NASHVILLE, Tenn. (WJHL) — A Johnson City cardiology group won its bid for approval to build a free-standing cardiac catheterization lab Wednesday despite opposition from Ballad Health and others.

Tennessee’s Health Facilities Commission approved Karing Hearts Cardiology’s certificate of need (CON) request at a hearing in Nashville, with five board members in favor and three opposed.

Karing Hearts founder and partner Dr. Jeff Schoondyke lauded Wednesday’s decision and said it would provide much-needed options and cardiac cath capacity in the Johnson City area. Ballad’s Johnson City Medical Center (JCMC) has Washington County’s only cath lab, where implants of cardiac devices such as pacemakers and defibrillators also occur.

“We believe this project will bring improved access and choice to our patients,” Schoondyke told News Channel 11 in a statement Wednesday.

Ballad also provided a statement saying the evidence it provides “demonstrates that separating diagnostic from interventional cardiac catheterization exposes patients to higher cost, higher risk, less convenience for patients and potential delays in care when an emergency occurs.”

Ballad’s official opposition also included reference to new non-invasive technology — a tomography procedure called CT-FFR — it says will send cath volumes down by an estimated 17% by 2027.

Karing Hearts’ written application cited backlogs in the JCMC cath lab and sufficient demand to warrant additional capacity in its application for the $3.3 million center, which would provide device implants in addition to caths. The application had many letters of support, including from state representatives Tim Hicks of Gray and Rebecca Alexander of Jonesborough.

It also included a July 1 letter to JCMC CEO Kenny Shaffer that 11 non-Karing Hearts cardiologists signed, including six Ballad-employed doctors, outlining what they claimed were “severe limitations within the cath lab” with no likelihood for improvement in the near future.

“We want to thank the community and citizens for their overwhelming support of this project,” Schoondyke said Wednesday.

Ballad’s opposition stated that Ballad’s cardiac facilities already meet the area’s needs and argued that a Karing Hearts standalone facility would be detrimental to patient safety, increase patient expenses and be contrary to the kind of “value-based care” initiatives that help reduce health care costs.

Ballad’s main opposition letter from attorney Dan Elrod also said the facility would hurt Ballad financially in ways that would impact its ability to keep rural hospitals open, that new technologies are decreasing the need for invasive cardiac caths, and that a Karing Hearts facility would decrease opportunities for cardiology residents and fellows to receive training.

Ballad’s opposition included supporting letters from East Tennessee State University’s medical school dean Dr. William Block, State of Franklin Healthcare Associates (SOFHA) and Johnson City Commissioner Jenny Brock.

“Johnson City Medical Center’s primary concern is for patient safety,” Ballad said in its statement. “This is why we are investing millions of dollars into technology that actually reduces the need for cardiac catheterizations, thus reducing risk for patients. Our actions will always reflect what provides the most optimal outcome for patients.”

Work on the one-lab facility is scheduled to begin in April 2023 with completion slated for January 2024. Ballad did not answer News Channel 11’s question about whether it would appeal the decision, but it has 15 days to do so.