AG Jackson Wins Key Arguments as HCA/Mission Hospital Case Proceeds to Trial

FOR IMMEDIATE RELEASE
Tuesday, July 28, 2026
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RALEIGH - Attorney General Jeff Jackson's lawsuit against HCA Healthcare about its operation of Asheville's Mission Hospital will proceed after North Carolina Business Court Judge Julianna Earp ruled in favor of several of the Attorney General's arguments and largely denied HCA's motion for summary judgment.

"HCA threw every argument against the wall to try to get this case thrown out, but they didn't stick," said Attorney General Jeff Jackson. "I'm grateful the judge saw through them. We're going to trial, and I will keep fighting to defend emergency and cancer care in western North Carolina."

Attorney General Jackson alleges that HCA failed to provide the emergency and cancer care it committed to providing when it purchased Mission Health System in 2019. HCA promised not to discontinue the provision of emergency and trauma services and oncology services at Mission Hospital until at least 2029, a commitment it broke.

Judge Earp ruled that all claims in the case will proceed to trial. The court agreed with the Attorney General that the HCA purchase agreement "requires HCA to take all steps necessary to actually provide" emergency and cancer services at Mission Hospital. Notably, the court denied HCA's request to avoid trial on the Attorney General's allegations that the company failed to provide emergency and trauma services by understaffing and creating unsafe nurse-to-patient ratios.

Additionally, the court denied HCA's motion to exclude expert testimony from Dr. Kia Parsi, a doctor with over 27 years of clinical experience who serves as the Executive Director of the Texas A&M Rural and Community Health Institute. The court highlighted Dr. Parsi's conclusion that it was not possible for an emergency department to have as low a staffing plan as Mission's and still provide adequate care.

Since HCA purchased Mission in 2019, the Centers for Medicare and Medicaid Services (CMS) have found the hospital to be in "immediate jeopardy" four times in the past five years, most recently in January of 2026. An immediate jeopardy finding means that the hospital's actions have "placed the health and safety of recipients in its care at risk for serious injury, serious harm, serious impairment, or death." A finding of immediate jeopardy is the most serious deficiency a hospital can receive.

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