“Bonuses Before Babies”, seems like an odd title for an article about a healthcare system. But then again, there’s very little about Ballad Health that one might not consider “odd”.
Remember, this is a medical monopoly that was created at the behest of a group of businessmen who call themselves the “Hole in the Wall Gang”, a state senator who also happens to be a contracted vendor of said healthcare system, and a healthcare executive whose past employers have been found guilty of Medicare/Medicaid fraud.
So, maybe “odd” is the best we can hope for when referring to Ballad Health.
If you haven’t followed Ballad Health, you may not be familiar with the COPA (Certificate of Public Advantage) they received in order to become the owner of every hospital in a geographic region the size of New Jersey and the pretty much the sole provider of inpatient care for approximately 1.2 million people.
You may not know that despite repeated testimony by FTC staff in opposition to the granting of the COPA, a report by an independent expert, Robert Town, hired by the State of Virginia, and another expert report by Kenneth Kizer (hired by the FTC), the powers that blessed the union of Wellmont Health System and Mountain States Health Alliance giving them unprecedented control over healthcare in 21 counties.
I mean, there was no ambiguity.
The report from Kenneth Kizer contained statements like this one:
“After carefully reviewing and considering the application and other publicly available materials, I find there to be a pronounced paucity of detail and lack of specificity about how the claimed benefits will be achieved. In fact, the application is generally so vague about the means and mechanisms by which purported benefits will be achieved that it is impossible to determine whether they are plausible. As a result, I do not find them to be credible.”
The report from Robert Town said:
“The proposed cooperative agreement will eliminate that competition, and likely lead to a combined healthcare system having a 77% share in general acute care inpatient services, and shares of over 50% in several outpatient and physician specialty services. This substantial decrease in competition is likely to result in anticompetitive harm in the form of higher hospital prices, and lessened quality of care and hospital services.”
Despite these in-depth, clear, and definitive expert reports, the states of Tennessee and Virginia, granted them this COPA and created Ballad Health.
And you thought the title of this article was “odd”; but I digress…
Let’s talk about the most vulnerable of us: babies.
More specifically, babies so sick they require neonatal intensive care.
On November 14, 2018, Ballad Health announced their intent to downgrade one of only two NICUs in the region. While there are several worthy conversations we can (and will) have about this decision, I want to focus solely on the money.
We won’t spend time asking why Ballad Health would want to close a recently renovated $2.5 million state-of-the-art NICU that had been the region’s Children’s Miracle Network Affiliate for nearly 30 years. We won’t ask why Ballad Health would want to eliminate the closest sick baby ICU for its entire southwest Virginia patients.
Instead, we will focus on what Ballad Health said.
Despite including the closure of the NICU in their SEC documents for the bond refinancing, Ballad Health had not submitted the request to the Department of Health as required by the COPA. After public outcry about this breach in protocol and protest of the loss of care, Ballad Health was required to submit information justifying the move.
In a series of exchanges between Alan Levine, Ballad’s CEO, and the Department of Health, it became clear that the move would accomplish two things:
- Ensure Niswonger’s NICU at Johnson City Medical Center operated at an average of 80%+ census and ensure its “safety net” hospital status.
- Eliminate the need for 24/7 neonatology care at Holston Valley Medical Center.
Both of these things meant one thing for Ballad Health: More Money.
By eliminating the neonatal intensive care unit at Holston Valley Medical Center, Ballad Health claimed it would “save” a little more than $1 million annually.
While here’s the point where I could address the telemedicine equipment and its functionality (or lack thereof at times), but again, this article is solely about the money.
Because what’s interesting about Ballad Health’s claim about monetary commitments to the community, cost of paying for travel staff, and “operating costs that are not sustainable”, is that they don’t seem to have ANY problem paying their executives.
Heftily.
In the same fiscal year that they closed the sick baby ICU in order to “save” $1,043,160, Ballad Health gave its top executives almost $3.3 million just in bonuses.
One might ask did they actually save a million dollars or just defer it to their execs.
I mean, Alan Levine and Tony Keck’s bonuses together were over $1 million.
In fact, of the 15 active employees listed on their 2020 Form 990, not a single Ballad Health executive received a bonus less than 100,000.
You read that right.
A non-profit healthcare system that was in such dire straights that its future relied on the unprecedented step of becoming a legal medical monopoly…
A not-for-profit healthcare system that needed the $1 million in “synergy savings” from closing a neonatal intensive care unit so badly…
Gave its top highest paid executives almost $3.3 MILLION dollars in BONUSES.
Ballad Health’s fiscal year runs from July to June. The 2020 Form 990 covers 7/1/2019–6/30/2020.
They closed Holston Valley Medical Centers Level III state-of-the-art Neonatal Intensive Care Unit on September 1, 2019 in order to “save” just over $1 million. And in that same fiscal year, Ballad Health rewarded their executives with over $3 million dollars in bonuses.
In a region where the 20–30% of the people live in poverty, 8–10% don’t have access to reliable transportation, and they’ve closed or downgraded the life-saving services that were most centrally located, Ballad Health gave their execs almost $3.3 million dollars — in BONUSES.
Oh yeah, part of that time was in the middle of a global pandemic.
Makes you excited to see their next Form 990 due out in May, right?
