Tenn. regulators say Ballad Health needs to do a better job of responding to complaints

Miller serves on the Local Advisory Council that was set up by Tennessee when the state approved a COPA, or certificate of public advantage, that allowed Wellmont Health System to merge with Mountain States Health Alliance and create Ballad, a health care behemoth that covers an area about the size of New Jersey. Ballad has a monopoly in Tennessee’s Tri-Cities region and Virginia’s coalfields. Virginia maintains similar regulatory control.

The council’s meeting Thursday centered on members’ continued frustration with Ballad over its lack of public response to complaints.

Ballad said in a statement, “There are many changes occurring, and we are learning how to better communicate. We appreciate the advice of the state.”

Many of the members said council service is the most demeaning and frustrating experience they have had, as they are inundated with complaints to which they have no ability to respond. Their role is to ask the state’s monitor to look into potential COPA violations; concerns that don’t deal with the terms of the COPA fall outside their purview.

Many of the problems involve patient care at Holston Valley Medical Center in Kingsport, where Ballad plans to downgrade both the trauma level in the emergency department and the level of care for newborns and move the services to Johnson City. Ballad has said that the region’s declining population does not support having more than one top-level trauma center and specialized nursery, and that it could better attract and retain specialists at one center. Protesters have camped outside the hospital since May 2, when Tennessee approved Ballad’s plans to eliminate the neonatal intensive care unit and move the sickest babies a half-hour away to Niswonger Children’s Hospital.

Dani Cook, who has led the protest, said Thursday she was skipping the advisory council meeting, as the group has ignored their concerns. Although Ballad has served her legal notice not to trespass on its property, Cook said she continues to hear complaints from patients and their families that they’ve had to wait hours to be seen in the emergency department, that once they are admitted they wait up to 12 hours for a bed, and that patients are receiving treatment in the waiting rooms and shots in the hallway.

“We have people sitting up there in the street 24/7. While I disagree that’s the way to do that, there is a reason these things are happening,” Dennis Phillips, chairman of the advisory council, said during the meeting at Northeast State Community College in Blountville.

Council members spent much of the meeting expressing their frustration. They said they receive emails, calls and complaints without any way to address them. People don’t understand that their role is to advise Tennessee’s health commissioner, not Ballad, they said.

Miller said he received an email a week and a half ago wanting to know what he was going to do about a wing being closed at the hospital.

“I went to the hospital to see that, and yes, there was a whole wing of the hospital closed down, and I asked them why. They said, ‘We don’t have any staff, Dr. Miller,’ ” he said.

Council members said they understand there is a bedside nurse shortage everywhere and a shortage of rural area physicians. But what they don’t know is whether the merger has prompted staff to depart.

“I get calls all the time, and I try to be as positive as I can because everybody is working on this, and there is no easy solution. But I just wish we could have more input or more sessions on education of people,” Miller said. “Communication from Ballad ought to be better than it is.”

They had asked Larry Fitzgerald, the state’s COPA monitor, several months ago to look at the issue of physician retention.

“Ballad has suggested to me to get that data would be hard, but not impossible,” he said. Council members asked him to press for the information.

Ballad said the national nursing shortage is well documented and it is responding by increasing nurses’ wages.

“The U.S. government recently released a study saying that by next year, Tennessee may only be able to meet half the demand for nurses. So we are working hard to protect our patients from this national problem.”

Jeff Ockerman, director of Tennessee’s division of health planning, said that he and Fitzgerald are discussing the wait times in the emergency department.

“Some of what we heard about is distressing. We are doing some work on that to try and figure it out,” he said.