HCA Healthcare Doesn’t Understand the Basis of the Lawsuit, Says AG

North Carolina Attorney Josh Stein is asking a state commercial court judge to reject HCA Healthcare’s latest attempt to limit the scope of the lawsuit Stein filed against HCA in December 2023.

In his Oct. 28 filing with the court, Stein claims the Nashville, Tennessee, health care system does not understand the lawsuit he filed against it.

The lawsuit alleges that for-profit HCA violated the terms of an amended asset purchase agreement when it bought the nonprofit Mission Hospital system in 2019 for $1.5 billion and then discontinued certain aspects of cancer, emergency and trauma care services without permission. hospitals. advisory board.

Stein signed the deal after negotiating changes to the terms of the deal, including maintaining health care services, the Citizen Times previously reported. HCA denied the allegations in a February response seeking dismissal of the lawsuit while asserting its own counterclaims.

In July, HCA filed a motion for partial summary judgment, arguing that the amended asset purchase agreement did not provide that HCA must continue to provide the same quality of service, quantity and staffing standards that Mission provided prior to its sale.

HCA’s attorneys wrote that Stine’s “complaint does not allege that Mission discontinued any of the enumerated lines of service” set forth in the “Hospital Services Commitment,” which is part of the asset purchase agreement.

HCA said a breach of the agreement could only occur if it “cancelled” or “discontinued” the specified service.

“Instead, (Stein) claims that emergency room wait times are longer than he would like, that hospital rooms are not as clean as he would like, and that some local oncologists have made an independent choice not to send some of their patients to Mission Hospital . ” HCA’s lawyers wrote. “While the Mission takes each concern seriously, none of them – even if proven – constitute a breach of the hospital’s service obligations.”

In its motion, HCA also cited Stein’s admission to the Asheville Watchdog in October 2023 that he was “powerless to deal with issues such as emergency room wait times or room cleanliness.”

A ruling in HCA’s favor will expedite the case by narrowing the scope of what the health system will have to provide during discovery, HCA said.

In an Oct. 28 statement opposing HCA’s motion for partial summary judgment, Stein, the Democratic candidate for North Carolina governor, said HCA’s motion is “based on a fundamental misunderstanding of this entire lawsuit.”

“HCA is wrong” in its statement regarding its allegations, Stein wrote, adding that the “central thesis” of the 2023 lawsuit was that HCA had “ceased” certain services it had agreed to maintain in its oncology, emergency medicine and trauma departments.

“The parties disagree as to the scope of this obligation,” Stein wrote, adding that the agreement requires HCA to continue to offer “the same types of cancer services” that Mission provided before its sale.

“HCA, in contrast, believes that the only termination that would constitute a breach of its obligations to provide cancer services would be if HCA ceased to provide any cancer services in general,” Stein wrote.

Nancy Lindell, a spokeswoman for HCA/Mission, said in an Oct. 31 email to the Citizen Times that HCA disagrees with Stein’s allegations and that it is “confident that Mission has fulfilled its obligations under the Asset Purchase Agreement.”

“We will continue to aggressively defend the lawsuit and let our claims speak for themselves,” she said. “Unfortunately, the lawsuit and the rhetoric surrounding it are a distraction from the important work the Mission continues to do in Western North Carolina, especially in the wake of Hurricane Helen.”

In September, Tropical Storm Helen tore through western North Carolina, killing more than 100 people in the state and destroying hundreds of homes and businesses.

In an Oct. 31 email to the Citizen Times, Nazneen Ahmed, a spokeswoman for the attorney general’s office, said Stein “is confident that the court will review HCA’s attempts to evade its obligations to provide cancer and emergency services at Mission Hospital.”

“We look forward to continuing to vigorously investigate this matter on behalf of North Carolinians in the western part of the state,” Ahmed said.

“Discontinued” services

In her Oct. 28 statement, Stein repeated her claims that HCA failed to “continuously provide” all of the trauma and emergency services that Mission offered before its sale.

In addition to concerns about trauma and emergency services, Stein alleges that HCA violated its asset purchase agreement by discontinuing its inpatient oncology service for patients with acute leukemia or lymphoma—comprehensive hematology care—in September 2023.

At the time, Messino Cancer Center felt it was “no longer safe to treat such acute patients at Mission Hospital,” according to the attorney general. So, HCA has stopped offering this service in Mission.

Stein cited testimony from Dr. Martin Palmeri on Aug. 16, who stated that complex hematology care was not provided at Mission after Sept. 20, 2023, although it was provided prior to Mission’s purchase by HCA. Palmeri said some patients who faced increased risk by traveling elsewhere for treatment continued to receive care at the Mission.

“And so we told them about our concerns about safety and our ability to provide adequate care,” Palmeri said in the deposition. “And if they were willing to say they were willing to take on that extra risk, then we actually provided that service. But it was extremely limited.”

A partial transcript of Palmieri’s testimony was included in Stein’s Oct. 28 filing, along with text message exchanges between Palmieri and Chad Patrick, former CEO of HCA/Mission, regarding chemotherapy treatment for “new uninsured, underinsured and publicly insured patients.”

“On the Monday after Thanksgiving, (the mission) will not be able to accept new patients,” Patrick Palmieri wrote. “I would appreciate this text remaining confidential.”

“There’s a lot people don’t know about the Mission deal.”

Stein’s Oct. 28 document also includes hundreds of pages of emails between Mission and HCA executives sent before the sale of the hospital.

The emails, sent between July 2017 and September 2018, describe some of the behind-the-scenes negotiations that led to the purchase of HCA Mission, as well as executives’ concerns about media coverage and public opinion.

One of those emails between Ron Paulus, CEO of Mission before the sale, and Chuck Hall, national group president of HCA, mentioned a magazine article that quoted Alan Levine, CEO of Tennessee-based Ballad Health.

In an article published by Business North Carolina in May 2018, Levine called the pending acquisition of HCA Mission Hospital a “conundrum” given the few details that have been made public.

“I think there’s a lot that people don’t know about the Mission deal,” Levine said. “Yes, Mission is technically a private organization, but it has benefited from tax exemption. He has an even greater obligation to the public to be transparent.”

In his email to Hall, Paulus called Levine’s comments “nonsense.”

“The arrogance is astonishing,” he wrote.

The material also included the Mission’s official responses to Levin’s comments, which the attorney general cited in his October 28 statement.

When asked why more detailed information about the sale had not been made public, the Mission stated that it was not necessary.

“But once we reached sufficient consensus on the key points that were included in the non-binding letter of intent, we decided to make an announcement to ensure that significant input and consideration could be made before any final agreements were signed,” the Mission said. .

The mission announced the signing of a letter of intent in March 2018.

In his Oct. 28 statement, Stein wrote, “This consensus was memorialized in the term sheet attached to the letter of intent, which provided that “HCA will not discontinue any health care services provided at the closing of the transaction.” Missionary Hospital Campus Facilities.”

Stein called this commitment the basis of “the whole deal.”

“Mission Health would ‘never’ consider selling HCA without a promise that Western North Carolinians would continue to have access to the same health care services they have long come to expect,” he wrote.

Jacob Biba is a reporter for the Asheville Citizen Times. Contact him at [email protected].

HCA Healthcare Doesn’t Understand the Basis of the Lawsuit, Says AG

“Discontinued” services

“There’s a lot people don’t know about the Mission deal.”

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