Beruflich Dokumente
Kultur Dokumente
8-15-19
Strengthening Healthcare in Wise County
Top Takeaways
1. After several months spent working through complicated licensing issues with the Commonwealth
of Virginia, Ballad Health has submitted a formal plan to the Virginia Department of Health to
protect healthcare safety and access in Wise County. This plan represents the initial steps necessary
to protect patient safety and create space and opportunity for new services.
2. All three facilities remain open and all services remain in the county.
3. We are working to bring a number of new and enhanced services to the county, including the
addition of behavioral health services and upgrading of oncology services.
4. To support patient safety in the immediate term and to prepare for new services, we have
requested the state’s permission to:
a. Move inpatient and critical care services from Mountain View to Lonesome Pine and
combine the two hospitals medical/surgical and ICU units
b. Integrate Emergency Room services at Norton Community Hospital and cease operation of
the ER at Mountain View
5. Mountain View offers important and high-quality services in skilled nursing and long term care. We
will work with the state to expand and enhance these and other post-acute care services at
Mountain View going forward.
• We have been working through very complicated licensing issues with the state for a number of months and
recently submitted a formal plan to the Virginia Department of Health to protect healthcare safety and access in
Wise County:
o Enhancing healthcare services in Wise County will require a long process of bringing our three hospitals
together, combining services where appropriate and launching new services in areas where we know we
have both capacity and need.
o As always, our first priority is patient safety.
o Importantly, all 3 facilities will remain open and all services remain in the County— even though where and
how some services are provided may change.
o We are working to bring a number of new and enhanced services to Wise County, in collaboration with our
physicians and the Wise County Visioning Advisory Committee. A few of the initial investments include:
▪ Introducing new behavioral health services in Wise County, working with community partners,
physicians, the Wise County Visioning Committee and Ballad Behavioral Health service line over
the next several months to identify the best location for these services among our three
hospitals.
▪ Upgrading radiation oncology equipment in Norton by replacing the linear accelerator at the
Southwest Virginia Cancer Center with a newer model
o To support patient safety in the immediate term, and to prepare for new services, we have requested the
state’s permission to make the following initial changes at Mountain View:
o Move inpatient and critical care services from Mountain View to Lonesome Pine and combine the
two hospitals’ medical/surgical and intensive care units.
Wise County Update Info Sheet
8-15-19
▪ The medical staff at Mountain View temporarily stopped performing surgeries last fall due to low
patient utilization and safety concerns, and we have requested that the state ratify this decision
going forward.
▪ Fewer than 8 patients a day were in ICUs in Wise County, and these high intensity services were
split between three hospitals. Lonesome Pine average only a little over one patient per day in the
ICU.
▪ Bringing these services together allows us to do the best job we can keeping our patients safe.
o Integrate Emergency Room Services at Norton Community Hospital, and cease operation of the ER at
Mountain View. Last year, Norton Community Hospital saw four times as many ER visits as Mountain
View. The emergency department at Mountain View is now only seeing about 18 patients per day.
The two hospitals are only 2 miles apart. It makes sense to combine these Emergency Departments
at Norton Community Hospital.
o Mountain View Regional Hospital offers important services in long-term care and skilled nursing care. We will
continue working with the state on options for expanding and enhancing these services and other post-acute
care services at Mountain View going forward.
• These decisions were not made quickly, and these improvements reflect months of thoughtful research and
conversation to determine the right next steps for healthcare in Wise County. These decisions are motivated
solely by the need to protect patient safety, improve patient care, and bring needed services to Wise County.
Ballad Health is committed to Wise County, and we believe that by combining our talented physicians and team
members, along with the right resources and equipment, we can greatly improve patient safety, provide
adequate staffing and enhance the quality of patient care.
• We are committed to implementing these improvements thoughtfully. Pending state approval, we anticipate
these improvements to be implemented beginning early this fall. As we move forward, we will keep our team
members informed of any upcoming changes that might affect them.
• We know that team members will have questions about how changes in Wise County will affect them
individually. It’s important for team members to know that our workforce in Wise County is needed and valued,
and jobs will be available for team members who wish to remain with Ballad Health. Understand that nothing
changes today. If the state approves our plan, we will have a 60- to 90-day time period before we can begin
implementing changes. In the meantime, we are working on the plans for this transition, and this communication
is the first step so you can participate in this process.
• More changes will be necessary in order to fully arrange services in Wise County to meet the community’s need.
These initial steps are necessary in order to protect patient safety in the immediate term and to create space
and opportunity for new services. We will continue to work with the Wise County Visioning Advisory Committee,
the community, our physicians, our team members and the Virginia Department of Health to finalize plans for
the full scope of Wise County services.
• It’s important to know that all 3 facilities remain open and all services remain in the County, even if the specific
location where these services are delivered may change. We appreciate your support and hope you will reach
out anytime if you have questions or thoughts to share.
• Like rural communities across the country, we face many challenges in Wise County.
o Declining population. The population has declined 8.5% since 2000. Many counties in the area – including
Wise, Dickenson, Lee, Scott and others – are expected to lose about 8% of their population between 2020
and 2040. These population declines, combined with changes in the way healthcare services are used
nationwide, mean the use of hospitals in our region has declined and will continue to decline in coming
years.
o Low average daily census. There are three full-service Ballad Health hospitals in Wise County that are
located less than 12 miles from each other and offer duplicative services. The average daily census of
patients in Lonesome Pine and Mountain View typically ranges from 1 to 6 patients per day in facilities that
were built to house 78 and 118 patients, respectively. On average, the three Wise County hospitals are each
less than 20% full (occupancy rates at Norton, Mountain View and Lonesome Pine were 19 percent, 10
percent and 15 percent respectively) and inpatient utilization dropped 23% between 2011 and 2017. Our
two birthing centers each deliver only around 14 babies per month, sometimes going several days without a
single delivery. These low volumes can be dangerous for patients, as healthcare staff cannot sustain
competencies if they do not perform enough procedures to keep their experience level high. This is a proven
issue for low volume hospitals and has been widely studied and validated. This is a patient safety issue, and
Ballad Health will always do what is in the best interest of our patients.
o Difficulty recruiting needed doctors, specialists and adding key services. Physician recruitment for rural
areas has been a challenge for years in rural America and Wise County is no exception. While we’ve put
significant resources into filling the need for specialists and have succeeded in recruiting in the areas of
cardiology, internal medicine, family practice, hospitalist and orthopedic surgery, other areas remain
extremely difficult to cover.
o For example, only one obstetrician is on staff at each of the birthing centers at Norton Community Hospital
and Lonesome Pine Hospital, making it difficult to staff nights, weekends, and holidays. We’ve had to rely on
temporary (locums) coverage to full in the gaps, but occasionally even locums aren’t available. When
adequate physician coverage cannot be secured, the hospitals are forced to go on OB diversion, directing
women elsewhere for deliveries.
o Mountain View and Norton community hospitals are located only 2.3 miles drive from each other. Splitting a
small number of admissions and surgeries between these two facilities has led to wasted money and
staffing shortages over the years.
• Our doctors have told us the need for change is clear. Last fall, the challenges regarding low patient use of
services led local Wise County physicians and clinical leaders to strongly recommend that Operating Room
surgery procedures no longer be performed at Mountain View. The number of procedures taking place was too
low to meet industry-accepted patient safety standards, and surgeries were halted at the urging of local
physicians.
o We notified Virginia state health officials immediately of this decision, and our physicians communicated this
change to their patients as appropriate. We have asked Virginia officials to formally ratify our decision to halt
surgeries at Mountain View.
o Surgical procedures have continued to be performed at Lonesome Pine and Norton Community Hospital.
• We will work with local leaders in Wise County through the newly appointed Wise County Visioning Committee to
determine how we make the greatest positive impact on community health.
o The Visioning Committee is made up of local leaders who are committed to playing an important role in
shaping the future of healthcare in the county.
o The Committee will help to study the current health services and needs of the county, review the
recommendations of the Community Health Needs Assessment work groups and make recommendations to
Ballad Health on how we can best serve our community’s healthcare needs going forward.
o Committee members include: Mike Allen, Chairman, LPH Board; Dr. Matt Cusano, Physician and NCH Board
Member; Mike Hatfield, Wise County Administrator; Donna Henry, PhD, Chancellor, The University of
Virginia’s College at Wise; Terry Kilgore, District 1 Representative, VA House of Delegates; Mark Caruso, City
of Norton Vice Mayor; John Schoolcraft, Vice Chairman, LPH Board and Wise County Supervisor; Jessica
Swinney, Wise County Emergency Management Manager; Jibber Ward, Chairman, NCH Board; and Kris
Westover, EdD, President, Mountain Empire Community College; and Dr. Michael Wheatley, family practice
physician and LPH Chief of Staff.
We have a tremendous opportunity to make healthcare better in Wise County. We are committed to making this
happen by working closely with our team members, physicians and the community.