In the end, though, none of them got the nod.
Doctors Hospital, Georgia Regents Health System and University Hospital each painted different visions of why they should be the one to work with the county on getting state permission to build a hospital there.
The Columbia County Hospital Review Committee, however, voted not to make a recommendation to the Columbia County Commission on which bid works best for the county.
Committee member Barry Paschal, who made the motion to defer the decision back to the commission, said a lot of the committee members did not feel comfortable taking a public stand on behalf of an individual hospital. But questions asked by the committee and answered during the presentations should give commission members a better understanding of those proposals, he said.
Columbia County Commission Chairman Ron Cross said some of the committee members became uncomfortable once their closed meeting was made a public meeting, after a protest by The Augusta Chronicle. Commission members will still need time to study the proposals and might have to schedule a special work session to do that, he said.
“We will have to do it in open session,” Cross said.
Whoever is chosen would have to seek a Certificate of Need from the state that would allow it to build a hospital. Doctors and University were denied certificates last year for competing proposals to build freestanding Emergency Departments in Columbia County.
The state ruled the county is adequately served by emergency services at Augusta hospitals. And with a surplus of hospital beds in Augusta, “it would be very difficult” to meet the needs standard for additional beds in Columbia County, University CEO Jim Davis said.
County officials instead are pinning their hopes on three exceptions to the needs standard: if the proposal comes from an existing teaching hospital or if it is from an existing trauma center or if the county assumes 20 percent of the cost of construction. None of the exceptions has ever been tried.
Georgia Regents’ bid would address two of those exceptions, as both a teaching hospital and Level One Trauma Center, which would require no funding from the county, said David Hefner, the executive vice president for clinical affairs at Georgia Regents University.
The health system also had the most extravagant of the three proposals, establishing a $280 million-$310 million “health campus” in the county with a satellite of the university and a 144-bed hospital with a Level II trauma center that would employ 750-900 people.
GRU would pay for it out of “cash on hand, public or private debt instruments or some combination of these sources,” according to the bid.
One problem with its proposal is while GR Health owns land in the county, it would not be adequate and it would have to work with the county on a location. If chosen, the health system would work with the county on the best site but it would likely need 80-100 acres and would likely be west of Belair Road, said Shawn Vincent, the vice president of partnerships, international health care and strategic alliances.
In response to a question from the committee about negative publicity and the need to build trust with the county, GRU President Ricardo Azziz took that head-on and acknowledged some of that is him.
“When you are the face of an organization, you’re the face for both success and failures,” he said. “When we’ve done as much as we’ve done, you will make mistakes and I am responsible for those mistakes, whether I am directly or not doesn’t really matter. It’s important to remind, not just this group but this community in general, that at the end of the day leaders will be magnets for both positive and negative feelings but that shouldn’t really affect the vision of the future and what is being built.”
At less than a mile from the border with the county, Doctors touted itself as the greatest provider of health care services already to Columbia County, accounting for nearly half of emergency room visits by county residents.
Doctors is proposing a $150 million, 108-bed hospital with a Level III trauma center. That will probably just be the starting point and it will grow in services, much as the Joseph M. Still Burn Center at Doctors started with 2 beds and now is the country’s largest with 70 beds, said Dr. Fred Mullins, the medical director.
Doctors’ proposed hospital would add about $1.5 million in property taxes to the county, the proposal noted.
Doctors plans to use the trauma exception as it hopes to be named a trauma center later this year. CEO Doug Welch said the hospital must collect data for six months and then be surveyed by the state, which could happen by June or July, but he did not see that would be a problem.
But Davis said he thinks the only exception the state will accept is the county putting in 20 percent, and University is the only bidder asking the county to do that. The trauma and teaching hospital exceptions require “existing” services and neither of those is currently in Columbia County, he said.
“The other proposals will be turned away at the state level,” Davis said.
By putting up its own funds for the proposed 100-bed, $130 million-$140 million hospital, which would be $26 million-$28 million that can be deferred, the county shows state officials the hospital is important to the community, he said.
“This shows that the service is needed and the county is buying into it,” Davis said.
For University’s part, it will forego a tax exemption and pay property tax on the hospital, which would be about $1.5 million a year.
The hospital would go on the 68-acre Evans campus University has been developing since 1986 off North Belair Road. It would also benefit from all of the existing University offices and facilities there but also the other medical offices that chose to settle nearby because of the campus.
“It is the thriving medical hub of Columbia County,” Davis said. “We think it is the ideal location” for a new hospital.
Staff Writer Steve Crawford contributed to this story.