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Columbia County might pick hospital partner soon

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The Columbia County Commission will likely pick a partner this month from the three Augusta hospitals vying to help it build the county’s first hospital. At least one loophole the county hopes to exploit to get state permission has been used by two other Geor­gia hospitals for expansion, according to a document obtained by The Augusta Chronicle.

At a work session Friday, commissioners reviewed questions and answers from Doc­tors Hospital, Georgia Regents Health System and University Hospital about their bids.

Chairman Ron Cross said the commission will hold another work session next week and then take up the matter at its March 18 meeting for a possible decision.

About half of the points it will use to score bids concern costs, Vice Chairman Ron Thigpen said.

Of the three, only University is asking the county to contribute 20 percent of the cost of building its 100-bed hospital, which would be about $26 million to $28 million of the $130 million to $140 million cost. That request targets one of the exceptions in the state’s need standard for building a hospital.

Because Columbia County is next to Au­­gus­ta and its four acute care hospitals, it will need to get an exemption to obtain a Cer­tificate of Need, Cross acknowledged.

According to calculations by The Chronicle, using the average daily census for inpatients in the four hospitals in 2012, the average daily number of patients in hospital beds in Augusta was 853 out of the 1,644 beds the hospitals are licensed to operate.

The Certificate of Need law has an exception that could allow a county’s sole provider to build or expand beyond what it can
prove is needed by contributing 20 percent of the total cost.

Henry Medical Center in Hen­ry County used that exception to justify its request to expand by 91 beds, from 124 to 215, though the need calculation said only 48 additional beds would be
allowed, according to a 2003 decision by the Georgia Department of Community Health in upholding the request.

The request was upheld despite the objections of two competitors. The decision noted that Rockdale Hospital and Health System also used the 20 percent contribution rule to get approved
for a 31-bed expansion when only 12 beds were justified under the needs methodology.

University structured its bid to take advantage of the exception, “not because we need the money,” said Ed Burr, its senior vice president for legal affairs.

Georgia Regents would rely on two of the other exceptions, which allow existing trauma centers or teaching hospitals to bypass the need requirement, and would not require county funds, said Shawn P. Vincent Sr., its vice president of partnerships, international
health care and strategic alliances.

“Taxpayers are burdened enough,” he said.

Doctors Hospital also hopes to use the trauma center exception to avoid asking the county for the $30 million that might otherwise be required to get permission to build its $150 million, 108-bed hospital. It is not yet been designated by the state as a trauma center.

“We anticipate being a Level III (trauma center) by this summer,” CEO Doug Welch said.

Neither of those two exceptions has ever been used to get a Certificate of Need, officials have said. Con­versations with state officials did not provide clarity on that, Columbia County Ad­min­is­trator Scott Johnson said.

If the county is contributing, that would be the “No. 1 item” on the next special purpose local option sales tax program, Cross said.

However, Commissioner Bill Morris said that might take away from other projects the county might want to do.

“That’s going to eliminate some other quality of life projects,” he said.

Many of the commissioners’ questions concerned the most ambitious proposal, from Georgia Regents, to create a $280 million to $310 million “health campus” with a 144-bed hospital that would need up to 100 acres.

While the health system owns land in the county, it is not sufficient for the idea and commissioners questioned where the hospital would go.

Vincent said the health system would work with the county on what site would be best, but it is looking in a corridor along Interstate 20 west of Belair Road because that is where future needs will be increasing.

“The growth largely seems to be west of the Belair Road area,” Vincent said.

University would put its hospital on its Evans campus off North Belair Road. Doctors Hospital owns a site nearby that it could use but has an option on another.

Cross questioned Georgia Regents about whether its deal with Phillips Health­care, which is touted in its bid, really offered a clear advantage over the other two.

“It’s more than just an equipment deal,” Vincent said.

Through the 15-year, $300 million partnership, the health system gets access to new equipment in its developmental pipeline and has a research agreement, he said.

It’s not really an advantage to be “locked into technology that is not always the best,” Burr said. “Our philosophy is to buy the best technology at the time.”

University can leverage its buying power through a deal with Novant Health. Doctors has had an arrangement with General Electric since the 1990s but can go out and buy the best available technology if it is not with them, Welch said.

Thigpen asked the bidders to provide more detailed financial records and projections on how their proposed hospital would do over the next five to six years.

The decision will be about the future of the county, and commissioners are focused on that, Cross said.

“It’s just a matter of being sure that what is promised will take place,” he said.

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Riverman1 03/01/14 - 07:59 am
Do not give University $28 million

Do not give University $28 million. If we don't and they don't want to apply, it's either GRU or Doctors. Why not support both of them in their applications for the state CON?

iaaffg 03/01/14 - 07:51 am
we don't need the burden of a

we don't need the burden of a hospital here in columbia county. again, this is simply going to cause all our taxes to go up, up, up, which they do every year as it is anyways. this is just a feather for ron cross' cap, since he's planning on one more tenure as a coco commissioner, he wants to go out with a bang and be able to pat himself on the shoulder a million times a day, cause he'll say he was the guy who brought progress to columbia county. i think he and his merry band of pranksters have ruined this county all the way around, ever since they widened belair road back in the early 1990's. it's been one 'progressive' project after the other, which has just turned this into a big shopping center county and nothing much more. now they want a hospital. just because, dadgummit it, ron wants one! let's put this to the taxpayers of columbia county and see if they want the hospital, want to foot the bill for the hospital, want to police the hospital, etc etc etc. but then law isn't by the people anymore in this county, just like in the whole country, is it?. no more by the people and for the people, it's all decided for the people ahead of time. once again this is an example how far the dumbing down of america has gone.

foster 03/01/14 - 12:38 pm
Columbia County might pick hospital partner soon

Having attended the meeting at the government center and listening to all three presentations, I have come to a conclusion that GRU is the best choice for our county. My decision is based on the facts presented by the hospitals themselves.

Doctor's Hospital plan is based on their attaining the designation as a Level Three Trauma Center in the future. GRU would add a level two trauma center in their plan.

University says they will make room at their existing campus to build their hospital . This area is heavily congested now and would delay the arrival of emergency vehicles to the facility. Also University is asking the county to contribute millions of dollars to support their venture.

GRU would build a much larger hospital than the other two while at the same time no county funds would be needed. It already owns a piece of property in the county which is too small and has agreed to work with the county to find a suitable location. This location would probably be built near I20, which would provide better access for the entire county especially fast growing Grovetown. GRU already has a statewide presence in several counties around Georgia helping to teach medical students including a satellite campus at UGA. Not only would GRU build a new and larger hospital but they would also train the next generation of doctors there. GRU also would establish an Open Practice Plan which would encourage the existing physicians in the county to partner with them to treat their patients. I believe the strength of the GRU plan far outweighs the other two proposals and would encourage the commissioners to pick GRU.

Sweet son
Sweet son 03/01/14 - 12:39 pm
Columbia County doesn't need a hospital.

This is nothing about medical need it's about monetary gain for all of the three that made proposals.

Little Lamb
Little Lamb 03/01/14 - 05:45 pm

I still think the best solution is to have University sink whatever money they were planning for this one into the one they are already upgrading in Thomson. That way, the western Columbia Countians could go to University in Thomson and the eastern Columbia Countians can continue to go to Doctors, Trinity, University, or MCG in Augusta.

Esctab 03/01/14 - 07:29 pm
Maybe not Foster.....

While the proposal by GRU may claim that no county funds are needed, I’ll bet that in the end not only will it cost the county to support GRU but it will cost the entire state as well. This is especially true if GRU plans to use a Columbia County hospital to train physicians - that is just one of many reasons why ultimately all the accounting/funding/bill paying etc. would be handled as a single entity with the state of Georgia being the responsible, not just the county. GRU already does lots shell games with its accounting of how the campus and current hospital swap revenue and costs; an expansion to Columbia County will only give them more ways to do it.

Additionally, ask the current GRU physicians how happy they are with the current practice plan, most are not happy campers. I seriously doubt that an “open practice plan” will bring physicians flocking to GRU. Azziz might want to conduct a “survey” of physicians to find out if the idea of an open practice plan will work according to the proposal…….. :)

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