness of environment, and clear discharge information. The results are then combined and summarized into a single one-to-five star rating scale that is produced annually. This survey is standardized across hospitals, national in scope and publicly reported on “Care Compare” at Medicare.gov. Survey responses are confidential (individual patient responses are not shared with the hospital) and collected by a neutral third party.
The chart below shows the HCAHPS overall patient experience summary star ratings for Advent Health Hendersonville, Novant Presbyterian, UNC Pardee and HCA/Mission hospitals from 2018-2024, with star scores of one-to-five (five being the best score) listed on the left hand side of the graph and the years across the bottom of the graph. Each hospital is color-coded (see the legend), with Mission always the last bar in each yearly grouping and in bright yellow.
Compared with the other CON applicants, Mission had the worst ratings (two stars out of five) from 2020-2024. (Complete 2025 data is not yet available.) HCA purchased Mission Hospital in 2019. Among CON applicants, Advent saw the highest and most consistent ratings over time (four stars out of five across all seven years) and UNC Pardee and Novant saw ratings of three and four stars out of five over the seven years.
The data speaks for itself. While patient experience is not a specific criterion that DHHS is required to consider in awarding beds, quality of care is. Patient experience is an official indicator of quality of care per the Centers for Medicare & Medicaid Services (CMS). According to the National Institute of Health, higher patient experience scores consistently correlate with safer care, better clinical process adherence, and fewer readmissions.
And, of course, quality is also reflected in Mission’s track record of multiple Immediate Jeopardy citations and EMTALA violations issued by CMS. DHHS cannot repeat its mistake from their 2025 CON process and award additional beds to HCA/Mission. Rather, the agency should select applicants that have a strong record of high patient satisfaction and high quality of care.
You can take action by encouraging NC DHHS to award beds to HCA’s competitors. If you are able, please attend and speak at the DHHS hearing on August 19 at 10 a.m. at Ferguson Auditorium on the campus of AB Tech. We also ask that you email DHHS Secretary Dev Sangvai at dev.sangvai@dhhs.nc.gov and weigh in on which hospital systems you think can best serve our community.
Miriam Schwarz, MPA is Vice Chair of the Board of Directors for Reclaim Healthcare WNC. She served as the Executive Director at the Western Carolina Medical Society as CEO for 14 years and retired in 2022.
This article originally appeared on Asheville Citizen Times: Opinion: Time to weigh in on which hospital systems can best serve our community
