Change never stops. On Monday, that truth will be all the more evident for many in Greene County when Laughlin Memorial and Takoma Regional hospitals officially become the two campuses comprising Greeneville Community Hospital.
The two competing entities, joined together now for more than a year as part of Ballad Health, will share a name (Laughlin becoming the east campus, Takoma becoming the west). Though they have operated as one entity since Feb. 1, 2018, the name change signals the important merging of operations and legacies.
The story appearing on today’s front page of The Greeneville Sun is meant as an homage to those legacies. But what it is not is a nostalgic hope that things — the health care industry in Greene County included — could go back to the way they used to be.
Laughlin and Takoma could not continue on as separate, competing entities. In the fiscal year that ended in 2018, the two hospitals reportedly operated at a combined loss of $18 million. Those figures weren’t flukes. Checks of the several preceding years’ financial statements show both hospitals were losing big money. In fiscal year 2014, for example, Laughlin operated at a $6.7 million loss. In the previous year, Takoma posted a $1.8 million loss.
Health care has been one of the most volatile industries in the last two decades, and Greene County was not immune to those changes. Like it or not, the days of two small-town hospitals operating independently of each other in a community like ours are gone.
Thus came Ballad Health — merging the former Mountain States Health Alliance (which had acquired Laughlin Memorial Hospital by the time Ballad came on the scene) and Wellmont Health System (which owned and operated Takoma Regional Hospital). The new and hotly debated company says it can operate the two hospitals as one entity, reducing duplicative services and even adding services (such as a planned step-down unit for Greeneville Community Hospital East).
We hope Ballad is right. It’s comforting to know that the Greeneville market is being managed by a someone like CEO Tammy Albright, someone who understands Greene County and the unique dynamic the Laughlin-Takoma situation produced. Co-Chief Medical Officers Dr. Mark Patterson and Dr. Daniel Lewis — and much of the local staff — understand that too. We believe they know what needs to happen to serve this community.
But now that change has come, the devil will be in the details. Since Ballad came into being, lots of patients from around the region have lodged complaints about pricing, plans for facilities, staffing levels, patients’ quality of care, compensation for nurses and more.
The Certificate of Public Advantage that governs Ballad Health and its performance imposes many requirements for determining whether the advantages of the consolidated entity outweigh the disadvantages. The Local Advisory Council that helps steer public feedback about Ballad issued a report earlier this month, following a public hearing in February, making several recommendations to the Tennessee Department of Health in how it is regulating Ballad and the job it is doing (the full report is available at GreenevilleSun.com).
Here’s our takeaway, at least as it relates to Greene County: Yes, change was needed at Takoma and Laughlin, but Greene Countians want Ballad to communicate with the public more before and as those changes happen. The Local Advisory Committee (which includes State Rep. David Hawk) concurred, saying in its report: “A common theme we heard is the need for improved communication between Ballad Health and the community, especially in terms of giving notice before major decisions are announced to the public and even offering opportunities for community engagement and buy-in on the front end when possible.”
The Tennessee Department of Health is reportedly developing a better public input process for monitoring Ballad Health and community feedback, and that needs to happen sooner rather than later.
The Local Advisory Council also criticized Ballad Health for how its first annual report (submitted in late 2018) is “excessively broad and contains a lot of information that does not appear to be relevant.” That goes back to the urgent need for effective communication.
Ballad’s effectiveness will also be judged by how it performs on a number of measures, including improving access to health care services, health care quality, the health of its constituent populations and financial performance. The Local Advisory Council recommends the Department of Health further probe several issues brought up by the public.
We implore state regulators to do so. If Ballad is not living up to its obligations in improving health care in the region (and Greene County), regulators need to act swiftly and decisively. If Ballad is living up to its obligations, that too should be communicated as quickly and clearly as possible.
Some of these measures may take time to evaluate. This venture is still young. But the public — many of whom are uneasy and wary of Ballad — needs to be able to trust the organization now handling the majority of the health care in this region.
Change in Greene County was needed. Now we hope Ballad will be listening as implementation of that change continues.