Certificate of Public Advantage
Information and resources about the Certificate of Public Advantage with sections and information on COPA announcements, history, official correspondence, submitting public Input and complaints, reports, and spending plans.The COPA
A Certificate of Public Advantage (COPA) is a written approval issued by the Tennessee Department of Health that governs a Cooperative Agreement (such as a merger) between two or more hospitals. The COPA provides a specialized form of state oversight to a system to allow a merger that may otherwise be blocked under federal antitrust laws. This oversight structure is designed to mitigate potential impacts that may result from a health system holding a majority share of the regional market, including possible effects on access, quality, pricing, and patient experience.
On January 31, 2018, the Department issued a COPA to Mountain States Health Alliance and Wellmont Health System, allowing them to merge under the name Ballad Health.
The COPA Statute is T.C.A. § 68-11-1301
- Press Release
- Executed Letter of Approval
- Fifth Amended and Restated TOC Governing the COPA, Fourth Amended and Restated TOC Governing the COPA, Third Amended and Restated Terms of Certification, dated July 1, 2022, Second Amended and Restated Terms of Certification, dated April 27, 2021, Amended and Restated Terms of Certification, dated July 31, 2019
- Terms of Certification, Approval Certificate Signed by MSHA, Approval Certificate Signed by WHS
*The resolution unanimously adopted by the Board of Wellmont Health System approved the September 16, 2017 draft of the Terms of Certification and any subsequent “more favorable terms” as may be agreed to by the State of Tennessee. The September 18, 2017 draft of the Terms of Certification contains a “more favorable term” that was agreed to by the State and, therefore, the September 18, 2017 draft of the Terms of Certification were approved by the Wellmont Board.
Current Information
05/06/25 - The "Fifth Amended and Restated Terms of Certification Governing the Certificate of Public Advantage Issed to Ballad Health Pursuant to the Master Affilication Agreement and Plan of Integration By and Between Wellmont Health System and Mountain States Health Alliance," dated January 1, 2025. A summary of the changes.
10/23/24 – The Tennessee Department of Health postpones Nov. 21, 2024 COPA Public Hearing.
Official Correspondence
03/11/25 – A letter from the Tennessee Department of Health regarding Ballad Health’s request for a waiver of the notice period for a proposed Long Term Care and Assisted Living Facilities transaction.
01/11/24 – A letter from the Tennessee Department of Health regarding Ballad Health’s waiver request related to employment of 8 general surgeons in Sullivan County, TN. (RE Ballad Health’s 11/07/23 general surgery employed physicians waiver letter.)
01/05/24 – A letter from the Tennessee Department of Health consenting to Ballad Health’s request to close surgical services at Hawkins County Memorial Hospital. (RE Ballad Health’s 11/02/23 request to close surgical services at Hawkins County Memorial Hospital. )
06/28/23 – A letter from the Tennessee Department of Health approving Ballad Health’s FY24 budget for FY23-FY25 spending plans. (RE Ballad Health’s FY24 Plan Budget. )
06/15/23 – A letter from the Tennessee Department of Health regarding Ballad Health’s waiver request related to Urologists in Washington and Sullivan County. (RE Ballad Health’s 05/12/23 urology employed physician waiver letter.)
05/05/23 – A letter from the Tennessee Department of Health consenting to Ballad Health’s proposed consolidation of Intensive Care Unit (ICU) and Progressive Care Unit (PCU) Services/Units at Sycamore Shoals Hospital with Johnson City Medical Center. (RE Ballad Health’s 12/08/22 Sycamore Shoals ICU/PCU notice Letter.)
04/10/23 – A letter from the Tennessee Department of Health approving Ballad Health’s request for a ninety-day extension on the replacement capital plan submission requirement. (RE Ballad Health’s 03/22/23 Capital Plan Extension Letter. )
01/27/23 – A letter from the Tennessee Department of Health regarding Ballad Health’s Fiscal Year 2021 Monetary Commitment.
COPA Reports
Ballad Health Annual Reports
Ballad Health Annual Reports FY2025 | FY2024 | FY2023 | FY2022| FY2021 | FY2020 | FY2019 | FY2018
FY2024 Ballad Annual Report Cover Letter
COPA Monitor Reports
COPA Monitor Annual Report on fiscal year 2024 | 2023 | 2022 | 2021 | 2020 | 2019 | 2018
COPA Compliance Annual Reports
COPA Compliance Office Annual Reports FY2020 | FY2019 | FY2018
As of FY2021 each COPA Compliance Office Annual Report is included with the Ballad Health Annual Report for the same fiscal year
Department Reports
Department Annual Report by Fiscal Year 2024 | 2023| 2022 | 2021 | 2020 | 2019 | 2018
Sub-Index Reports
- 2020 Access to Health Services Report
- 2020 Other Report
- 2020 Population Health Report
- 2019 Access to Health Services Report
- 2019 Other Report
- 2019 Population Health Report
- Updated 2018 Baseline Sub-Index Report
- 2018 Baseline Sub-Index Reports
As of FY2021 each Sub-Index Report is included with the Department Annual Report for the same fiscal year.
How to Provide Feedback to the Tennessee Department of Health
The Tennessee Department of Health (TDH) is responsible for on-going active state supervision of mergers granted under a Certificate of Public Advantage (COPA), according to Permanent Rules 1200-38-01-.01 et seq. , effective January 4, 2016, implement TCA Sections 68-11-1301 – 68-11-1309, which govern the COPA process.
The public is encouraged to provide feedback on the progress and impact of the Ballad Health merger on the region.
Leave a Comment
How to File a COPA Complaint
The public is encouraged to alert TDH of potential violations to the Terms of Certification that should be investigated.
For complaints specific to the impact of the COPA, please download and complete this complaint intake form. Please submit the completed complaint intake form to TDH:
By email: TN.Health@tn.gov (as an attachment).
By mail: TN Department of Health – COPA
710 James Robertson Parkway, 5th Floor
Nashville, TN 37243.
How to File Other Complaints Against Ballad Health
Some issues are not a result of the merger of the two hospital systems and thus, not resolvable under the COPA Terms of Certification (TOC). There are processes in place for receiving and investigating certain health care complaints. Examples of issues that are not COPA-related include:
Cleanliness, staffing concerns, and certain health care issues. These issues may or may not have happened as a result of the merger of the hospital systems and are not violations of the COPA Terms of Certification. Safety concerns should be directed to TDH’s Office of Health Care Facilities. The Office of Health Care Facilities remains responsible for the licensing and regulation of hospitals in the State. The process for filing a complaint against a Tennessee health care facility or provider is available here.
To be clear, while it is not the role of the TDH under the TOC to assist or track individual patients who have a negative experience at a Ballad Facility, TDH is tracking Ballad’s performance on dozens of safety and quality measures including timely and effective care, infection rates, and patient satisfaction scores at 1) a system level, 2) a statewide level, and 3) each Ballad facility. Quarterly and Annual data for Ballad Health’s total patient population will be used to track demonstration of an overall improvement or decline in care quality subsequent to the issuance of the COPA.
Labor concerns. Staff labor concerns are regulated by the Tennessee Department of Labor and Workforce Development. Information on its statutes governing employee meals and breaks, wage regulation, and fringe benefits can be accessed from that Department’s website here and its Labor Standards Unit with information how to file a complaint can be contacted by calling 844-224-5818.
Certain employee benefits and protections are covered by the COPA and are described under Section 3.08 Terms of Certification.
Billing issues. High deductibles, high premiums, and co-pays are a part of the complex United States health care system and not related to the COPA. Double billing or coding issues may be errors caused by a human data entry error. Those issues should be directed to Ballad Health’s billing department, which can be reached by calling at (423) 431-1700 or (423) 408-7400.
Compliance questions. The COPA Compliance Office is part of the Active Supervision Framework outlined in the Terms of Certification. The Ballad Health COPA Compliance Office reviews, logs, investigates, and seeks to resolve compliance issues. The COPA Compliance Office can be contacted through an Anonymous Alertline, at 1-800-535-9057, or via general email, at copa.compliance@balladhealth.org.
How to Submit General Comments Regarding Ballad Health
General comments regarding the progress of the Ballad Health merger and its impact on the region can be submitted to the Tennessee Department of Health.
Spending Plans
Current
FY23 - FY25 Spending Plans
Former Spending Plans
Ballad’s Three-Year Plans
Revised Children’s Health Plan (submitted April 2021)
Ballad Health ‘s Rural Health Plan.
Ballad Health’s Behavioral Health Plan.
Ballad Health’s Children’s Health Plan.
Ballad Health’s Population Health Plan.
Ballad Health’s Plan Updates (“Implementation Roadmaps”)
FY20 Implementation Roadmaps containing updated schedules of quarterly milestones and data metrics for Ballad Health’s six 3-year plans: Behavioral Health, Children’s Health, Health Information Exchange, Health Research and GME, Population Health and Rural Health.
One-Year Plan Extension
Ballad’s request for a one-year extension of the three-year plans.
TDH letter approving the one-year extension of Ballad Health’s three-year plans.
Plan Modification Requests
Ballad’s HR/GME Plan Modification Request to add a program at the Appalachian School of Law dated 9/18/20.
TDH Approval of Plans
TDH’s conditional approval of Ballad Health’s Rural Health Plan.
Mountain States Health Alliance and Wellmont Health System
Last Updated: May 22, 2017
Dates have been updated to reflect the document date rather than the date posted.
Application Documents
- Application
- Addendum 1
- Addendum 1 Exhibit 11.4-D
- Addendum 1 Exhibit 11.4-E
- Response to April 22 Questions (1/2)
- Response to April 22 Questions (2/2)
- Revised Plan of Separation
- First Amendment to Master Affiliation Agreement and Plan of Integration (Exhibits in this document can be found in the other application documents above.)
Public Hearing Video and Transcripts
- Blountville, 8/2/17 Video | Transcript
- Nashville, 9/29/16 Transcript
- Blountville, 6/7/16 Video | Transcript
- Kingsport, 9/1/16 Video | Transcript
- Bristol, 10/6/16 Video | Transcript
- Johnson City, 11/21/16 Video | Transcript
January 31, 2018
December 15, 2017 –
December 8, 2017 –
August 9, 2017 –
April 11, 2017
April 7, 2017
Letter from WHS and MSHA to Janet Kleinfelter regarding Expert Reports
Report from the Advisory Board
Report from the Healthy Communities Institute
December 13 to December 17, 2016
November 28, 2016 –
Select comments submitted to the Tennessee Department of Health
November 22, 2016
September 30, 2016
September 12, 2016
First Amendment to Master Affiliation Agreement and Plan of Integration (Exhibits in this document can be found in the other application documents above.)
September 9, 2016
August 17, 2016
July 20, 2016
April 22, 2016
April 19, 2016
Written Comments of America’s Health Insurance Plans
Economic Analysis submitted by America’s Health Insurance Plans
March 28, 2016
March 16, 2016
WHS-MSHA Addendum #1 to COPA Application
Exhibit 11.4 – Attachment D: Mountain States Covenant Compliance Certificates
Exhibit 11.4 – Attachment E: Mountain States Officer’s Certificate
March 3, 2016
February 29, 2016
January 15, 2016
January 7, 2016
December 22, 2015
October 29, 2015 –
The purpose of the Advisory Group is to recommend measures for an Index. If a COPA is issued, this Index would be used to track the progress of a Cooperative Agreement over time to ensure public advantage. The Advisory Group will hold a series of public meetings to assure regional input for these measures.
September 25, 2015 –
The Rulemaking Hearing for proposed permanent rule 1200-38-01 was held on September 24, 2015.
The video from this hearing can be viewed here .
Written comments are posted below.
America’s Health Insurance Plans
BlueCross BlueShield of Tennessee
Announcement on the COPA decision: Tennessee Department of Health Commissioner John Dreyzehner, MD, MPH, announced Sept. 19, 2017 that the request for a Certificate of Public Advantage from Wellmont Health System and Mountain States Health Alliance has been granted.
Approval Certificate Signed by MSHA
Approval Certificate Signed by WHS
*The resolution unanimously adopted by the Board of Wellmont Health System approved the September 16, 2017 draft of the Terms of Certification and any subsequent “more favorable terms” as may be agreed to by the State of Tennessee. The September 18, 2017 draft of the Terms of Certification contains a “more favorable term” that was agreed to by the State and, therefore, the September 18, 2017 draft of the Terms of Certification were approved by the Wellmont Board.
If a COPA is issued, the department will be responsible for on-going, active state supervision, according to recently promulgated state rules. This supervision will be informed by a transparent index of measures designed specifically for each COPA that will include measures of population health, access to health services, economic and other factors. All stakeholders will have opportunities to comment on the design of this index. Should a COPA be issued, the results of the index would be publically reported on a regular basis.
Commissioner John Dreyzehner, MD, MPH, chose the members from the area that will be most affected by the proposed merger of Mountain States Health Alliance and Wellmont Health System. The purpose of the Advisory Group is to recommend measures for an Index. The Advisory Group will hold a series of listening sessions to seek regional input for these measures, and their work will conclude when they recommend measures to the Commissioner.
Members:
Chair Gary Mayes, Director, Sullivan County Health Department |
Sullivan |
Rep. David Hawk, State Representative, Greene County |
Greene |
Rep. Matthew Hill, State Representative, Part of Washington County |
Washington |
Mayor Johnny Lynch, Unicoi |
Unicoi |
Ms. Susan Reid, Executive Director, First Tennessee Development District |
Washington |
Mr. George Brewer, Administrator, Hancock Manor Nursing Home |
Hancock |
Mr. Brant Kelch, Executive Director, Highlands Physicians, Inc. |
Sullivan |
Dr. Teresa Kidd, President & CEO, Frontier Health |
Washington |
Dr. David Kirschke, Medical Director, Northeast Tennessee Regional Health Department |
Washington |
Ms. Minnie Miller, Former Director of Schools, Johnson County |
Johnson |
Ms. Erika Phillips, Coordinated School Health Director, Hawkins County Schools |
Hawkins |
Ms. Chantelle Roberson, Associate General Counsel, BlueCross BlueShield of Tennessee |
|
Mr. Perry Stuckey, Senior Vice President and Chief Human Resources Officer, Eastman Chemical Company |
Sullivan |
Ms. Jan Tillman, Nurse Practitioner, Roan Mountain, Rural Health Consortia |
Carter |
Mr. Thomas J. Wennogle, President, JardinZinc |
Greene |
Dr. Brenda White Wright, Former CEO, Girls Inc. of Kingsport |
Sullivan |
Meeting Dates, Transcripts, and Video
Advisory Group Organizational Meeting
Tuesday, March 15, 5:30 – 7:30 p.m., Northeast State Library L106 (1st Floor), 2425 TN-75, Blountville
Advisory Group Listening Session #1 For any members of the general public
Tuesday, March 22, 5:30 p.m. – 7:30 p.m., Carter County Health Department, 403 East G Street, Elizabethton
Advisory Group Listening Session #2 For internal stakeholders, including employees, contractors, vendors, staff clinicians and others who currently work with Mountain States Health Alliance or Wellmont Health System
Tuesday, March 29, 5:30 p.m. - 7:30 p.m., Northeast State Regional Performing Arts Center, 2425 TN-75, Blountville
Advisory Group Listening Session #3 For any members of the general public
Tuesday, April 5, 5:30 p.m. – 7:30 p.m., Holston Electric Cooperative, 1200 West Main Street, Rogersville
Advisory Group Listening Session #4 For external stakeholders, including competing health care providers, non-staff clinicians, payers (including self-insured employers), government agencies and non-profits.
Tuesday, April 19, 5:30 p.m. – 7:30 p.m., Northeast State Regional Performing Arts Center, 2425 TN-75, Blountville
NEW DATES ADDED: Advisory Group Working Meetings
New Time for May 17 Working Meeting: 3:30 p.m. – 7:30 p.m. EST
April 26, May 3, May 10, May 24 all from 5:30 p.m. – 7:30 p.m., Additional meetings as needed. Sullivan County Regional Health Department, 154 Blountville By Pass, Blountville
NEW DATE AND LOCATION: Advisory Group Listening Session #5 For the general public and all stakeholders; during this meeting the Advisory Group will present the proposed COPA index and receive comments
Tuesday, May 31, 5:30 p.m. – 7:30 p.m., Sullivan County Regional Health Department, 154 Blountville By Pass, Blountville
Media inquiries about the Advisory Group can be directed to tn.health@tn.gov or 615-741-3111
LAC Annual Reports
LAC Annual Public Hearings
LAC Annual Public Hearing #1 For members of the public who wish to provide comments on Ballad Health’s Annual Report and the progress of the COPA.
Thursday, February 7, 2019, 5:00 p.m. the doors will open at 4:00pm, Northeast State Community College, Center for the Arts, 2425 Highway 75, Blountville, TN 37617.
Public Hearing Transcripts can be read here.
LAC Annual Public Hearing #2 For members of the public who wish to provide comments on Ballad Health’s Annual Report (see also the Executive Summary of Ballad’s Annual Report) and the progress of the COPA.
Tuesday, January 7, 2020, 5:30 p.m. the doors will open at 5:00pm, Northeast State Community College, Center for the Arts, 2425 Highway 75, Blountville, TN 37617.
The transcript from the COPA Local Advisory Council’s Annual Public Hearing held January 7, 2020.
LAC Annual Public Hearing #3 For members of the public who wish to provide comments on Ballad Health’s Annual Report and the progress of the COPA.
Monday, January 25, 2021, 6:00 p.m. EST, via WebEx.
Due to COVID-19 considerations this year’s event will be held online.
Please join the online event using the attendee information below:
https://tngov.webex.com/tngov/onstage/g.php?MTID=eab940aa996ba9e3b7da57a790a29d69d
Event Number: 178 446 4252
Event Password: TNCOPA2021
To join by phone:
To receive a call back, provide your phone number when you join the event, or call the number below and enter the access code.
Phone number: 1-415-655-0003 US TOLL
Event Number/Access Code: 171 446 4252
LAC Working Meetings
Local Advisory Council Meeting #1
Tuesday, June 6, 2018, 3:00 p.m., Northeast State Community College Basler L106, 2425 TN-75, Blountville
Agenda can be read here. Meeting minutes can be read here.
Local Advisory Council Meeting #2
Tuesday, September 11, 2018, 6:00 p.m., Northeast State Community College, Basler L226, 2425 TN-75, Blountville
Agenda can be read here. Meeting minutes can be read here.
Local Advisory Council Meeting #3
Tuesday, October 25, 2018, 5:00 p.m., Northeast State Community College, Basler L226, 2425 TN-75, Blountville
Agenda can be read here. Meeting minutes can be read here.
Local Advisory Council Meeting # 4
Tuesday, April 16, 2019 3:00 p.m. Northeast State Community College BASLER L226 2425 highway 75, Blountville
Note: The COPA Local Advisory Council business meeting originally set for, January 22, 2019 has been postponed due to scheduling conflicts and will be rescheduled for a later date. The new date will be posted here once it has been set.
Agenda can be read here. Meeting minutes can be read here.
Local Advisory Council Meeting # 5
Thursday, July 25, 2019 3:30 p.m. Northeast State Community College BASLER L226 2425 highway 75, Blountville.
Agenda can be read here. Meeting minutes can be read here.
Local Advisory Council Meeting # 6
Tuesday, October 29, 2019, 1:30 p.m. Sullivan County Health Department 154 Blountville Byp, Blountville, TN 37617
Agenda can be read here. Meeting minutes can be read here.
Local Advisory Council Meeting # 7-canceled
Tuesday , April 21, 2020, 2:00 p.m. EDT via WebEx.
CANCELED DUE TO COVID-19
Local Advisory Council Meeting # 7
Wednesday, July 29, 2020, 2:00 p.m. EDT via WebEx. (Click here for meeting details)
Agenda can be read here. Meeting minutes can be read here.
Local Advisory Council Meeting # 8
Thursday, November 5, 2020, 2:00 p.m. EDT via WebEx. (Click here for meeting details)
Agenda can be read here. A full recording of the LAC’s November 5, 2020 meeting can be accessed here[ .
07/01/23 - The "Fourth Amended and Restated Terms of Certification Governing the Certificate of Public Advantage Issued to Ballad Health Pursuant to the Master Affiliation Agreement and Plan of Integration By and Between Wellmont Health System and Mountain States Health Alliance," dated July 1, 2023. A summary of the changes.
06/12/23 - Transcripts from the COPA Public Hearing in Blountville, TN, June 12, 2023.| Comments | Speaker sign-up sheet.
12/19/22 – A letter from the Tennessee Department of Health approving Ballad Health’s request for a one-year extension on the replacement capital plan submission requirement. (RE Ballad Health’s 10/14/22 One-year Extension on Capital Plan Letter. )
08/15/22 - A letter from the Tennessee Department of Health approving Ballad Health’s proposed Population Health Process Measures for FY23.
08/01/22 – A letter from the Tennessee Department of Health approving Ballad Health’s request for a waiver related to a Gynecologic Oncologist in Sullivan County. (RE Ballad Health’s 06/23/22 Gynecologic Oncology Waiver Request. )
04/19/22 – A letter from the Tennessee Department of Health regarding Ballad Health’s 03/03/22 restatement of numbers (full-time equivalents and corresponding percentages) for a previously granted waiver to accurately reflect the employed physicians that were in place as of January 31, 2018.
04/19/22 – A letter from the Tennessee Department of Health regarding Ballad Health’s 03/14/22 request regarding a partnership lease agreement with Care Centers Management Consulting, Inc. for the continuation of post-acute services at the Laughlin Healthcare Center location.
03/22/22 – A letter from the Tennessee Department of Health regarding Ballad Health’s 11/12/21 waiver request related to Vascular Surgery in Washington and Sullivan County.
11/12/21 – Ballad Health’s waiver request related to Vascular Surgery in Washington and Sullivan County.
11/12/21 – Ballad Health ‘s waiver request related to Neurology in Washington County.
09/29/21 – A letter from the Tennessee Department of Health regarding Ballad Health’s request to modify the Health Research and Graduate Medical Education Plan to include a Milligan University addictions counseling program.
09/14/21 – The Tennessee Department of Health responded to Ballad Health‘s waiver request for Actions related to Ballad Health’s Cardiology Program.
08/25/21 – A letter from the Tennessee Department of Health responding to additional information provided by Ballad Health in their 07/06/21 letter regarding Ballad Health’s Children’s Health Plan Modification Request to add Miracle Field.
07/27/21 – A letter from the Tennessee Department of Health regarding the approval of Ballad Health’s Rural Health Plan Modification Request to add the purchase of new cardiac monitors for regional EMS providers.
06/07/21 – A letter from the Tennessee Department of Health regarding the approval of Ballad Health’s Children’s Health Plan Modification Request to add Miracle Field.
04/02/21 – Ballad Health submitted a Revised Children’s Health Plan.
03/26/21 – The COPA Monitor Annual Report for the year ending June 30, 2020.
02/25/21 – The Department published its Year 2 COPA Index Reports: the 2020 Population Health Report, 2020 Access to Health Services Report, and 2020 Other (Quality) Report.
02/24/21 – The COPA Local Advisory Council 2021 Annual Report was published.
02/12/21 – Ballad Health ‘s waiver request related to the Ballad Health cardiology program in Greeneville, TN.
01/11/21 – Ballad Health submitted to TDH a letter requesting a one-year extension of their three-year plans.
07/01/22 - The "Third Amended and Restated Terms of Certification Governing the Certificate of Public Advantage Issued to Ballad Health Pursuant to the Master Affiliation Agreement and Plan of Integration By and Between Wellmont Health System and Mountain States Health Alliance," dated July 1, 2022. A summary of the changes.
05/18/21 - The "Second Amended and Restated Terms of Certification Governing the Certificate of Public Advantage Issued to Ballad Health Pursuant to the Master Affiliation Agreement and Plan of Integration By and Between Wellmont Health System and Mountain States Health Alliance," dated April 27, 2021. A summary of the changes.
12/21/20 – The COPA Monitor submitted to TDH a letter on Ballad’s compliance with provisions related to Charity Care in the Terms of Certification.
12/21/20 – A letter from the Tennessee Department of Health regarding the approval of Ballad Health’s request to consolidate labor and delivery services in Kingsport, Tennessee.
11/30/20 – Ballad Health submitted to the Tennessee Department of Health the system’s Addendum 1 Report for Fiscal Year 2020.
11/25/20 – Ballad Health submitted to the Tennessee Department of Health the Fiscal Year 2020 Ballad Health Annual Report, and the Fiscal Year 2020 COPA Compliance Office Annual Report, for the reporting period July1, 2019 – February 29, 2020.
11/12/20 – Ballad Health submitted to the Tennessee Department of Health a letter requesting approval of the permanent consolidation of labor and delivery services in Kingsport, Tennessee.
11/05/20 – A letter from the Tennessee Department of Health regarding the approval of Ballad Health’s request to repurpose Greeneville Community Hospital West into a residential addiction treatment facility for women who are pregnant or parenting.
10/28/20 - Ballad Health’s update on plan to reinstitute inpatient services at Unicoi County Hospital.
10/13/20 - Ballad Health ‘s waiver request for actions related to Ballad Health cardiology program.
9/29/20 - The Tennessee Department of Health’s response to Ballad’s request for HR/GME Plan Modification.
09/25/20 – Ballad Health submitted to the Tennessee Department of Health a letter requesting consent to terminate the Geropsychiatric Unit Service Line and the Inpatient Rehab Service Line at Greeneville Community Hospital West in order to repurpose it into a residential facility to treat addicted women who are pregnant or parenting.
9/18/20 - Ballad Health ‘s request for HR/GME Plan Modification.
4/6/20 – The COPA 2020 Department Annual Report covers Fiscal Year July 1, 2018-June 30, 2019.
3/6/20 - The 2020 COPA Monitor Annual Report.
2/28/20 – Commissioner Piercey extended the Waiver for Cross-Credentialing Employed Physician at Ballad Health hospitals through April 30, 2020.
2/25/20 – The Department published its Year 1 COPA Index Reports: the 2019 Population Health Report, 2019 Access to Health Services Report, and 2019 Other (Quality) Report.
2/17/20 - Ballad Health ‘s requests related to reorganization of cardiovascular services in Greene County, TN.
2/13/20 - The Ballad Health FY20 2nd Quarter Quarterly Report, for reporting period October 1, 2019-December 31, 2019. Ballad Health’s submitted amended language for Item G of their FY20 2nd Quarter Quarterly Report by email on February 28, 2020 and by formal letter on March 1, 2021.
2/6/20 – The COPA Local Advisory Council 2020 Annual Report.
1/14/20 – Commissioner Piercey signed two Employed Physician Waivers, one granting Ballad Health’s request for a continuation of the waiver of the 35% limitation for cardiovascular disease at Holston Valley Medical Center, and one granting Ballad Health’s request for a continuation of the waiver of the 35% limitation for pulmonary disease at Bristol Regional Medical Center and Johnston Memorial Hospital.
1/14/20 – A letter from the Tennessee Department of Health regarding the conditional approval of Ballad Health’s Rural Health Plan.
1/7/20 – The transcript from the COPA Local Advisory Council’s Annual Public Hearing held January 7, 2020.
12/04/19 – Ballad Health submitted to the Tennessee Department of Health a letter requesting a waiver of the 35% limitation for pulmonology at Bristol Regional Medical Center and Johnston Memorial Hospital and a letter requesting a waiver of the 35% limitation for cardiovascular disease that would allow Dr. Ponder to obtain privileges at Holston Valley Medical Center.
12/3/19 – Commissioner Piercey signed an Employed Physician Waiver, granting Ballad Health’s request for a continuation of the waiver of the 35% limitation for neurology at Johnson City Medical Center.
12/3/19 – Commissioner Piercey signed an Employed Physician Waiver, granting Ballad Health’s request for a continuation of the waiver of the 35% limitation for cardiothoracic surgery at Bristol Regional Medical Center.
11/30/19 – The Department’s COPA Index Reports, which include the Population Health Report, Access to Health Services Report, and Other (Quality) Report, were updated by the Tennessee Department of Health.
11/15/19 – The Ballad Health FY20 1st Quarter Quarterly Report, for reporting period July 1, 2019-September 30, 2019.
10/28/19 – Ballad Health submitted to the Tennessee Department of Health, the Fiscal Year 2019 Ballad Health Annual Report, as well as the Fiscal Year 2019 COPA Compliance Office Annual Report, for reporting period July1, 2018 - June 30, 2019. Ballad Health also submitted an Executive Summary of these annual reports.
10/14/19 – Ballad Health submitted to the Tennessee Department of Health a letter requesting a waiver of the 35% limitation for neurology at Johnson City Medical Center.
10/11/19 – Ballad Health submitted to the Tennessee Department of Health a letter requesting a waiver of the 35% limitation for cardiothoracic Surgery at Bristol Regional Medical Center.
9/30/19 – A Letter from Alan Levine to Commissioner Piercey regarding a STRONG Children and Families Model for Change was received by the Tennessee Department of Health.
08/12/19 - The "Amended and Restated Terms of Certification Governing the Certificate of Public Advantage Issued to Ballad Health Pursuant to the Master Affiliation Agreement and Plan of Integration By and Between Wellmont Health System and Mountain States Health Alliance," dated July 31, 2019, can be read here. A summary of the changes can be read here.
6/26/19 – FY20 Implementation Roadmaps containing updated schedules of quarterly milestones and data metrics for Ballad Health’s six 3-year plans: Behavioral Health, Children’s Health, Health Information Exchange, Health Research and GME, Population Health and Rural Health.
5/31/19 – Commissioner Piercey signed an Employed Physician Waivers, granting Ballad Health’s request for a continuation of the waiver of the 35% limitation for cardiovascular disease at Johnston Memorial Hospital.
05/15/19 – The Ballad Health Quarterly Report, for reporting period January 1, 2019 – March 31, 2019, can be read here.
5/7/19 – A letter regarding the Department’s conditional approval of Ballad Health’s Health Information Exchange (HIE) and Health Research and Graduate Medical Education (HR/GME) Plans can be read here. The HIE Plan submitted by Ballad can be read here. The HR/GME submitted by Ballad can be read here.
5/7/19 – The Department Annual Report can be read here.
5/1/19 - Ballad NICU Consolidation Statement can be read here.
4/7/19 – The COPA Monitor Annual Report can be read here.
3/8/19 – The COPA Local Advisory Council’s Annual Report can be read here.
3/6/19 – The Department’s COPA Index Reports, which include the Population Health Report, Access to Health Services Report, and Other (Quality) Report, can be read here.
3/5/19 – A signed Conditional Waiver, regarding cross-credentialing of Employed Physicians at all Ballad hospitals, can be read here.
3/5/19 – A letter regarding the Department’s conditional approval of Ballad Health’s Behavioral Health, Children’s Health, and Population Health Plans can be read here.
2/22/19 – A letter regarding Population Health Sub-Index measurement revisions can be read here.
2/15/2019 – The Ballad Health Quarterly Report for reporting period October 1, 2018 – December 31, 2018 can be read here.
2/07/19 – The transcript from the COPA Local Advisory Council’s Annual Public Hearing held February 7, 2019 can be read here.
1/31/19 - Ballad Health ‘s Rural Health Plan.
1/29/19 – A letter from Alan Levine to Commissioner Piercey providing notice regarding Ballad Health’s plan to consolidate services in Greene County can be read here.
1/19/19 – A letter from Alan Levine responding to Commissioner Dreyzehner’s 1/16/19 request for additional information regarding Ballad Health’s NICU consolidation proposal can be read here.
1/16/19 – The COPA Local Advisory Council schedules its first Annual Public Hearing. Read the press release here.
1/16/19 - A letter from Commissioner Dreyzehner requesting additional information on Ballad Health's NICU consolidation proposal can be read here.
12/28/18 – A letter from Alan Levine responding to Commissioner Dreyzehner’s request for additional information regarding Ballad Health’s NICU consolidation proposal can be read here.
12/13/18 – A letter from Commissioner Dreyzehner regarding Ballad Health’s NICU consolidation proposal can be read here.
12/6/18 – A supplemental letter from Ballad Health detailing the organization's transport plans and telemedicine plans for the proposed coordination of newborn services can be read here.
12/5/18 - The Behavioral Health Plan submitted by Ballad can be read here. The Children’s Health Plan submitted by Ballad can be read here. The Population Health Plan submitted by Ballad can be read here.
11/20/18 – The Ballad Health Quarterly Report, for reporting period July 1, 2018 – September 30, 2018, can be read here.
11/19/18 – a supplemental letter to Commissioner Dreyzehner with additional information related to Ballad Health’s request to coordinate newborn services can be read here.
11/15/18 – The 2018 Ballad Health Annual Report, reporting on the period from February 1, 2018 – June 30, 2018, can be read here. The COPA Compliance Office Annual Report, for reporting period February 1, 2018 – June 30, 2018, can be read here.
11/12/18 – A letter from Ballad Health to Commissioner Dreyzehner regarding a proposed plan to coordinate newborn services can be read here.
9/26/18 – Commissioner Dreyzehner signed an Employed Physician Waiver granting Ballad Health’s request for an exception to and waiver of the 35% limitation on Employed Physicians for neurosurgery.
8/14/18 – Read Ballad Health’s 8/14/2018 Quarterly Report here. Read the 8/14/2018 COPA Compliance Office Quarterly Report here.
5/23/18 – Tennessee Department of Health Commissioner John Dreyzehner, MD, MPH announces the appointment of members of the inaugural COPA Local Advisory Council. Read the press release here.
5/15/18 – Larry Fitzgerald named COPA Monitor. Read the Press release here.
5/14/18 – A letter from Ballad Health to Commissioner Dreyzehner regarding the submission of their Quarterly Report and COPA Compliance Office Quarterly Report can be read here. Read Ballad Health’s first Quarterly Report here. Read the COPA Compliance Office Quarterly Report here.
4/16/18 – A letter from Ballad Health to Commissioner Dreyzehner regarding planned merger related synergies can be read here.
3/1/18 – Lists of competing services with respect to each COPA Hospital, specifically lists of Ancillary Services and Post-Acute Services offered by providers competitive with Ballad Health can be read here.
2/28/18 – A signed Employed Physician Waiver, granting Ballad Health’s request for an exception to the 35% limitation on Employed Physicians for neurosurgery and for Employed Physicians for physical medicine and rehabilitation, respectively, can be read here.
1/31/18 – Tennessee Department of Health Commissioner John Dreyzehner, MD, MPH, announced that the state is officially allowing a merger of Wellmont Health System and Mountain States Health Alliance by issuing a Certificate of Public Advantage or COPA to their parent company, Ballad Health. Read the news release here. Read the Terms of Certification here. Read the Certificate of Public Advantage here.
This Page Last Updated: May 15, 2026 at 11:18 AM