With all that has taken place and is being said about ambulance service in Carroll County, provided by Priority Ambulance under the name “Baptist Ambulance,” it seemed appropriate to look back on how we arrived at this point as a county.
It is well known that Carroll County does not pay anything for its ambulance service. Baptist covers the entire cost. The arrangement is quite unique, especially compared with neighboring counties, which either fund their own service, contract with a hospital, or contract with a provider such as Priority or AMR. Those contracts are not cheap.
A January 2026 report to the state’s Advisory Commission on Intergovernmental Relations found that counties paying an outside provider saw those payments rise 81 percent in four years, to an average of about $464,000 a year.
How did Carroll County get so lucky?
Sale of Carroll County General Hospital
Back in 1982, Methodist Hospital out of Memphis, through its management company, American Medical Management, had just purchased and taken over operations of the hospital in McKenzie. That spring, Methodist and Baptist Memorial Hospital, also out of Memphis, began studying the possibility of taking over Carroll County General Hospital.
The hospital at the time was located where the Carroll County Library and office complex is today, at 625 High St. in Huntingdon.
It was about 16 years old, with 72 licensed beds that were often near full, and a study found it needed renovation and expansion expected to cost $7.2 million. Methodist’s own study warned that unless the hospital grew, residents would “seek care in adjacent cities and counties boasting more sophisticated facilities.”
Both Methodist and Baptist made offers for the hospital, and both offers included taking over the ambulance service. That was welcomed news to commissioners at the time.
The county was paying for ambulance service itself, and Bill Fleming of Baptist described it that fall as “a $75,000 a year burden on the taxpayers.”
That is roughly $257,000 in today’s dollars, according to the Bureau of Labor Statistics inflation calculator.
On the front page of the Oct. 13, 1982 Carroll County NEWS, a letter from Fleming corrected statements hospital administrator Dwayne French had made about Baptist’s offer at the hospital board’s previous meeting.
On the ambulance service, Fleming wrote: “Baptist will assume ALL financial and operational responsibility for the Ambulance Service. The county will NOT be required to fund any deficient operation expense.”
Methodist made a similar promise. Its proposal said it “assumes all financial and management obligations relative to the County’s Ambulance Service.”
Two Different Offers
Beyond the ambulance service, the offers were very different.
Methodist offered to buy the hospital for $4.7 million, with $600,000 at closing and the rest paid over 15 years at 12 percent interest. The county, in turn, would pay $150,000 a year for 15 years into a fund for indigent care. Methodist planned to renovate and expand the existing building.
Baptist offered no purchase price. It would lease the old hospital for three years while it built a new $10 million hospital in Huntingdon, with the lease payments going into a permanent trust to pay for care for residents who could not afford it. It also offered to build a doctors’ office building and pay off the hospital’s bond debt.
“The hospital was paid for with health care dollars,” Fleming wrote. “Therefore, Baptist believes these dollars should stay in health care.”
The hospital’s board of trustees unanimously recommended Methodist.
Raymond Terry, then editor of the Carroll County NEWS, urged commissioners to think harder.
In a Dec. 22, 1982 editorial titled “Please Consider All The IFS!”, he asked what would stop Methodist’s management company from selling the county’s hospital if a for-profit company made an offer, and raised a question about the McKenzie hospital Methodist had just taken over.
“IF the hospital in McKenzie or Huntingdon became a burden, would Methodist close one? IF so, which one?,” he wrote.
The decision of who to sell the hospital to nearly split the county in half.
Eleven to Nine
On Jan. 10, 1983, all 21 county commissioners were present in a courtroom so packed that spectators filled the hallway and peered through the windows in the doors.
“There was a quietness in the packed courtroom as the votes began,” the paper reported.
Sheriff Joe Parker tallied the votes one by one on a blackboard.
Baptist won, 11 to 9.
Two weeks later, hospital board chairman Jack Brummitt said that although he “did not go through the Civil War,” the hospital fight had “pitted friend against friend, neighbor against neighbor, church against church.”
Baptist took over management of the hospital the next morning.
On April 11, 1983, after three more months of wrangling, commissioners voted 20-0 to approve a lease with Baptist and the agreements that went with it.
The lease’s ambulance commitment is a single sentence: “[Baptist represents and warrants that]…An ambulance service shall be operated at a level at least equal to the level of ambulance service currently provided.”
Carroll County Gets in the Ambulance Business
By the time Methodist and Baptist came along with offers, the county had been paying for ambulance service for nearly 13 years.
In 1970, the county’s governing body was called the “Quarterly County Court”, and its members, then called magistrates or “squires,” did the job commissioners do today.
That spring, the county’s funeral homes, which had long run its ambulances, announced they would stop on June 30, citing requirements placed on them by the state and federal governments, with ‘additional and much more expensive laws’ on the way.
State law at the time allowed counties to provide ambulance service but did not require it.
The court took it on anyway. Its April 13, 1970 resolution declared that “it is necessary to provide such service for the residents of Carroll County.”
By a vote of 40-0, it put the service under the hospital’s board of trustees, to be run countywide “on a non-profit basis,” and gave it $25,000 to get started ($217,500 today).
The service began July 1, 1970, under supervisor Denton Baker.
Its first year ended with a loss of $47,773.40.
Controversy Quickly Ensued.
On Aug. 9, 1971, the County Court’s three-member Ambulance Committee brought a resolution to take the service away from the hospital.
Before the meeting began, an unsigned, four-page list of 13 charges against the service and its supervisor was handed to court members.
The charges included wasting ambulance funds, overcharging patients, refusing to cooperate with the Rescue Squad, slow response to calls, improper care of patients and causing a patient’s death.
Ambulance driver Charles Barnhart, called before the court, said the charges were true.
He told the crowded courtroom that someone in McKenzie had died “because it took 25 minutes to decide who the driver would be.”
Hospital administrator W.B. Hollowell said the charges were not true.
Baker was not asked to answer them.
By a vote of 14-4, the court took the ambulance service away from the hospital, declaring that it “has not given satisfaction” and that “the cost … is too great”. They also relieved Baker of his position.
The resolution they voted on was prepared the day of the meeting, and many members had not seen it.
Because it never went to the Resolutions Committee two days in advance, as the court’s own rules required, critics called it illegal.
Public Ordeal
For two months the fight played out in the courthouse and in the newspaper.
Hospital administrator W.B. Hollowell warned that “there is no way for an ambulance service to pay its [own] way.”
In a letter to the newspaper, court member Bendell Birdwell, who also sat on the hospital board, defended Baker, calling his firing “a railroad job” carried out “to satisfy personal grudges and to give jobs to personal friends.”
He also warned that separating the ambulance service from the hospital would cost taxpayers more.
The service, he wrote, had run for a year on about $30,000, and the new setup had already added six employees at more than $20,000 a year.
Barnhart had written the week before that there was now “much harmony” among the ambulance crews.
Birdwell answered: “Is it wise to spend over $20,000 of our money just so there can be harmony among the ambulance drivers, and a telephone in the Jail???”
“They got Mr. Baker and they ‘got Mr. Taxpayer’ also,” Birdwell wrote.
More than 200 spectators packed the court’s September meeting, “the biggest crowd” the paper had seen there. The court voted 11-6 to hold a public hearing Sept. 27. When only 12 magistrates showed up that night, it was reset for Oct. 4.
Ambulance Service Hearing
At the hearing that ran for two nights in October, in front of capacity crowds, more than 30 people testified under oath.
Baker’s witnesses disputed every charge, and the lawyers on the other side called no witnesses of their own.
In November, the court cleared Baker’s name “of any misconduct or any illegal action” but did not give him his job back.
Taking the service away from the hospital did not make it cheaper.
By early January 1972, the service had spent more than $32,000 in six months and had $9,461.39 left for the rest of the fiscal year.
The court had to raise the ambulance budget from $42,000 to $62,000 (from $339,000 to $500,400 in today’s dollars).
Within a few years the service was back under Carroll County General Hospital, still losing around $60,000 a year that the county covered.
By 1982 the cost had reached the $75,000 that Baptist offered to take off the county’s hands.
Recent History
Carroll County has not paid any money towards ambulance service since 1983.
Baptist built its new hospital at its current location in Huntingdon in 1986.
Baptist operated ambulance services through its hospital for decades. In 2017, it partnered with Priority Ambulance, which now operates it under the Baptist Ambulance name. Priority is a for-profit corporation, headquartered in Knoxville, Tennessee.
In 2018, Quorum Health, which owned the McKenzie hospital by then, closed McKenzie Regional Hospital.
Baptist bought its buildings, land, equipment and ambulance service, and said it would work with Priority to “ensure uninterrupted 911 ambulance service for all of Carroll County, including McKenzie.”
Since 2021, state law has made ambulance service an “essential service,” and counties are “directed to make provisions to ensure” that at least one licensed service is available.
County officials today still point to the 1983 agreement as the foundation of the arrangement Carroll County has, though, opinion is mixed on whether it’s still in effect.
In 1971, hospital administrator Hollowell warned that ‘there is no way for an ambulance service to pay its way.’ For 44 years, Carroll County has been fortunate that someone else has paid.
In recent weeks, though, complaints about the level of service provided by Priority have become hard to ignore.
The question now is this: Will Baptist and Priority give Carroll County a seat at the table and fix what isn’t working, or will Carroll County try its hand at the ambulance business once again?
The sad thing is the way things changed with EMS this week Baptist Memorial Hospital Carroll County now has patients that are choosing to refuse ambulance transportation out of the hospital to other hospitaos out of town for higher levels of care or testing that is not available at Baptist Huntingdon and they are going in their private vehicles with no medical staff with them because Baptist ambulance service is now refusing to do more than one transfer out of the hospital at a time. This could possibly result in a worse outcome for the patients, what of the pregnant woman gives birth in the car in the side of the road trying to get to another hospital and when that baby is born in a private car is having trouble breathing. Who will help that newborn baby somehow get the needed oxygen? How about the patient having the heart attack or stroke who has no way to get to a hospital with the ability to go into their body through an artery to get the blockage out of their brain or heart and stop the process of what is happening to them so they can continue to live with any kind of quality of life. Sure Baptist Hospital can give people a medication that can help “dissolve” a blood clot, but said medicine can also cause sudden death as a person dies bleeding out of every opening of their body. Had an ambulance not left an hour earlier headed to Memphis or Nashville with a trauma patient who had come in from a vehicle accident they could have taken the person who came in with chest pain who was found to be having a heart attack to another hospital with capabilities to open the blocked blood vessel in their heart to stop the damage being done. How about that wife, mother of 4 fairly young children who came in because her right arm and leg suddenly went numb and she could barely speak who was found to have bleeding in her brain from a fall she had earlier that day where she hit her head who needs to get to a “real” hospital with a specialist who could get into her brain to stop the bleed and help her be able to live many more years to see her children grow up and have children of their own, but that can’t happen now because that one ambulance that could transfer patients out of town had just left with the vehicle accident victim to a trauma center two hours away and they won’t make it back in time for another ambulance to take her to where there is a specialized surgeon who could get her into an operating room to stop the damage being done to her brain. Do we say “oh well, sorry for that families loss, but the county at least had ambulances available to go pick up the person that called 911 because they had a tooth ache and the the one that was constipated and must get to the emergency room now with their problem that wasn’t an emergency.” EMS is being abused by people every day for their colds, tooth aches, constipation, chronic back pain, etc., simply because they think coming to a hospital in an ambulance will get them seen by a doctor faster instead of going to their doctor, dentist or a walk-in clinic. EMS gets abused and has been getting abused for years, but it is much worse now because so many people have become selfish, uneducated or want attention so they call an ambulance to take them to an emergency room for their non-emergent problem instead of getting into one of the many cars in their driveway and taking themselves to a clinic that could take care of their colds, ingrown toenails, backache, etc. Also, many of those abusing EMS and the ER have no insurance and no intention of ever paying the ambulance bill or the ER bill they are going to get and this goes on ago over the United States, not just in Carroll County.
Baptist ambulance service also has a major staffing issue because they can go to work for a different ambulance service where they will make more money per hour as well as get Healthcare coverage that is much cheaper and they are appreciated for what they do and the care they provide.
The sad thing is the way things changed with EMS this week Baptist Memorial Hospital Carroll County now has patients that are choosing to refuse to wait for ambulance transportation out of the hospital to another hospital out of town for higher levels of care or testing that is not available at Baptist Huntingdon and they are going in their private vehicles with no medical staff with them because Baptist ambulance service is now refusing to do more than one transfer out of the hospital at a time. This could possibly result in a worse outcome for the patients, what of the pregnant woman gives birth in the car in the side of the road trying to get to another hospital and when that baby is born in a private car is having trouble breathing. Who will help that newborn baby somehow get the needed oxygen? How about the patient having the heart attack or stroke who has no way to get to a hospital with the ability to go into their body through an artery to get the blockage out of their brain or heart and stop the process of what is happening to them so they can continue to live with any kind of quality of life. Sure Baptist Hospital can give people a medication that can help “dissolve” a blood clot, but said medicine can also cause sudden death as a person dies bleeding out of every opening of their body. Had an ambulance not left an hour earlier headed to Memphis or Nashville with a trauma patient who had come in from a vehicle accident they could have taken the person who came in with chest pain who was found to be having a heart attack to another hospital with capabilities to open the blocked blood vessel in their heart to stop the damage being done. How about that wife, mother of 4 fairly young children who came in because her right arm and leg suddenly went numb and she could barely speak who was found to have bleeding in her brain from a fall she had earlier that day where she hit her head who needs to get to a “real” hospital with a specialist who could get into her brain to stop the bleed and help her be able to live many more years to see her children grow up and have children of their own, but that can’t happen now because that one ambulance that could transfer patients out of town had just left with the vehicle accident victim to a trauma center two hours away and they won’t make it back in time for another ambulance to take her to where there is a specialized surgeon who could get her into an operating room to stop the damage being done to her brain. Do we say “oh well, sorry for that families loss, but the county at least had ambulances available to go pick up the person that called 911 because they had a tooth ache and the the one that was constipated and must get to the emergency room now with their problem that wasn’t an emergency.” EMS is being abused by people every day for their colds, tooth aches, constipation, chronic back pain, etc., simply because they think coming to a hospital in an ambulance will get them seen by a doctor faster instead of going to their doctor, dentist or a walk-in clinic. EMS gets abused and has been getting abused for years, but it is much worse now because so many people have become selfish, uneducated or want attention so they call an ambulance to take them to an emergency room for their non-emergent problem instead of getting into one of the many cars in their driveway and taking themselves to a clinic that could take care of their colds, ingrown toenails, backache, etc. Also, many of those abusing EMS and the ER have no insurance and no intention of ever paying the ambulance bill or the ER bill they are going to get and this goes on ago over the United States, not just in Carroll County.
Baptist ambulance service also has a major staffing issue because they can go to work for a different ambulance service where they will make more money per hour as well as get Healthcare coverage that is much cheaper and they are appreciated for what they do and the care they provide.
If the county starts it own service, do they have the founds to buy 5 type 2 ambulances at 135K each? How about 5 stretchers with a load system that is the safest system at 55K each?. How about 5 65K each heart monitor/defibs. How about stocking the ambulances, paying fuel cost, wages and benefits for the employees? All with no money from Medicare for a year. That would take millions of dollars. The ambulance service now is free. No matter how many ambulances you run, there will days you run out. When you do you have to mutual aid another service to help. Evan the big cities run out with their services. Then there are days where you wish someone would call so you can get out of the station. Ambulance services are a losing money business. Medicare and Medicaid will not reimburse enough to pay your bills. Private insurance are trying to pay only what Medicare pays. Thats makes it difficult to pay employees. Thats why you see EMT’s and Medics move from service to service. If the employer says to do something that is clearly wrong, they will pack up and leave, and be working elsewhere the same day. Plan on investing alot of money if you want a good quality service.