Cook County EDC | Citizens unite to save hospital

Citizens unite to save hospital

The biggest crowd in recent memory at a Cook County Board of Commissioners’ meeting gave the Commissioners a standing ovation Monday. The Board had voted unanimously to authorize a Memorandum of Understanding and Intergovernmental Agreement between Cook County and the Hospital Authority of Tift County to begin work on a new hospital.

Some people in the crowd couldn’t help but stand. The meeting room at the County Administration Building was overflowing with an estimated 200 concerned citizens. As the Commissioners looked out into the audience, they could see dozens of red shirts with the slogan, “#WeAreCMC” (Cook Medical Center, a campus of Tift Regional Medical Center.” Some hospital supporters even wore red with University of Georgia sweaters to make their point. Six hundred ninetyseven (697) registered voters had signed a petition “to support keeping Cook Medical Center in Cook County,” and that was presented to the Commissioners.

A woman and her husband carried around signs reading “No Hospital - Dead City” and “Vote Yes - New Hospital.” They marched in front of the County Commissioners with the signs.

Tift Regional Health System officials have been negotiating building a new hospital with local officials for more than two years. Recently, the basic details of a memorandum of understanding between all parties were hammered out and given to local officials so that the project could be given the green light. When certain objections that had already been clarified resurfaced, Tift Regional set a deadline of March 17, 2017, for local officials to green light the project or the deal would be off the table. One of the issues of concern for the County Commissioners was the absence of an Emergency Room from Tift Regional’s proposal.

The March 17, 2017, was set only after 27 months of continued negotiations had once again stalled.

The new hospital will cost more than $35 million. Tift Regional has asked the community to pay $9.2 million over a 30-year time period. That equals out to less than $40 per citizen in Cook County, per year.

The model for the modern facility with modern technology includes:

Urgent care center, surgical center, inpatient facilities, nursing home, geriatric psychiatric center and related medical facilities. In absence of an Emergency Room, there will be an urgent care center operating from 8 a.m. to 10 p.m. Monday-Friday and 10 a.m. to 10 p.m. Saturday and Sunday. All active medical staff in the community will have privileges to make rounds in the new hospital. Every 90 days, Tift Regional Health Services will re-evaluate the need to adjust hours of operation to accommodate more patients. Meaning if they see a need to expand hours, they will. In addition, a 24-hour nurse line will be available for medical guidance, as it is now at the current urgent care facility.

Cook Medical Center would be a destination facility for specialty surgery services.

Finding a suitable location for a Cook Medical Center replacement facility and receiving financial assistance from the city and county to offset the growing expense of indigent and charitable care for the community have been the focal point of discussions between the local governments and Tift Regional Health System. Tift Regional is also seeking aid from the county in a land/facility use project for the current hospital and nursing home facilities once the replacement facility is completed.

Buddy Duke, Mayor of the City of Adel, had called upon all Cook County residents with the urgency of the vote on Monday night. “The hospital plays a crucial role in ensuring the safety and well-being of our family and friends,” he said. “Tonight at 6 p.m., the Cook County Board of Commissioners is scheduled to vote on a critical aspect of the hospital project.

“As a community, we cannot afford to lose the county’s second largest employer. Two hundred people will be out of work. [Sixty more with the nursing home, with the added disruption of the lives of 90 residents and their families.] Insurance costs may go up for employers, and our doctors could leave town. I ask you that join me tonight in support of our hospital.”

Changes in the healthcare landscape, which are affecting rural hospitals across the state and country, are why Tift Regional Health System is working on a new delivery model for health care in Cook County. The Cook Medical Center emergency room was closed on Feb. 28 and began offering a new after-hours clinic for minor injuries and illnesses on March 1. According to Michael Purvis, CEO of Cook Medical Center, about 95 percent of Cook Medical Center’s ER patients were non-emergent.

“By opening a new convenient care clinic in Adel for minor medical issues and sending emergency patients to the closest, appropriate ER, we will be able to offer a more appropriate level of care for the community,” said Purvis. “We have to adapt in order to thrive in the future. If we can secure assistance from the county, we can build a new contemporary facility, which will continue to provide important medical services such as primary care, geriatric psychiatric care, skilled rehabilitation, diagnostic services and introduce new services such as ambulatory surgery.”

Comments from audience

Prior to the County Commissioners’ vote Monday night, they heard comments from several audience members. Jimmy Lewis, CEO of HomeTown Health (a network of rural hospitals (50 in Georgia alone), healthcare providers, and best practice business partners) - Lewis said significant changes in the marketplace have forced many rural hospitals to change their business models from “conventional” with an ER to a model with tertiary (or specialized) and surgical services, so they may stay open. That is the plan for Cook Medical Center. “This hospital in a conventional form is an unsustainable model,” Lewis said.

He noted several rural hospitals that closed in recent years in such communities as Folkston, Ashburn, Dawson, and Vienna. “When you take the tracks up on a short line railroad, the train isn’t ever going to run again,” he said. “Those towns have suffered tremendous economic loss.”

Lewis also emphasized the positive impact that telemedicine technology can have in emergency care provided in ambulances before patients reach ERs.

Chris Dorman, President/Chief Operating Officer of Tift Regional Health System - Tift Regional’s goal is to improve health care in the community while saving jobs and expanding jobs, Dorman said. Howard McClain, member of the Adel Industrial Development Authority and Economic Development Commission: “Tift Regional has come to the place where we will shut down or build a new facility,” he said.

Closing the hospital would mean losing $12.2 million annually in employee salaries and benefits as well as losing a $21 million annual local economic impact, he said.

According to the agreement that was developed between the local governments and hospital officials, Tift Regional will pay more than 72 percent of the cost of the replacement facility, he emphasized. The most that the local governments would be locked in to pay would be up to $10 million, with Tift Regional to absorb the balance. With land to be made available through the Adel Industrial Development Authority for the new facility, the actual maximum possible cost for the local governments would be up to $9.2 million. In addition, Tift Regional has agreed to finance the project at the same rate they are borrowing money from USDA, which is low compared to commercial rates.

McClain spoke about a loss of more than $13 million Tift Regional has experienced with the local ER since 2012 due to 95 percent of the patients being served not requiring emergency care. He said hospital officials have told him that patients will be treated in the Urgent Care facility regardless of ability to pay.

Dr. Russell Acree: “It’s imperative that our county have a health care system,” he said. He pointed to the destructive effect that losing hospitals had on Ashburn and McRae. “If you ever go through McRae, you will see it’s a shadow of a former thriving community,” he said.

Shirley Logan: Mrs. Logan questioned if Tift Regional owns the hospital, why should the city and county be responsible for any part of the debt of the new facility. Mayor Duke replied that local officials feel it’s just as important to provide a hospital for citizens as such services as fire departments and recreation. Hospital officials also informed Mrs. Logan that the replacement facility will have 95 beds for the nursing home and eight acute care beds in the hospital; that babies will not be delivered at the new facility; and no decision has been made about what should be done with the current hospital and nursing home facilities. It also was noted that ambulances can’t deliver patients to Urgent Care.

Dr. Mary Sue Ward: Dr. Ward spoke about how community leaders came together to open the current hospital facility in 1950. She stressed the need for a state-of-the-art facility and having a healthcare system around for the next 67 years of growth.

Melanie Covington, director of nurses at Cook Senior Living Center: She said the hospital and Senior Living Center not only protect the wellbeing of citizens, but they also protect the needs of residents and their families.

Liza Tillman, public relations director for Cook Medical Center: Mrs. Tillman said losing Cook Medical Center would not only cripple the community’s opportunity for economic growth in the future, but it would also eliminate a major sponsor for such community programs as football, the Boys and Girls Club, and Relay For Life. In Fiscal Year 2016, Cook Medical Center made $228,000 in donations for such community outreach. The hospital contributed $50,000 in tornado relief efforts. Without Cook Medical Center’s response to the disaster, “I don’t think Cook County would have fared as well in the aftermath of the tornado,” Mrs. Tillman said.

She also said if that another natural disaster happens like on Jan. 22, when a tornado tore through Cook County during the early morning hours, Cook Medical Center would spring into action at 4 a.m. with full staff.

Dr. Jay Goberdhan: “We need a hospital in this community,” he said, while acknowledging that he was not happy about the ER’s closure. “For the past 11 years, I have been very happy here in Cook County,” he said. “I want this community to remain my home.” He added that he remains optimistic that with the right dynamics, the hospital may bring the ER back one day.

Dr. Tom Fausett: He said a new hospital facility fits in well with other improvements seen in the community, such as a new post office, new schools, and new recreation facilities, and that progress needs to continue.

Jeanne Dixon: Mrs. Dixon, a teacher, praised the support given by Cook Medical Center to local education, including $50,000 donated to athletic programs last year alone. She added that her daughter wants to become a pediatrician and it would be nice if she would have the opportunity to practice her career within a Cook County healthcare system.

Martha Darden: Mrs. Darden said her husband Laddie recently injured his thumb in a work accident and it would have been good to have local state-of-the-art facilities available for treatment, which could be available with the replacement hospital. Her daughter is in the third year of medical school, and it would be nice to have the opportunity for her to practice here, just like with Mrs. Dixon’s daughter, Mrs. Darden said.

Other speakers were Simmie McNeal, who serves on the Cook Medical Center advisory board; Michael Moore, who works as an engineer at the hospital; and Ronnie Register, who is a CT tech in the hospital radiology department and thinks the radiology department would offer more specialized imaging with the new facility. Deborah Farmer as the daughter of an elderly father spoke about the need for a geriatric psychiatric center for helping patients with Alzheimer’s and she felt ambulances may help fill the gap in stabilizing patients before they are transported to ERs. Cindy Moore said, “I am a taxpayer in this county. I have no doubt our taxes will go up. (But) how do you put a price tag on somebody’s life?” Burt Moore who worked with GE years ago said having a hospital is key to attracting such businesses and industries to a community.

Sharon Harnage said that in speaking with small businesses around Adel, 87.5 percent were in favor of having a local hospital even without an ER.

Dale Boone, who was born at the Memorial Hospital of Adel (Cook Medical Center’s predecessor), urged community leaders to look for alternative sources other than property taxes to help fund the replacement facility. “I’m not against the new facility,” he said. “It’s just how we get there.”

Chase Daughtrey said Tift Regional officials have negotiated with local leaders in good faith. He spoke about the response to the Jan. 22 tornado. He said the hospital has an emergency operation plan in place that if such a disaster occurred here again, the local facility would be available to help take care of the injured.

Commissioners’ response

Commissioner Audie Rowe thanked those who turned out in such a great number on the hospital issue. He said he conducted much research to reach his decision about the replacement facility.

Commissioner Debra Robinson said her initial dilemma was with the ER not being part of the hospital plan. However, she said, if the citizens are in favor of the Urgent Care plan, she will go along with them.

Commissioner Lin Parrish said he has been researching the issue for two to three weeks and now thinks Cook County does need a hospital. He remains hopeful that Cook County will eventually have 24-hour emergency care.

Chairman Dwight Purvis said he also has done his due diligence in looking at the issue and considering such aspects of it as economic development. He noted that some harsh statements had been made on Facebook but the Commissioners are trying to do what is best for the citizens of this county.

Commissioner Jeff Lane said his “heart bleeds” after having to help dig bodies out of the debris at Sunshine Acres after the tornado and notifying parents that two of their children had been killed. For those who are saying the Commissioners don’t want a replacement hospital, “that’s not right,” he said. “We have always wanted one. We just wanted to figure out to how to pay for one.”

Commissioner Lane said he doesn’t want a quick fix for the hospital issue; he wants a permanent fix. He said he still feels there should be referendum election on the matter.

Commissioner Rowe made a motion to have County Attorney Daniel Connell work out a Memorandum of Understanding and an Intergovernmental Agreement for the hospital replacement facility. Commissioner Lin Parrish seconded the motion, and all voted in favor.