With the Columbia County Commission poised to pick a partner tonight to build the county’s first hospital, the decision could just be the opening salvo of what might be a months-long campaign of legal wrangling and maneuvering among three Augusta hospitals.
The commission will have to make a decision on proposals offered by Doctors Hospital, Georgia Regents Health System and University Hospital.
“We will be making one,” Chairman Ron Cross said.
Whoever is chosen will then have to seek the required Certificate of Need necessary to build the new hospital, officials said.
University would file the letter of intent to seek a CON within two weeks and then would use the required 30-day wait or more to put the application together, said CEO Jim Davis.
Georgia Regents would likely bring in outside consultants and would look to have an application in within 90 days, said Shawn P. Vincent, vice president of partnerships, international health care and strategic affiliations. Doctors declined to comment.
Both Georgia Regents and University said those not chosen will not walk away quietly.
“There’s probably going to be some sort of litigation around this,” Vincent said.
“I will guarantee you whoever gets selected will get challenged by whoever doesn’t get selected,” Davis said. “We’re figuring it is probably a good year’s worth of fighting before we get to building.”
Getting the CON will also depend upon the state accepting an exemption to its complicated needs standard to show the facility should be built. Two Georgia hospitals were able to get bed expansions beyond what the state calculated was needed because the county paid 20 percent of the cost. That is the approach University is taking for its 100-bed, $144 million hospital.
“(That) is the main reason we like that 20 percent contribution from the county because that shows there is need,” Davis said. “The citizens of the county believe there is a need for services. Without that, I think it is going to be really tough to show need.”
The other two exemptions open for Columbia County are if the proposal comes from an existing trauma center or from an existing teaching hospital. Georgia Regents could pursue either one and Doctors hope to use the trauma center exemption after it aims to be named a trauma center this summer. Neither of those two has been utilized before to justify a new hospital or an expansion.
If a CON can be granted, University is looking at 18 months to two years for construction, and University officials planned on 2017 as the first year of operation. In its proposal, Doctors estimated it would take 29 months to design, build and move into its 108-bed, $150 million hospital, which would look similar to one parent company HCA is building in Loudon County, Va. Georgia Regents was looking at around 30 months for construction of its $244 million, 144-bed hospital in part because of a heavy emphasis on future needs, Vincent said.
“One of the things we’ve done in our proposal was really focusing a lot on the future and what does the health care of tomorrow look like,” he said. “Therefore a lot of the construction as we think about this project focuses on what potentially may be needed tomorrow.”
The work will be done in concert with the health system’s technology partners, Cerner and Royal Phillips, and the facility will be built to accommodate technology that might not even exist yet, Vincent said.
“We are definitely in their pipeline, related to their research and development, which gives us an opportunity to perhaps access certain technology that is not even commercially available yet,” he said.
It is more expensive – the hospital would be more than the College of Dental Medicine Building and the Medical Education Commons building at GRU combined – but that will pay off in the long run, Vincent said.
“By having international partners, we’re able to pull best practices from not only around the United States but from around the world to actually incorporate into a project of this size to improve efficiencies and improve patient care,” he said.
University deliberately tried to keep down the cost of the facility partly because some of it will be borne by the taxpayer, but also because efficiency and cost-effectiveness is becoming more important in health care as future cuts loom, Davis said.
“My vision of health care is it has got to be high quality but it is going to have to be very inexpensive down the road,” he said. “It will be a very nice facility. It will be a lot like the building I am sitting in right now, which I don’t think is too bad. It will still be a very nice facility, but we do everything very efficiently around here.”