Doctors and University hospitals are vying for state permission to build a free-standing emergency department in Columbia County, the state’s largest county without one, officials said.
The state has never allowed such a center before, though South Carolina and about half the other states do, a University official said.
A decision last month by the Georgia Department of Community Services to shoot down a similar proposal in Walton County might not signal doom for Columbia County’s proposal.
Doctors Hospital is proposing a $9.8 million, 12-bed facility with a room to handle trauma on North Belair Road across from Marshall Square; University is putting forth a $9.67 million plan for an 18-bed facility with five trauma rooms on its Evans campus off North Belair Road.
Both sides concede it is likely the state will pick only one, if either, of the plans.
Unlike adding hospital beds, in which the state has a formula to calculate how many an area needs, there is no strict criterion and it will be up to regulators to decide whether there is a general need for the services, said Ed Burr, University’s vice president of legal affairs.
“It is theoretically possible they could find a general need for both facilities. Probably not,” he said. “They may find a general need for neither and deny them both.”
“I would be very shocked if it was both (approved),” Doctors CEO Doug Welch said. If that were the case, it would hinder the state’s ability to limit the number of the centers and they would spring up all over the Atlanta area, he said.
Because the applications are similar and were filed within 30 days of each other, the state has “joined” the applications, indicating it will decide the fate of both at the same time, with a deadline of Jan. 25.
The hospitals said that their emergency rooms are overflowing and that they have a compelling need for their free-standing expansion.
Welch said Doctors has seen “phenomenal growth” in ER patients over the past few years, seeing almost 50,000 last year, up 12 percent from the previous year.
“We’re out of space; we’re out of treatment rooms to run our emergency room efficiently,” he said. “It’s very difficult for us to expand here on campus, so let’s take it to where the people are.”
University is also limited by its downtown campus, and each of the four expansion scenarios it presented the state would be double to four times as expensive as the Evans option, Burr said.
“Our (emergency department) is just swamped,” he said. “We don’t have any way to expand it, realistically, cost-effectively.”
Nor is there a way to avoid issues such as limited parking.
University looked across the Savannah River, Burr said, but was told “only a South Carolina hospital could have a free-standing ED in South Carolina.”
Through Nov. 30, University’s ER had seen 70,222 patients, well beyond the 67,668 it had budgeted and putting it on pace for at least 10 percent growth over the previous year, spokeswoman Rebecca Sylvester said.
Before putting in its application in September, Doctors was told the state would be willing to consider it, Welch said.
The state denied an application Dec. 19 by Eastside Medical Center in Snellville to open a free-standing ER in nearby Walton County.
In that application, two other hospitals – including the community hospital in Walton – and residents opposed the plan, Burr said. Eastside might also have failed to demonstrate it had exhausted the ability to expand its ER, he said. Those factors aren’t germane to this case, Burr said.
“We spent a lot of time and effort trying to come up with alternative plans (before choosing Evans),” he said.
Both sides said the hospital that is not picked is likely to appeal, which Burr said could drag the process out a year.
Columbia County officials said Monday they know there could be a fight ahead.
“It’s so adversarial they’re going to go after it hammer and tongs,” Columbia County Commissioner Trey Allen said.
“We’ve already sent a letter to (the state) saying we’d support anybody,” commission Chairman Ron Cross said. “We need that. Doctors isn’t far away, but we need our own facility out here.”
Free-standing ERs have been a trend for HCA, the hospital chain that includes Doctors. The company has 24 now and seven in development, Welch said. He opened one when he was a CEO in Texas before coming to Augusta, so “we have both the national and local expertise to do this,” Welch said.
Staff writer Barry Paschal contributed to this article.