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A timeline of Ballad Health, from 2014 to present

Zach Vance • Nov 18, 2018 at 12:07 AM

Earlier this week, Ballad Health leaders announced what is arguably the biggest move in the hospital system’s brief history: The formation of a regional trauma system that is expected to save resources, increase effectiveness and expand access.

Here’s a look at how Ballad Health came to be and some of its latest developments.

Jan. 9, 2014 — Wellmont announces search for partner

Wellmont Health System CEO and President Margaret “Denny” DeNarvaez announced her hospital system had “launched a process to evaluate strategic options for the organization’s future, including the possibility of aligning with another health system.”

April 2, 2015 — Mountain States-Wellmont leaders announce merger plan

Wellmont and Mountain States Health Alliance’s boards of directors sign a term sheet agreeing to explore the merger. A new board is created with equal representation from both hospital systems would direct the proposed conglomerate.

May 18, 2015 — The Tennessee General Assembly votes to amend the Hospital Cooperation Act

First passed in 1993, the state legislature reaffirmed that policy by stating competition among hospitals could be displaced in certain instances and replaced with regulation. It also outlined specifically what benefits and disadvantages must be considered, while providing state action immunity from federal and state antitrust laws.

Feb. 16, 2016 — First COPA application submitted

Five months prior, the hospitals submitted a letter of intent and followed it up in February with an exhaustive 2,578-page Certificate of Public Advantage application. Over the next seven months, the Department of Health requests more information and the hospital systems submit an addendum and respond to various questions posed by the state.

Sept. 26, 2016 — First merger application complete in Tennessee

Finally, Tennessee Department of Health Commissioner Dr. John Dreyzehner deems the merger application complete, initiating a 120-day review period that would culminate in a decision. Or so everyone thought. On the 120th day, both hospital systems issued a news release stating Dreyzehner had granted them more time to provide additional information. Because of this, the application was no longer deemed complete and the process started over again.

May 22, 2017 — 120-day review process begins anew

Five months after the application was withdrawn, the amended version with “additional submissions” gets deemed complete and another 120-day review period begins. Those “additional submissions” turned out to be three “independent” reports supporting the merger, but each was paid for by the hospitals.

Sept. 19, 2017 — The merger gains approval

This time around Dreyzehner gave his stamp of approval, and one month later, the Virginia Department of Health gave its approval. Ballad Health announced its board of directors in November, but the whole ordeal in Virginia and Tennessee did not officially “close” on the deal until Jan. 31, 2018.

Jan. 30, 2018 — Public records protections

Ballad Health employee and state Sen. Rusty Crowe filed a bill that would restrict access to some of Ballad’s “proprietary” information, including operating budgets, audits, facility assessments and all records related to the COPA monitor, from becoming public record. Backlash ensued and by March, Crowe chose to amend his bill to narrow the scope, while giving the health commissioner discretion to reveal certain records. The amended bill was signed by the governor May 1, 2018.

April 17, 2018 — Job cuts 

As expected with consolidation, Ballad Health laid off 150 employees and eliminated 49 positions through attrition. When the merger was still in its early stages, officials initially projected a loss of 250 jobs. Had the merger not occurred, Ballad CEO Alan Levine made the case that closer to a thousand jobs could have been in jeopardy.

May 5, 2018 – Urgent care realignment

Ballad Health announced plans to close four urgent care clinics — in Johnson City, Abingdon, Kingsport and Greeneville — over the coming months, noting that after the merger, Ballad Health was operating two urgent care clinics in each of those four cities.The decision to consolidate its walk-in clinic services, according to the statement, was to “make better use of its resources.”

Oct. 23, 2018 — Unicoi County Hospital officially opens

The new 40,000-square-foot facility officially opened to the public after a year of construction. The new hospital features a 24-hour emergency department with a telemedicine connection to Niswonger Children’s Hospital; 10 inpatient beds; pulmonary, cardiac and acute care services; a chest pain center and outpatient services. Ballad Health CEO Alan Levine said he thought the merger helped make the new hospital a reality.

Nov. 8, 2018 — Strong financial quarter 

Revenue for Ballad Health during its first quarter of operations showed a 2-percent increase compared to the year prior, before Mountain States and Wellmont’s budgets were combined. Operating cash flow increased 9.8 percent and total cash flow jumped 25.2 percent. Expenses did see a 1.5 percent increase, making for a wider operating margin.

Nov. 16, 2018 — Trauma realignment

In the biggest shake-up since the merger was finalized, Ballad announced its plan to regionalize its trauma and emergency care operations by shifting Holston Valley Medical Center’s trauma center status from a Level I to Level III, while maintaining the Level I trauma center at Johnson City Medical Center. Other announcements included the formation of a new pediatric trauma service at Niswonger Children’s Hospital.

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