JOHNSON CITY, Tenn. (WJHL) — Ballad Health has appealed a state decision that would allow Karing Hearts Cardiology to build a freestanding cardiac catheterization lab in Johnson City.

Tennessee’s Health Facilities Commission (HFC) approved Karing Hearts’ “certificate of need” (CON) application by a 5-3 vote at its Sept. 28 meeting. Ballad spoke in opposition at that hearing and had 15 days to file an appeal, which it did on Oct. 10.

The hospital system’s brief notice of appeal states that Karing Hearts planned cath lab “is not necessary to provide needed heath care in the area to be served, it will not provide quality healthcare in the proposed service area, and the effects of the CON application attributed to competition or duplication would not be positive for consumers.”

The case will go before an administrative law judge next, though a date has not been set. Logan Grant, the HFC’s executive director, said the agency’s staff attorney, Jim Christoffersen, will actually defend the initial decision before the judge. The attorney who represented Karing Hearts, Jerry Taylor, is likely to be involved as well but would not be the primary lawyer defending the initial decision.

State law requires the parties to consider a mediation alternative before it proceeds to an actual hearing, which would have to take place within 180 days of Ballad’s Oct. 10 filing. A final decision would be due within 60 days after that, although further appeals are still possible following that decision.

At stake is a planned one-room cath lab that would also be the site of procedures such as pacemaker and defibrillator implants. The project is estimated to cost $3.3 million and would open in early 2024.

Jerry Taylor, an attorney for Karing Hearts, argued at the initial contested hearing that a new lab would improve access for patients, reduce cost and provide an alternative choice to the sole cardiac cath provider currently available, Ballad’s lab at Johnson City Medical Center (JCMC).

“(T)he recurrent themes that you’ll notice running throughout the presentation today and throughout the application for that matter are access, choice and cost,” Taylor said. “Those are exactly the goals that the CON program seeks to achieve and they are achieved by this project.”

Dan Elrod, who will argue for Ballad at the next stage, said during the initial hearing that the JCMC labs do provide enough access and that the risk of financial loss at Ballad and further staffing issues would hamper the system’s ability to serve rural and at-risk communities.

“This project is based on Karing Hearts’ low-risk patients being self-referred to its own cath lab” instead of using even less expensive diagnostic methods, “(a)nd this is consumer detriment and not a consumer benefit.”

Several commission members who voted to approve the Karing Hearts lab said it met the state’s CON criteria, would save consumers money, and shouldn’t be denied just because it might cause Ballad financial or staffing difficulties. At least two who voted not to approve said those were relevant factors to consider.

Ballad declined to detail its reasons Asked to comment on its reasons for appealing beyond providing this statement:

This is judicial proceeding. It is not appropriate for anyone to discuss the content of it before a judge has the opportunity to hear the arguments and reach her or his conclusions.  

Any filings and our arguments will be a matter of public record, and we will conduct ourselves in a manner that respects the role of the State and its rules in making this determination.

Ballad Health

A representative for Karing Hearts said the practice intends to begin work on the cath lab even if the outcome is not decided.