According to a report released Thursday by Ballad, Mountain View Hospital in Norton could see its emergency department shut down and folded into nearby Norton Community Hospital under a plan awaiting Virginia Department of Health approval.
“It is important to know that all 3 facilities remain open and all services remain in the county,” the report states, “even if the specific location where these services are delivered may change.”
If the state Department of Health approves the Ballad plan, the changes could begin in the early fall, and it could take from 60 to 90 days to begin implementing them.
Mountain View, which saw a suspension of surgical services in the fall of 2018 because of low utilization, would also see its inpatient and critical care services moved to Lonesome Pine Hospital in Big Stone Gap as Ballad plans to shift Mountain View’s role to a skilled nursing and long-term care facility.
Ballad Health officials in Norton and Wise County, during a press tour of the three hospitals in July, discussed how Wise County’s declining population over the past two decades has affected overall patient levels as well as demand for obstetric services.
According to the latest Ballad report, Wise County and surrounding counties could see an 8 percent population drop between 2020 and 2040 on top of the 8.5 percent decline over the previous 19 years. Lonesome Pine and Mountain View each see a daily census of one to six patients.
Mountain View was built with a 78-patient capacity, while Lonesome Pine has a 118-patient capacity. According to the report, when Norton Community Hospital is factored into patient levels, the three hospitals are typically at less than 20 percent occupancy.
Mountain View’s ER sees about 18 patients daily, the report states — about a quarter of the Norton Community ER patient load.
Intensive care unit usage is also low among the three hospitals, the report states. The typical daily ICU census for the facilities is less than eight patients a day, with an average ICU patient count at Lonesome Pine of just over one patient a day.
One factor in the Ballad plan to merge the two Norton emergency departments is that Mountain View and Norton Community are 2.3 miles apart. Each hospital is within about a mile of different exits from the U.S. Route 23 bypass.
Inpatient usage of the three hospitals dropped 23 percent between 2011 and 2017.
The report also cited difficulties in recruiting doctors and specialists for the three hospitals. Norton Community and Lonesome Pine both deliver babies, but each hospital has only one staff obstetrician. Even with bringing in temporary specialists to allow those obstetricians time off, the report states, sometimes the two hospitals have to divert delivering mothers to Ballad’s Tri-Cities hospitals.
Deliveries at the Lonesome Pine and Norton Community birthing centers run about 14 babies a month.
Ballad has been able to bring a cardiologist and orthopedic surgeon into the Wise County area. along with internal medicine and hospitalist specialists, the report stated.
The Southwest Virginia Cancer Center in Norton is already scheduled for upgraded radiation oncology equipment, the report states, and Ballad is planning to introduce additional behavioral health and substance abuse treatment services in coming months.
The report states that since the merger of the Wellmont and Mountain States Health Alliance systems, 700 more patients in the past year have been able to be kept in Wise County and Norton for care. Surgeries in the county over the same period also increased by 18 percent despite a declining population.
The report also states that further Ballad decisions on its county and city facilities and health services will be done in conjunction with a Wise County Visioning committee composed of physicians and board members from the hospitals, leaders of UVa-Wise and Mountain Empire Community College and local and state elected and appointed government officials.