This the final installment in a four-part series examining how competing truths over consolidation impact a health system and its community.
JOHNSON CITY, TENN.—Morale is low at Ballad Health’s hospitals since the merger became official in 2018, according to several current and former nurses and doctors. They say they’ve watched many colleagues leave, fed up with being overworked, with management that doesn’t listen and changes to pay and benefits.
“I just felt like the direction that everything was going was unsafe and that we were completely marginalized from the decision-making process,” said Dr. John Keeley Jr., a trauma surgeon at Ballad’s Holston Valley Medical Center in Kingsport, who resigned from his position after the merger. Ballad is downgrading that hospital’s trauma center.
System executives say that’s not true, that the health system is weathering the same nursing shortage as the rest of the country. They say nurse turnover here is no different than before the merger.
“To attribute that to the merger is intellectually dishonest,” said Alan Levine, Ballad’s CEO. “The nursing shortage began before the merger and it's continued and it's going to get worse. I think you'll hear that from anybody who's out in the field right now.”
Johnson City, Tenn.-based Ballad was formed through a controversial maneuver that allowed it to avoid a federal lawsuit, even though the Federal Trade Commission opposed the deal. The not-for-profit health system covers a largely poor and rural 21-county region in northeast Tennessee and southwest Virginia, where it’s the only hospital provider.
But current and former nurses, doctors—some of whom spoke off the record—and patients say the departures have led to logjams at some Ballad hospitals. Patients sounded off about long waits in emergency rooms at a February public hearing, and said it wasn’t due to a lack of beds, it was because there wasn’t enough providers to treat patients.
“The outflow of nursing talent has been tremendous,” said Dr. Ken Smith, a neurosurgeon with level 1 trauma experience in Kingsport who has performed surgeries at Holston Valley in Kingsport for the past 30 years. “Some days I go up and I don’t know anyone on the floor.”