Three Augusta hospitals submitted very different cases for why they should work with Columbia County to build a hospital in the state’s largest county without one. Two would not require any funding by the county at all.
Georgia Regents Health System would create a campus with a $280 million to $310 million 144-bed hospital, with a medical office building, but would not require any funding from the county. The “state of the art” facility would include “smart” patient rooms that continuously monitor and report patient conditions.
University Hospital’s bid relies on the old real estate maxim: location. It already has a campus in the center of health care providers in Columbia County.
“There are all kinds of providers that are very close to that Evans campus,” said Ed Burr, the senior vice president for legal affairs for University. “All of these other health care providers have already made their investments, have gotten their property. For them and for their patients, the best thing is going to be a hospital that is close to where they are already located.”
While it would require a 20 percent investment from the county to get state permission, which would be between $26 million to $28 million, University’s 100-bed hospital would be significantly cheaper at $130 million to $140 million. University could also decline a tax exemption on the building, meaning it would be on the county’s tax rolls.
Doctors Hospital is proposing a 108-bed $150 million hospital with a $14.5 million medical office building/ambulatory care center. Its project would add $1.5 million to the county tax rolls, according to the proposal.
County Commission Chairman Ron Cross said the county received three bids by the deadline Friday but would not open them until next week. Both University and Georgia Regents Health officials said they expect to soon make presentations before the selection committee.
The state Department of Community Health shot down proposals last year by University and Doctors for free-standing emergency departments in Columbia County, arguing there were more than adequate resources in Augusta to cover the need.
However, state officials also pointed the county to three exceptions to the need standard, which have never been used. The three that might apply are: if the facility was part of an existing trauma center, if the facility is part of an existing teaching hospital or if the county provides 20 percent of the cost of construction.
Georgia Regents is relying on the first two in its proposal, and University’s would require county funding. Doctors Hospital said it would rely on the trauma exception, which would not require county funding. Doctors is hoping to receive a trauma designation later this year. If county funding is required, Doctors said it would work with the county on that.
By far, Georgia Regents is the most ambitious proposal. Its project is twice the cost of either the Doctors or University proposals and at 425,000 square feet, the hospital would be nearly twice the size of University’s 252,000-square-foot facility or Doctors’ 228,035-square-foot building.
“When we evaluated the county and we looked at the current needs of the county, as well as future growth needs, we really felt like it was important for us to plan a hospital not only for today but for the future,” said Shawn Vincent, Georgia Regents’ vice president of partnerships, international health care and strategic affiliations.
Georgia Regents is also proposing a “health campus” that would include a satellite of the university that would offer classes, perhaps in conjunction with the school system industry or Fort Gordon.
Where the money will come from might be the question. University proposes to pay it out of cash on hand, and Doctors is part of the massive HCA chain. If it cannot use the trauma exception, Doctors would work on helping the county meet its 20 percent share – $30 million – through land or land improvements or other contributions or through a joint venture.
Vincent insisted funding would not be a problem for Georgia Regents.
“For us, we would actually look at both cash on hand as well as potential public and private debt models that we could use,” he said. ”From our perspective, that has really not been a major issue for us. The financing of this, while it is a sizable amount of money, is something that we feel like is easily attainable.”
Both University and Doctors say their advantage lies in their long history of providing care in and investing in Columbia County. University has owned the 68-acre site where the hospital would go since 1986, and the Evans campus already has a surgical center, an imaging center, five medical office buildings totaling 160,000 square feet and “Columbia County’s only parking deck,” the proposal said.
“It is already a medical destination,” Burr said.
University would also provide local control by letting the county commission appoint some members to the governing board, much the way it does now with University Hospital McDuffie.
Doctors Hospital, about a mile from the Columbia County border, said it is already the “community hospital” for the county and claims to have treated more of its residents than any other hospital in Augusta. Doctors owns the land it would build on, operates a surgery center in the county and has previously given up strategically placed land so Columbia County could grow, according to the proposal.
Georgia Regents’ physician group owns a 58-acre parcel off Washington Road where it once considered building a clinic, but it would not be large enough for its plan. The health system would have to work with the county on acquiring the right place for its campus, the proposal said.