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Three Augusta hospitals vie for Columbia County project

Friday, Jan. 10, 2014 4:10 PM
Last updated Saturday, Jan. 11, 2014 1:54 AM
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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.

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Bizkit
31570
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Bizkit 01/10/14 - 05:33 pm
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Great let em duke it out-to

Great let em duke it out-to the victor goes the spoils.

Riverman1
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Riverman1 01/10/14 - 06:35 pm
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Appears To Be A No Brainer

"While it would require a 20 percent investment from the county to get state permission..."

Of course, I disagree with that statement. It is possible the state will grant a CON without the 20 percent contribution for a hospital. The free standing emergency room has never been approved anywhere in the state. But if that's University's bid, so be it. Let's see what Doctors says. From the two bids, it appears a no brainer to choose GRU. Keep in mind, Columbia County will be a gold mine for a hospital.

soapy_725
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soapy_725 01/10/14 - 06:34 pm
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Every new hospital facility increases the cost to patients. FACT
Unpublished

Every new hospital facility increases the cost to patients. FACT

soapy_725
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soapy_725 01/10/14 - 06:35 pm
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The CSRA already has more hospital beds than it can afford.
Unpublished

The CSRA already has more hospital beds than it can afford.

soapy_725
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soapy_725 01/10/14 - 06:36 pm
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We can't all have an ER next to our home. We may want same.
Unpublished

We can't all have an ER next to our home. We may want same.

Riverman1
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Riverman1 01/10/14 - 06:56 pm
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Clarification

"But state officials also pointed the county to three exceptions to the need standard, which actually 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."

I don't want to belabor this because we covered it the other day, but if Columbia County kicks in 20% of the cost to build a hospital, those making the decision are amiss.

If you notice the above statement was what the state told them after they turned down the free standing ER. They were telling the county how to get one of those approved. Paying 20% of the cost for a small free standing ER could be practical. That's also what they were referring to when they said part of an existing trauma center. They were NOT telling the county to kick in 20% for a HOSPITAL which would be a huge cost. It's a huge jump to assume they were. A hospital of any kind would be a whole different consideration. Again if University has that as a requirement, so be it. Cross them off, Mr.Cross.

Tom Corwin
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Tom Corwin 01/10/14 - 07:21 pm
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Riverman

No. The state was talking to Columbia County officials about their ambition to get a hospital. The 20 percent contribution is one of the exceptions to the need standard for a hospital. You don't seem to understand that the state has pretty much ruled that Columbia County cannot meet the need standard to justify a hospital there. This is from the proposal from Doctors Hospital: "If CON rules, including its need methodology for additional hospital beds, had allowed, Doctors Hospital would already have a hospital in Columbia County." I think that is a widely held view in Augusta health care that the CON rules prohibit any new acute care hospital in the immediate Augusta area, except for those three exceptions referenced in the story. The state may only allow a CON if the county contributes. No one knows what the state will do, hence the different proposals.

Riverman1
84225
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Riverman1 01/10/14 - 09:21 pm
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Thanks, But...

“You don't seem to understand that the state has pretty much ruled that Columbia County cannot meet the need standard to justify a hospital there.”

I’m curious how you come to that conclusion? What does “pretty much ruled," mean? They ruled about free standing emergency rooms. Is there some information that’s not public knowledge? From your story, it appears the state was giving stipulations for ERs and possible loopholes.

That’s interesting what Doctors said. What is the need methodology for hospital beds that they believe the state uses to grant a CON? Keep in mind, they would be more than happy to accept the 20% financing, also. Let's put the methodology for hospital beds the state uses out and see just how Columbia County stands.

Didn’t University say the reason they hadn’t applied sooner for a full hospital is because of past economic conditions?

As far as what you say being a widely held view in Augusta health care, I want to be careful that it’s an accurate view. I and MANY others who are in local health care don’t buy it although I certainly don’t know everything. Please educate me.

Riverman1
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Riverman1 01/10/14 - 09:22 pm
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Careful With $40 Million

Like I said before it seems like a no brainer to me to accept the proposal that doesn’t require any county funding and that appears to be GRU. It will also be informative to see what Doctors proposes. If the county somehow ends up putting $40 million into the thing using some tortuous reasoning, I’d be asking questions of what all this effort to get the county to put out that kind of money is about.

Bizkit
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Bizkit 01/10/14 - 10:37 pm
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W'ell normally I'd support

W'ell normally I'd support GRU but screw em. I'm still stewing over all the name changes. I'll get over it, but some things take me longer than others. If they'd just admit what they were doing rather the pretense of cost savings, blah, blah, blah and sell me a bill of goods I'd feel better about it. I don't like being deceived-you can't trust em.

Bizkit
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Bizkit 01/10/14 - 10:45 pm
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Wow Tom so the State has

Wow Tom so the State has ruled to let people needlessly die from cardiac arrest because of a twenty minute or more ambulance response time from Columbia county to Richmond? Studies indicate the shorter response time the better the chance of survival-statistically they have chosen to let people needlessly die.

Bizkit
31570
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Bizkit 01/10/14 - 10:49 pm
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Who makes up this death squad

Who makes up this death squad of the State so readers can send them some burnin' comments and suggestions and questions. If it was a small population they've always let them make out best they could but a large population could mean large numbers of needless deaths because of simple proximity. It'll probably be like getting a railroad crossing-it use to be it had to be so many deaths or some big name dude or dudette got hit by a train to finally get a crossing guard. This will be the same-some big name "aged" county official will have a cardiac arrest and needlessly die to highlight the need. A great sacrifice but that's the way it seems to work. I note a fancy new hospital off I-20 at Gray on Lake Oconee. Wow big need there-lots of old rich retired folks in all the fancy new developments.

Riverman1
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Riverman1 01/10/14 - 11:23 pm
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9:25 pm story addition

I see things were added to the story at 9:25 pm. So Doctors is claiming they will soon be a trauma center and they can use this for an exemption. Well, that's fine, too. Anything to keep the county from paying tens of millions.

iaaffg
2300
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iaaffg 01/11/14 - 10:15 am
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columbia county needs a

columbia county needs a hospital like it needs another shopping center. this is just going to drive our taxes up even further, count on it. time to move on! texas is looking better and better.

raul
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raul 01/11/14 - 11:50 am
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@iaaffg. Bye,Bye.

@iaaffg. Bye,Bye.

itsanotherday1
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itsanotherday1 01/11/14 - 12:23 pm
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Stepping back

On an earlier article I said NO to GRU. What they are proposing is a state of the art, high tech facility; which jogged my memory about another friend's experience.

He had a heart transplant at MUSC Charleston, and the patient care could not have been better. The staff were friendly and professional; johnny on the spot when called, and the facilities sparkling.

I was expecting an MCG situation when I went to visit, but was very surprised at what I saw. So, government facilities CAN be high quality with the right employees, facilities, and leadership.

Riverman1
84225
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Riverman1 01/11/14 - 02:41 pm
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If It Is GRU

IAD, interesting. I think MUSC and MCG had reputations as pauper hospitals in the past. A place where they "spermented" on you is what my factory working mother said. Heh. That's all changed, hopefully. I'm completely neutral on whichever one is chosen and have no ulterior motives bringing up concerns.

But talk of GRU has me wondering if they may expand more in Columbia County in the future. There's no doubt this hospital will bring in hundreds of millions over the years with the Columbia Cty demographics. By the same token, as Rebel was getting at, GRU downtown will lose considerably if GRU Columbia Cty opens. In the future, why couldn't more of the medical school functions be moved to Columbia County?

While we're at it, let's stipulate the hospital be named Columbia County GRU Hospital with the GRU in tiny letters. Know what I mean? Heh.

Riverman1
84225
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Riverman1 01/11/14 - 02:43 pm
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Raul, don't let him bother

Raul, don't let him bother you. For every person leaving, we have about ten moving in. One of the fastest growing counties in the nation.

Sweet son
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Sweet son 01/11/14 - 02:44 pm
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The whole deal seems to me to be nothing more than just

bragging rights. "We have a hospital: nannie nannie boo boo!" There are plenty of hospital beds in the area and there are plenty of outpatient facilities in the area including Columbia County.

I guess the ones who are bidding are just wanting to get into a market where most of the patients have insurance and will pay co pays and other balances.

Gardencity1
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Gardencity1 01/11/14 - 11:43 pm
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Riverman1

The exception stated in Tom's article earlier this week stated an existing designated trauma center, which Doctor's isn't, so I wonder how they think this will work. GRU's proposal seems to be the best long term for the county. In reading the link it looks like they are not trying to build a mini MCG, but something much different using a community hospital model. is that your understanding as well? Even if you hate them, it is clear they are the big economic machine for the CSRA. Big salary dollars are paid in both Richmond and Columbia County. CC could benefit the most from them. It looks like Doctors and University are building the minimum instead of something that will be relevant 20 years from now. Finally at a meeting earlier this year at the Kiawannis club, we were told that the state only covers something like 25% of the budget for the entire University and the hospital l makes up the rest. If that's true then it seems like they could easily afford to pay for this out of the hospital. Thoughts?

Riverman1
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Riverman1 01/12/14 - 12:48 pm
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GardenCity

GardenCity, yes, I think it’s going to be a smallish hospital without some specialties such as cardiothoracic surgery, neuro surgery and possibly no OB. If you believe as I do that CON approval for a hospital could likely be won without county financial support, trauma center connection or being a teaching hospital, then Doctors is still in the game. Plus, the definition of teaching hospital could be interpreted loosely. Didn’t University agree to a residents program a few years ago? But, yes, it does appear GRU plans to build the biggest facility and have the most jobs.

The GRU example that the hospital funds 75% of the costs of the entire medical college and hospital should make us all think. A hospital in Columbia County will be a monumental money maker. Not only is the demographic one of high income people with insurance, but the county has relatively few people seeking free care as GRU does.

So, yes, GRU appears to be the best option at this point. My main questions now are about taxes. How is their state owned status handled? How will University handle that besides waiving the property tax as they said? Doctors will be paying a full tax bill, but how much of the money made by a national company stays local? How much will the hospitals agree to reinvest in the hospital to make it a larger, full services hospital?

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