Carter County measure calling for more state scrutiny of Ballad Health fails to pass

Commission members voted 11-9 in favor of the resolution, but it failed to get the 13 votes necessary for passage.

By: - October 24, 2023 2:21 pm
Protesters gather in opposition to the closure of the neonatal intensive care unit at Holston Valley Medical Center, a Ballad Health hospital, in 2019. (Photo: Dani Cook)

Protesters gather in opposition to the closure of the neonatal intensive care unit at Holston Valley Medical Center, a Ballad Health hospital, in 2019. (Photo: Dani Cook)

The Carter County Commission failed to pass a resolution asking Tennessee officials to better regulate Ballad Health, a state-sanctioned East Tennessee hospital monopoly. 

Commissioners voted 11-9 in favor of the resolution, but two abstentions and two absent members prevented the tally from reaching the 13 yes votes required for passage. 

The resolution stems from a decision by Ballad Health in June to close the Intensive Care Unit at the Sycamore Shoals Hospital in Elizabethton, a town of 14,000 located at the heart of Carter County in the northeastern corner of Tennessee. 

With the closure, Carter County no longer has an ICU. The nearest facility is in Johnson City, located about 20 minutes from the Sycamore Shoals facility.

Ballad Health is a nonprofit hospital chain headquartered in Johnson City, operating 20 hospitals — including 13 in Tennessee. The company is the only hospital system covering 1.1 million residents over a 29-county region across Kentucky, North Carolina, Tennessee and Virginia. 

Ballad formed in 2018 after Tennessee and Virginia lawmakers agreed to let Mountain States Health Alliance and Wellmont Health System merge and operate as a state-approved monopoly under a Certificate of Public Advantage (COPA). 

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The COPA allowed Ballad to operate as the only hospital system in Tennessee’s Tri-Cities area, blocking competition from entering the market. 

In exchange for this special privilege, Ballad agreed to increased state oversight, including providing over $100 million annually in charity care, limiting price increases and maintaining health care quality standards.

But, an investigation by KFF Health News found that Ballad had met few of the COPA’s quality-of-care benchmarks and charity provisions. Federal health officials have also issued one-star ratings to three Ballad hospitals, including the facility in Johnson City. 

Carter County Commissioner Angie Odom sponsored the Ballad resolution, previously telling the Lookout that she and other community members “lacked confidence” in Ballad to fulfill its COPA obligations. 

Odom’s resolution and community discussions around Ballad’s Sycamore Shoals ICU closure appeared to anger hospital leaders. 

Carter County Commissioner Nick Holder said Ballad threatened to pull funding for an ambulance because of community meetings questioning the company’s decisions. 

Holder made the comments at the commission’s health and welfare committee meeting held on Oct. 3. He abstained from voting on the resolution during Monday’s commission meeting. 

“We appreciate the Carter County Commissioners who have done the hard work and taken the time to understand the challenges faced by all hospitals,” Ballad Health officials said in a statement after the meeting.


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Adam Friedman
Adam Friedman

Adam Friedman is a reporter with the Tennessee Lookout. He has a particular love for data and using numbers to explain all kinds of topics. If you have a story idea, he'd love to hear it. Email him at [email protected] or call him at 615-249-8509.