Do you file with the IRS?
Yes. Our financials are independently audited. A Form 990 is filed each year with the IRS.
Does the community have a say in how Mission is run?
Yes, through our Board of Directors. The board sets strategic, financial and operational goals for the hospital's administrative team. Board members are civic and business leaders who represent Asheville's diverse culture and community.
Is your board paid?
No. Mission's board members are not paid. Members serve as volunteers, donating their time to the cause of improved health for the region. The job is demanding and time consuming. Many board members spend 10 hours a week or more fulfilling their responsibilities.
What do you do with the money you make?
Mission reinvests our margin into our hospital and back to the community. In addition to purchasing new equipment and paying competitive salaries, the money supports outreach programs that keep people well and out of the hospital. Some of the programs include the School Nurse Program and school-based clinics in the Asheville City and Buncombe County Schools, ABCCM Doctor's Clinic, Emma Family Resource Center, pediatric dental care for low-income children in the region, and community-based medical clinics.
What is the relationship between Mission and physician practices?
We have more than 600 physicians on our medical staff. The majority of these physicians are in private practice, which means they operate independently from the hospital. They pay their own salaries, determine their own charges, and run their own offices.
Mission contracts with a few physician groups to provide hospital-based services such as emergency medicine and pathology. Finally, a small number of physicians are Mission employees, for example those doctors who work at Mission Children's Clinic.
We work closely with all physicians on our medical staff to make sure that we provide the facilities, services and staff they need to provide excellent care to patients. They are an integral part of our leadership team and their guidance to our work is essential.
What role do the Sisters of Mercy play at Mission Hospitals?
They no longer have any role. The Sisters of Mercy sold St. Joseph's Hospital to Memorial Mission Hospital in 1998.
What's the difference between not-for-profit and for-profit hospitals?
All hospitals must make money to survive. For-profit hospitals give most of their profit margins to stockholders. Not-for-profit hospitals like Mission put all of the margin they are able to earn into improving facilities and services, providing community outreach programs, and networking with other organizations to improve access to health care.
Who monitors Mission?
Mission is the most regulated hospital in North Carolina. We are the only hospital in the state to operate under a Certificate of Public Advantage (COPA). The COPA requires us to file financial reports with the state every year. We are then compared to other N.C. hospitals similar to us in size and the level of injury and illness of our patients. We are also monitored by:
- The Joint Commission on Accreditation of Healthcare Organizations
- The Occupational Safety and Health Administration
- The Environmental Protection Agency
- The Centers for Medicare and Medicaid Services
- The N.C. Division of Facility Services
Who owns Mission?
Mission is a community-owned, not-for-profit hospital. This means that our margin, that is, the difference between what we are paid to provide care and the cost of providing that care, gets reinvested into the hospital and the community. In the case of for-profit hospitals, like Tenent, Health South, MedCath and HCA, much of the margin is used to pay shareholders.
Why do you advertise?
We advertise for two reasons: to attract staff and to compete for patients.
Like all hospitals, we must compete for highly specialized personnel is areas such as nursing, pharmacy, respiratory care and information services. The shortage in clinical areas is serious now, and it is steadily getting worse. It is essential that we let these professionals know that Mission is an appealing place to work. We provide advanced health care delivered in a caring compassionate environment by clinicians who are tops in their field.
We also advertise in the areas where we have strong regional competition, such as heart and obstetrics.
Why does a not-for-profit hospital need to make a profit?
It's important to understand that the money that hospitals receive from the government and insurers for taking care of patients is not enough to cover all costs. Some profit, or "margin," is essential so that hospitals can update equipment, pay salaries that will attract and keep highly specialized staff, and upgrade outdated facilities. At Mission, the Board of Directors establishes goals for our margin each year. Additionally, patient care reimbursement is supplemented with other sources of revenue such as philanthropy and investment earnings. At Mission, our foundation has been able to fund a number of important services by getting grants and raising gifts from generous individuals and organizations.
One note: Mission relies on borrowing funds by issuing bonds. To issue bonds at a reasonable cost to us, and to maintain flexibility, it is essential for us to be able to demonstrate to bond agencies that we have a sound bottom line.