Ballad defends plan to realign services

Ballad Health Executive Chairman, President and CEO Alan Levine holds up a map showing the location of trauma centers in Tennessee during a meeting with the Kingsport Times News and Johnson City Press editorial boards on Thursday.

KINGSPORT — Ballad Health Executive Chairman, President and CEO Alan Levine launched a vigorous defense Thursday of the healthcare provider’s announced move to regionalize and realign services amid pushback from local governments and attacks — some of them personal — on social media.

In a meeting with members of the editorial boards of the Kingsport Times News and Johnson City Press, Levine and members of his Ballad Health management team emphasized that the changes are data-driven and will ultimately improve healthcare in the region.

“These attacks are wrong,” Levine noted.

Levine said a previously planned meeting to talk with Sullivan County commissioners about the changes has now been canceled. Commissioners passed resolutions on Nov. 15 opposing Ballad Health’s switch of Holston Valley Medical Center from Level One to Level Three trauma center status and move to close Holston Valley’s neonatal intensive care unit.

“I’m happy to meet with any of the commissioners individually,” Levine said. “I’ll take counsel from (the county) Mayor (Richard Venable) about how he wants to move forward. They’ve already made up their minds.”

In an email to commissioners, County Attorney Dan Street reminded them that Tennessee state law requires all meetings of the County Commission be advertised in a paid legal ad in the local newspaper and that the meetings be open to the public. “Merely attending an informational meeting is not, in my opinion, a violation of the Sunshine Law; of course that is just my opinion,” Street wrote. “However, once a commissioner discusses or debates any of these topics with another county commissioner, then a violation of the Sunshine Law will occur.”

Levine charged the pushback is the result of misinformation. He disclosed he spent Thanksgiving responding to social media attacks.

“There are a couple of things that have been said that are not true,” Levine pointed out. “One is this was a Mountain States takeover of Wellmont. Twenty-five percent of our board resides in Johnson City; four members of our board live in Kingsport. More of our board members live in Kingsport than Johnson City.

“Since the merger, the (inpatient) volumes at Holston Valley are up 1 and a half percent, the volumes at Bristol are up 3 percent, Johnson City is down 3 and a half to 5 percent. The reason for that is we are now referring patients to the closest appropriate hospital. Every decision we are making is about what’s best for the patient. For anyone to suggest that our board would make such important decisions purely because of the money is so irresponsible.”

Levine and his team also addressed these questions:

How were the announced changes decided?

Levine said an objective evaluation of healthcare data, including trauma care, was undertaken. A qualified outside consultant worked with a Ballad Health subcommittee, which made recommendations to the Ballad Health management team. “We did not want management to influence this decision,” said Levine. “There were four doctors on this subcommittee. All four of the doctors have experience in both Johnson City and Kingsport. Management stepped back, then the committee asked if we concurred with the recommendations. By and large, we did. It was unanimous. There wasn’t one ‘no’ vote.”

What’s involved in trauma care?

Dr. George Testerman, the new vice president of Trauma and Emergency services for Ballad Health, said much of the public doesn’t have a grasp of it.

“ ‘Injury’ might be a better word for ‘trauma.’ It’s like an injury center,” said Testerman. “We don’t take care of cardiac or heart attacks per se. There are specific teams for that. We take care of major injuries, patients who have injuries that are a direct threat to their life.”

Visioning’ process on future of healthcare coming to Kingsport

A visioning process is being initiated to see what healthcare should look like in Kingsport in the future, Levine said. 

In mid-November, Ballad reported Kingsport’s Holston Valley Medical Center will continue to be a trauma center, but not at Level 1 status. Ballad said that “major” trauma cases — representing approximately 10 percent of all trauma — will be transported to Johnson City Medical Center, but added the majority of the cases will continue to be served in the trauma center closest to the patient.

Ballad also said there will be realignment of Level III neonatal intensive care (NICU) services at Niswonger Children’s Hospital in Johnson City. Ballad said it will also establish new Niswonger Children’s Hospital pediatric emergency rooms in Kingsport and Bristol.

Levine said he is working with Kingsport Mayor John Clark to get the visioning process started.