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Five years after investor-owned HCA Healthcare took over an esteemed nonprofit hospital in North Carolina, Medicare is threatening to cut off payment for any services it provides seniors.

The rare and dramatic move follows a Medicare revelation that patient safety is in “immediate jeopardy” at Mission Hospital in Asheville. That designation is the most severe the agency can hand out. HCA has just a few weeks to fix the problems or lose its Medicare funding.

“If on average Medicare pays roughly one-third of your revenue, if they stop paying you, you will die,” said Michael Millenson, a national patient safety expert and president of the consultancy Health Quality Advisors. “That’s why it gets immediate attention from the hospital management, because it’s a death threat.”

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