Big South Fork Medical Center in Oneida is operating on diversion, with ambulances being rerouted from the hospital’s emergency room to other hospitals in neighboring communities.

The Scott County Ambulance Service is delivering patients to LaFollette Medical Center in LaFollette, Oak Ridge Medical Center in Oak Ridge, or Tennova North in Knoxville as a result.

The emergency room is not closed; walk-in patients are still being treated.

The diversion measure marks a first for the cash-strapped hospital, which has been beleaguered by delayed payroll and other financial setbacks but had not previously begun diverting ambulances.

The latest move came just days after U.S. Senator Marsha Blackburn, R-Tenn., called out the hospital’s parent company — Florida-based Rennova Health — in a letter addressing the firm’s “concerning” business practices.

“I write to express my concerns about access to health care for the rural residents of the State of Tennessee,” Blackburn said in the letter to Rennova CEO Seamus Lagan on Thursday. “Recent media reports regarding facilities owned by your company, Rennova Health, have been concerning.”

Blackburn issued three questions which she demanded an answer to by February 11. Among them: Does Rennova have the expertise to run a hospital? Is the company “adequately capitalized” to support up to three hospitals? And are BSFMC and Jellico Community Hospital compliant with CMS conditions?

Last summer, Jamestown Regional Medical Center — which is also owned by Rennova — closed after falling out of CMS compliance and losing its license to be reimbursed by the federal Medicare and Medicaid programs.

Blackburn isn’t the first lawmaker to take Rennova and Lagan to task. As the Jamestown hospital neared closure last year, state lawmaker John Mark Windle, D-Livingston, blasted Lagan in public statements, calling him an “Irish gangster” and demanding an investigation. Lagan later sued Windle. The defamation case is set for trial in early 2021.

BSFMC has not been without good news recently. Last month, the hospital’s CEO, Hal Leftwich, announced at a directors’ meeting of the Scott County Chamber of Commerce that the facility has cleared the first of two licensing hurdles to become a critical-access hospital, which would result in about $2.5 million in additional revenue for the facility each year.