Mission Hospital boosting resiliency 1 year after Helene
“Community shareholder meeting” focuses on current conditions at Mission Hospital
Officials held a “community shareholder meeting” April 24, 2025, on the campus of AB Tech to discuss the current conditions at Mission Hospital.
- In the aftermath of Helene, Mission Hospital remained open and provided care to 3,400 patients.
- The HCA Healthcare-owned hospital has faced criticism and lawsuits over patient care, but even its fiercest critics praised its response to Helene.
- Since the storm, HCA and Mission have implemented enhanced disaster protocols and other measures to improve resiliency.
ASHEVILLE – Last September, after Tropical Storm Helene devastated Western North Carolina, family members waited desperately outside Mission Hospital’s emergency department for word on loved ones.
Inside, nurses scrambled to triage and treat patients arriving with makeshift bandages, slings, and in at least one instance, a tourniquet fashioned out of caution tape. When they weren’t with patients, nurses were dumping buckets of water into toilets, forcing them to flush. The “once in a generation” storm had disrupted water service across the city, including the hospital. There was no running water.
Residents who lived nearby showed up to connect to the internet, to eat, or to watch what was unfolding in the aftermath of such a catastrophic storm. Helene had essentially wiped out reliable cell service across the region.
The hospital, which is owned by Nashville, Tennessee-based HCA Healthcare, had lost power after midnight on Sept. 27, 2024. A backup generator kicked in, but staff eventually lost access to electronic medical records and nurses had to resort to paper charting for a few days.
“It was very chaotic, very scary, because you couldn’t talk to your family, but you still have to take care of these patients that are in need,” Kelly Coward, a registered nurse, told the Citizen Times last October.
Despite the chaos, the hospital’s nurses, doctors and staff showed up to save lives and help deliver new ones. In the first five days after Helene, 33 babies were born.
‘I think they handled it heroically’
Asheville’s Mission Hospital is the region’s only Level II trauma hospital. It’s where people go if they suffer a stroke or cardiac event — or if they’ve been pulled from the rubble of a home buried by a landslide triggered by a deadly storm like Helene.
Since HCA Healthcare’s $1.5 billion acquisition of the formerly nonprofit hospital in 2019, Mission has faced numerous lawsuits and claims that understaffing has threatened patient safety and led to preventable deaths, which the health system denies. In 2024, before Helene, the Centers for Medicare and Medicaid Services placed the hospital in “immediate jeopardy,” citing safety issues within its emergency department.
In August, Mission Health announced that it was planning to hire 200 more employees, including 100 nurses, across its six-hospital system.
But the hospital’s response to Helene impressed even its fiercest critics.
“I think they handled it heroically,” state Sen. Julie Mayfield told the Citizen Times last year.
Mayfield, who leads a coalition of local elected officials, physicians, nurses, clergy and others who have called for HCA to beef up staffing or sell Mission to a nonprofit health system, lauded the hospital for being able to obtain much-need resources and the care it provided in the aftermath of the storm.
“It was powerful to see,” she said. “It was powerful to hear about.”
The hospital had over 750 patients when Helene hit, Greg Lowe, its CEO, told the Citizen Times last year.
In preparation for the storm, Lowe said the hospital brought in water tankers in case city water service was disrupted. Helene ended up severely damaging the city’s water system. It took seven weeks for drinking water to return.
Soon after the storm, 50-60 tankers were delivering water daily. HCA emergency staff and engineers arrived and helped develop a plan to provide pressurized water to the hospital so toilets could be flushed, food could be prepared and for medical equipment to be sterilized. They also suggested Mission drill its own wells to run its chillers to cool the hospital and medical equipment. Lowe said without the chillers, the hospital would have had to evacuate its patients.
In the days following Helene hit, the high was in the low 70s.
Crews drilled two wells on site.
“We did things that were unique and outside the norm of a hospital to care for the community that was in need,” Lowe said.
Hundreds of people showed up in need of oxygen, so the hospital set up oxygen lounges to provide it, he said. And more than a dozen heavy-lift helicopters brought in supplies and resources and transported radiologists and physicians to other Mission Health System hospitals in the region.
In the storm’s immediate aftermath, the hospital had essentially morphed into a community hub where people, who didn’t need medical care, showed up for its resources, which ultimately became a threat to patient and staff safety. Armed security was brought in to “create the environment that we needed to be able to care for our patients,” Lowe said.
More than 400 nurses and 40 physicians from HCA’s network of hospitals showed up to support the relief effort and care for 3,400 patients in the immediate aftermath, according to the health system.
The hospital also set up sleep stations for the hundreds of staff and opened free mini marts with groceries and laundry services. Tree crews were dispatched to homes of staff members who were trapped by fallen trees.
To its critics, like Mayfield, the hospital’s response in the face of Helene showed the level of care HCA and Mission Hospital are capable of providing. In December, she said it gave her “a little hope” that things might be different moving forward, and HCA and Mission might engage with, and be part of, the community.
Lowe admitted that he hears the criticism, but said HCA has provided Mission a “stronger foundation” and “a breadth of resources that we never had before” to provide that care.
“Where we are not doing our best, we try to improve every day,” he said. “But what I try to focus on is what we’re doing for this community.”
Boosting resilience
Since the storm, HCA and Mission Health have taken steps to strengthen resilience in preparation for future system failures, like loss of water, power and communications.
In a September email, spokesperson Nancy Lindell told the Citizen Times the hospital developed and expanded its “downtime playbook” so it can continue to provide patient care in the event of another catastrophe.
“While Asheville continues to recover from ongoing infrastructure challenges, HCA Healthcare is committed to delivering safe, uninterrupted care and building a more resilient healthcare system for the future,” Lindell said.
It also installed weapons detection systems, refined security protocols, and conducted an exercise to evaluate and better its response to downtime scenarios. System-wide training courses for enhanced protocols during disasters have been developed, too, Lindell said.
Alternative water sources have been added, and HVAC cooling contingency plans have been created.
In August, the health system launched a satellite-based communication system, dubbed BlueNet, at Blue Ridge Regional Hospital in Spruce Pine to make communication infrastructure more reliable.
After Helene hit, the hospital lost communications for three days. HCA is expected roll BlueNet out at other HCA hospitals in the future.
Jacob Biba is the Helene recovery reporter at the Asheville Citizen Times, part of the USA TODAY Network. Email him at [email protected].
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