ELIZABETHTON, Tenn. (WJHL) — Hours after announcing the end of intensive care unit services at Sycamore Shoals Hospital, officials from Ballad Health took questions, and criticism, from the Carter County Commission.

“This is not good for us, we need these services,” said Commissioner Angie Odom.

Several commissioners expressed concern that the ICU closure is the first step towards closing the Elizabethton hospital completely.

“It’s not going to stop at the ICU, I don’t care what any person from Ballad will tell you right now. It will not stop at the ICU,” said Commissioner Todd Smith.

Ballad officials say the closure is a necessary step as they face difficulty recruiting hospital staff and declining volumes. Lisa Carter, who serves as president of Ballad Health’s southern market, said the system began noticing declines in a system-wide study conducted several years ago.

“At that time we knew that we were seeing some things that were concerning related to the workforce, related to our ability to recruit and retain physicians and just the general volume of the hospital,” Carter told News Channel 11.

She said closing the ICU at Sycamore Shoals will allow the hospital to pivot, adding services like 3D mammography and behavioral health.

“By having the consolidation of those highest level of patients, we can offset the community need from an outpatient side,” said Carter.