Oncology News Central (ONC)Cancer Care Quality Declined After Hospital’s Acquisition, Study Finds

This investigative report examines quality of care changes following HCA Healthcare’s acquisition of Mission Health, a formerly highly-regarded nonprofit hospital system in North Carolina. The 178-page Wake Forest University study synthesizes interviews with hospital staff and public records, finding significant declines in cancer care services contrary to pre-acquisition assurances.

Key Clinical Considerations

• All oncologists at Mission Hospital resigned following the acquisition, including the recruited head of oncology, citing inadequate staffing, elimination of support services, and unsafe conditions for chemotherapy administration.
• Mission Hospital’s oncology pharmacy was closed and oncology bed space was reportedly reduced by nearly 50%, according to the state Attorney General’s lawsuit.
• Messino Cancer Centers withdrew from providing inpatient chemotherapy at Mission in 2023, citing chronic understaffing, laboratory delays, and shortages of chemotherapy-trained pharmacists.
• The hospital suspended leukemia treatment services due to safety concerns, forcing patients to seek specialized cancer care outside the region.
• Federal regulators placed Mission Hospital under an “immediate jeopardy” designation (CMS’s most severe sanction) following patient safety complaints, though this was later lifted.

Clinical Practice Impact

• Patient Communication: Providers should prepare to discuss care continuity options with patients following hospital acquisitions, including potential referral pathways if specialty services are reduced.
• Practice Integration: Independent oncology practices should carefully document service quality metrics before and after hospital acquisitions to preserve evidence of any care disruptions.
• Risk Management: Oncologists should maintain detailed documentation of staffing levels, resource adequacy, and safety concerns when practicing in recently acquired facilities.
• Action Items: Providers should familiarize themselves with their state’s regulatory framework regarding hospital acquisitions and know reporting pathways for quality concerns.

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