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Dr. David Ball Letter

An Open Letter to the People of Panola County

First, I want to thank the people of Panola County for the singular privilege of serving with you as we both pass through this pilgrimage called life. You have been gracious and loving to me and my family. I can only hope I have been able to give back a portion of what you have given me.

As I enter the fall season of my life I reflect on the circumstances that brought me to this place where I would spend my life attempting to find God’s purpose and do His will in my personal pilgrimage here on this earth.

I came to Batesville from Viet Nam where I had served in the US Air Force as a flight surgeon. I knew I was returning to a divided country and I knew there would be no welcome party. That did not bother me. I had done what I believed was right and had served the country that had given me the opportunity to come from a meager background and become a medical doctor.

I became a partner in Batesville Hospital, a privately owned facility operated by several local MDs. While I relished in the opportunity to be affiliated with Drs. House, Carlson, Moore and Lovelace—I did not feel comfortable as an owner of a hospital. When the county expressed an interest in building a publicly owned and operated facility, I readily moved to encourage the project

Eventually, Batesville Hospital, Inc. closed its doors with no remuneration for lost investment or lost income. That did not bother me. I had done what was right and had accomplished what I felt was in the ultimate best interest of our community.

Through the years I served in many capacities with the new hospital, including chief of staff, board member and director of the emergency room for about 23 years. In the latter capacity my charge to the hospital was always below the state average for a facility our size.

Even so, the hospital repeatedly got significantly behind in payments and I never sought legal recourse. It did not bother me. I had done what was right and the community and I both prospered.

In 2003 the hospital was in serious financial trouble. I was aware of some of the problems and had asked for permission to address the board in an attempt to resolve some of the issues. Unfortunately, it was too far gone for my simplistic solutions.

Eventually, Dr. Bob Corkern obtained a management contract and hired Ray Shoemaker to be the CEO. I was asked to serve on the board of directors—a job which I accepted with mixed emotions. The team (Dr. Corkern and Ray Shoemaker) did an incredible job of turning things around. The hospital flourished beyond our wildest expectations. Admissions skyrocketed and profits likewise soared. The board was pleased to say the least.

Much of the credit for this booming success was due to the innovative management techniques and federal grant acquirements of Ray Shoemaker. Unfortunately, this was also a major factor in the eventual downfall of the hospital. During this timeframe the board was heavily dependent on the accounting skills and legal expertise of our hired consultants. It is important to note that in the months prior to the Medicaid intervention, the board was never advised by our consultants that there were problems much less that we were facing a potential Medicaid crisis.

Considering the complexity of the issues, it would be unreasonable to expect that a local board composed of unpaid and voluntary citizens would be able to detect and uncover issues that had eluded the expert consultants.

Suddenly and without forewarning, the Mississippi Medicaid Commission stopped payments to the hospital. The basis for doing this was that the per diem payment to the hospital had far exceeded the state average over the previous 18 months. It is difficult to imagine how this could have gone on for 18 months and not have been detected by our accountant, our legal consultant or the Mississippi Medicaid Commission and yet at the same time have been the sole responsibility of the hospital board to have foreseen the problem.

For a small, rural hospital in Mississippi, cessation of Medicaid payments is tantamount to a notification of closing the doors. In the aftermath I have received a disproportionate blame for the problem—for reasons that are clear only to those who place the blame. That did not bother me. I had done what was right and attempted to conscientiously serve the community that had served me so well since returning from Viet Nam.

The ensuing details of reorganization are beyond the scope of this letter and will not be detailed here—except to say that many of the operational tactics of the CRO (Chief Reorganization Officer) have not been approved by a single member of the active hospital board. As an example, the Panolian front page headline last week read, “Medicaid, Tri-Lakes agree on amount owed…” The active board has not agreed on the amount. It is the unanimous opinion of the board that in most situations the CRO is not acting in the best interest of the hospital or community.

It was not a major issue for me when the CRO singled me out and convinced the judge that I alone should be denied voting rights as a board member. It was a bit of an issue, however, when the CRO had the board minutes reflect a statement he says I made that no board member (including myself) agrees that I made. It took the action of our legal counsel and the judge’s permission to include an alternate version of the minutes stating what I actually said. This is particularly problematic considering the minutes are the board’s and not the CRO’s minutes.

In the final analysis I have agreed and signed an affidavit stating that I will not serve on the future board. I was informed that this was a necessary requirement in order for “The Doctor’s Hospital” bid (a not-for-profit corporation) to be presented to the lenders and the bankruptcy judge.

Therefore, I agreed simply in an attempt to have a not-for-profit bid reach the attention of the lenders. Even so, I had no real problem with that—for serving on the board has been difficult, time consuming and contentious. But it does seem strange to me that this requirement precluded the presentation of a bid to the lenders.

What has finally become the “last straw” for me (that does really matter) is the notice to file a request with the judge (within one week and without forewarning to me) that not only would prevent me from being able to serve in any leadership or administrative capacity with a new hospital, but would also prevent my family and any future heirs of mine from ever being able to serve. I am willing to take responsibility for things that I even think were beyond reasonable expectation that an ordinary citizen would have been able to foresee. However, I cannot accept that the punitive effects of that choice should rest on all of my heirs for eternity. That is simply unreasonable and suggests an underlying bias to seek punitive action beyond the scope of justice.

In spite of all of this, I am still thankful for the many opportunities Panola County has given me to serve and for the wonderful friends I have grown to love during my 40 year tenure here. And even now, I would not choose to live and raise a family anywhere else. God has been good to me and Panola County has been good to me. However, I cannot help but fight the imposition of this punitive restriction on me and my family imposed by the current CRO. It is a needless expense for me but one that I consider necessary, for it not only affects the short time I have remaining on this earth but it affects all of my family and it affects them forever.

Thanks for the Good Times,

David A. Ball, MD