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Wednesday, Aug 1, 2018

Plans for sustainability and enhancement of Greene County healthcare

Following a period of detailed analysis and conversations with community stakeholders, physicians and other clinical leaders, hospital leaders in Greene County announced plans Wednesday outlining details of how the county’s two hospitals will work together to meet the needs of the community in the future. 

Both hospitals will remain open, and services will be organized to allow the hospitals to complement each other rather than create unnecessary duplication. This approach will ensure that volumes of care support the highest level of quality, and that the hospitals can continue to recruit and retain physicians and staff.

Ballad Health will submit the official notice to the state in accordance with the Terms of Certification of the COPA, and will comply with the provisions required in the Terms of Certification. Today’s announcement represents Ballad Health’s commitment to transparency with the community.

Beginning in early 2019, Takoma Regional Hospital will focus its services on advanced outpatient and non-acute inpatient care, while Laughlin Memorial Hospital will focus on providing acute inpatient services. The two hospitals will operate as one entity with two campuses. To reflect the unified nature of the new system of care in Greene County, the hospitals’ names will change. The new names will be announced in the coming months after consultation with the community.  

Services to be offered at Takoma will include inpatient rehabilitation, inpatient geriatric-psychiatric care, occupational medicine, sleep medicine, emergency medicine and advanced diagnostic imaging. Services to be offered at Laughlin will include inpatient surgery, inpatient medical/surgical care, same-day surgery, endoscopy, emergency medicine, ICU and obstetrics, including labor and delivery. The hospitals will also work together to provide a combination of observation and short-stay care for pediatrics.

In addition, a new 12-bed progressive care unit will be added to the hospital. Progressive care (also known as “transitional care” or “step-down unit”) provides an intermediate level of care between intensive care (ICU) and a general medical/surgical unit, where patients receive a high level of skilled nursing care and intensive monitoring, but with fewer visitation restrictions than an ICU. Twelve beds from the current medical/surgical unit will be converted to progressive care to create this new service.

Tammy Albright, CEO of Takoma Regional Hospital, will serve as CEO of the combined hospitals. Chuck Whitfield, CEO of Laughlin Memorial Hospital, will serve in an advisory role during the transition until his retirement on February 28, 2019.

“By allowing each of our Greene County hospitals to specialize in certain areas, we will improve the quality of care we can offer while also reducing the cost of providing that care,” said Albright. “Better organization of our resources protects healthcare in Greene County by creating a stronger and more stable system of care, and each of our local hospitals has an important role to play in that organized system of care.”

Greene County will be the first market within Ballad Health to move to a consolidated Epic electronic medical record (EMR). The Epic EMR is currently in use at Takoma, and will be installed at Laughlin in December. Medical services will begin transitioning between the two hospitals in early 2019 after the Epic installation is complete.

The environment for rural hospitals has been difficult and deteriorating over the last eight years, as nearly 90 rural hospitals have closed, with Tennessee ranking No. 2 in the nation for closure of such facilities. Last week, a major operator of rural hospitals based in Tennessee, and with assets throughout the nation, announced plans to be sold to a private equity firm, while other rural hospital operators based in Tennessee, and with assets throughout the nation, continue to struggle. The hospitals in Greeneville are facing the same challenges. In the fiscal year that just ended, the two hospitals saw combined operating losses of $11 million, with cumulative two-year losses totaling nearly $31 million.

Under each hospitals’ previous ownership, in 2014 and 2015, deteriorating financial results led to discussions between the incumbent boards and management for a consolidation of the two hospitals.  A mutual agreement could not be reached, which resulted in Takoma being acquired by Wellmont Health System, and Laughlin being acquired by Mountain States Health Alliance. The merger creating Ballad Health paved the way, with state approval, for this partnership to finally happen. Had the hospitals remained independent during the last two years as cash reserves declined, at least one would likely have closed. 

While many rural hospitals either close or substantially reduce their acute care service offerings, the formation of Ballad Health was intended to create a collaborative approach to saving rural hospitals by decreasing unnecessary duplicative cost and investing the savings into sustaining the assets and expanding into new services. 

“In our merger agreement, we pledged to the community and to our regional employers to reduce unnecessary cost by organizing our services in a way that makes the most sense for the community,” said Eric Deaton, senior vice president for Ballad Health’s market operations. “The decisions about where and how to consolidate services in Greene County were made by collaborative, multi-disciplinary teams working together to determine how these two hospitals could best meet the needs of Greene County residents. These teams, including leadership from both hospitals, gathered input from physicians and other clinical leaders and evaluated patient volumes and medical service needs in the area before making a final decision. We are excited about what the future holds for Greene County, and we believe we have built a good plan for sustaining healthcare in the region.”

In its approval of the merger creating Ballad Health, the state of Tennessee agreed with Ballad Health officials that “significant duplication of services exists in Greene County, Tennessee as a result of the two Rural Hospitals located therein.” Further, the state said Ballad Health “may consolidate services into one of such rural hospitals and repurpose the other rural hospital … without prior approval from the department” under certain circumstances.  

Today’s announcement details how the hospitals in Greene County – previously competitors in an environment where both were financially struggling – will collaborate in a manner that will preserve acute care services in Greeneville in accordance with the state’s primary goal of preserving access, and will enhance the viability of the hospitals going forward.

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