Retiring judge allows Jackson’s Asheville hospital lawsuit to proceed

A retiring North Carolina Business Court judge will allow state Attorney General Jeff Jackson to move forward with portions of his lawsuit against HCA Healthcare over its operations of Asheville’s Mission Hospital.

Judge Julianna Theall Earp issued a 55-page order in the case Monday, days before her Aug. 1 retirement from the state Business Court. Earp granted and denied motions on both sides of the legal dispute.

Earp “ruled in favor of several of the Attorney General’s arguments and largely denied HCA’s motion for summary judgment,” according to a news release Tuesday from Jackson’s office.

“HCA threw every argument against the wall to try to get this case thrown out, but they didn’t stick,” Jackson said in the release. “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.”

Jackson accuses HCA of failing to meet commitments it made when buying Mission Health System in 2019. The attorney general cited HCA’s commitment not to discontinue providing emergency, trauma, and oncology services before 2029.

“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,” according to Jackson’s release. “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.”

Earp held a Feb. 11 hearing on motions for summary judgment from both Jackson and HCA. Summary judgement could have resolved part or all of the case before a trial.

The order addressed section 7.13(a) of the asset and purchase agreement signed in 2019. It “states that HCA ‘shall not discontinue the provision of the services set forth on Schedule 7.13(a)’ for ten years after the closing date of the transaction,” Earp wrote. “The parties disagree on the interpretation of this key language.”

“Each of the parties posits a reasonable interpretation of the phrase ‘shall not discontinue,’” Earp added. “Accordingly, the Court turns to the extrinsic evidence to determine whether it is consistent with respect to the intent of the contracting parties such that summary judgment would be appropriate. It is not.”

Because Earp could not rule for Jackson or HCA on that issue, the case will proceed.

“The Court agrees that, when the extrinsic evidence is considered, there are inconsistencies that eliminate the possibility of judgment on this issue at this stage of the litigation,” she wrote. “The phrase ‘shall not discontinue’ is ambiguous because this language is ‘fairly and reasonably susceptible to either of the constructions’ the parties assert. The APA does not define this language, and both parties have presented evidence to support their respective interpretations.”

Earp addressed a dispute over the word “provision” when applied to the hospital’s disputed services.

“The Attorney General responds that the term ‘provision’ requires HCA to do all things necessary to provide the services listed in Schedule 7.13(a), not just to supply the infrastructure necessary for physicians who might choose to use it,” Earp wrote.

“After consideration, the Court agrees with the Attorney General,” she added. “The term ‘provision’ means ‘the act or process of providing.’”

“[T]he APA requires that HCA not discontinue supplying or making Schedule 7.13(a) services available to Mission Hospital’s patients,” the judge wrote. “It is unreasonable, then, to interpret the APA as merely requiring HCA to provide the infrastructure for Schedule 7.13(a) services and to leave a determination regarding whether the services are actually provided to third-party physicians. If HCA wanted a different result, it should have said so.”

Earp rejected arguments about whether the record showed discontinuation of oncology or initial chemotherapy services. Plus “issues of fact remain that preclude summary judgment with respect to whether HCA has satisfied its obligation to provide emergency and trauma services ‘generally consistent’ with the current Level II Trauma Program,” she wrote. Those issues can head to trial.

The judge also rejected HCA’s request to exclude expert testimony from Dr. Kia Parsi, executive director of the Texas A&M Rural and Community Health Institute.

“Dr. Parsi has extensive experience relevant to the matters at issue in this case,” Earp wrote. “His experience and opinions reflect familiarity with the standards governing hospital systems and the resources needed to ensure the effective delivery of care. As such, Dr. Parsi may reliably use his personal experience to evaluate Mission Hospital’s performance.”

“Retiring judge allows Jackson’s Asheville hospital lawsuit to proceed” was originally published on www.carolinajournal.com.