Public Input and Complaints


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.

How to Provide Feedback to the Tennessee Department of Health

The public is encouraged to provide feedback on the progress and impact of the Ballad Health merger on the region.

Leave a comment here:    

By mail: TN Department of Health – COPA
                 710 James Robertson Parkway, 5th Floor
                 Nashville, TN 37243.

In person:     at Public Hearings (to be announced at least three weeks in advance)

Please be aware that any comments or information you submit or share with the Department will be considered a public record.

  • Letters from individuals will not be posted to the website but may be considered public record. This might mean that the Department will give copies of these comments to news agencies upon request.
  • Upon a request for information, it will be the Department's policy to share the name of the individual submitting a comment and to redact other personally identifying information, including contact information, before releasing comments from individuals.

Filing a Complaint

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: (as an attachment).

By mail:      TN Department of Health – COPA

710 James Robertson Parkway, 5th Floor

Nashville, TN 37243.


How to File Other Complaints Regarding 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

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.