AMITE — The Tangipahoa Parish Council, on a split vote Monday, appointed Hammond lawyer Ron Macaluso as a commissioner on the board that oversees the operations of North Oaks Medical Center, a major health care provider for the parish.

The council’s decision resulted in the removal of Dr. James Nelson from the Tangipahoa Hospital Service District No. 1 board.

A standing-room-only crowd of Nelson’s supporters filled the Courthouse Annex, spilling out into the building’s lobby, and a procession of speakers spoke on his behalf before the council’s vote.

Parish Councilman Louis Joseph spoke glowingly of Nelson as he placed the physician’s name in nomination for reappointment, a motion that failed on a 5-5 tie vote. Voting with Joseph to reappoint Nelson were Bobby Cortez, Harry Lavine, David Vial and Lionel Wells. Voting against were Ronnie Bankston, Nicky Muscarello, Carlo Bruno, Greg Varnado and Trent Forrest.

Muscarello then nominated Macaluso.

Muscarello, who termed Nelson “a great guy,” said he had tried to get Macaluso on the hospital board “long ago.” He said politics played no role in his nominating Macaluso to the board.

Voting for Macaluso’s nomination were Forrest, Varnado, Joseph, Bruno, Muscarello and Bankston.

When Hospital Service District No. 1 was formed to create North Oaks Medical Center’s predecessor, Seventh Ward General Hospital, the legislation stipulated that three board members from Hammond and two from Ponchatoula would serve on the governing board.

Commissioners are nominated by the council members from the two cities.

Muscarello told reporters last week that he intended nominate Macaluso to the board rather than recommend the reappointment of Nelson.

Nelson told the council that while he did not want to appear to be “self-serving,” he felt it was in the hospital’s best interest for him to remain on the board. Nelson said he is the only physician on the board and that it was unprecedented not to have a doctor on a board that supervises management of a major hospital.

Nelson traced the growth of North Oaks Health System over the years and pointed out that when he joined the hospital’s staff, only 18 doctors were practicing there. Today, Nelson said, 204 physicians serve North Oaks. He said that with 2,400 employees, North Oaks has a huge economic impact on Tangipahoa Parish.

Dr. Chris Leumas, a pediatrician at North Oaks who is chairman of the hospital’s Credentials and By-Laws Committee, told the council that Nelson was a “gold nugget” who is trusted and admired by the professional medical staff at the hospital. He said changes are coming in the way health care is delivered and Nelson’s services are needed.

“If ever there was a time to exclude politics in the management of a hospital, it is now,” Leumas said. “We have to keep Dr. Nelson on the board.”

John Derenbecker, chief legal counsel for North Oaks, said keeping Nelson on the board would “ensure the medical staff’s confidence in the hospital’s leadership. If the doctors don’t see a physician on the board, they will think something is just not right with how the hospital is being run.”

Macaluso told the council that he has long held a special interest in North Oaks Hospital. Macaluso said he respected Nelson as a very competent physician and said he shared with Nelson a care and concern for the proper management of North Oaks.

Macaluso said he felt that he had unique qualities he could bring to the board, adding that it was not necessary to have a physician on the board because that body has input from the hospital chief of staff and the institution’s medical director.