UPDATE...Georgia lawmakers defied warnings from hospitals in 2008, when, with a last-minute vote, they created a loophole in the certificate of need process for new medical facilities. The Legislature said  doctors could skip that process to open out-patient surgical centers for a single specialty, such as orthopedics. Hospitals said that decision would add to their financial woes because they must treat every indigent patient who shows up in their emergency rooms, while surgeons could primarily serve the best-paying patients.

That same year, the Legislature also allowed Cancer Treatment Centers of America to open a hospital without showing the need for it.

JANUARY 30, 2015 RIVERDALE Photos from Southern Regional Medical Center in Riverdale, Friday, January 30, 2015. New CEO Kim Ryan and other officials detail efforts to revamp the troubled hospital. he county bailout Southern Regional Medical Center received might have saved it from immediate shutdown, but its financial future still is shaky. The problem is not just uncompensated care, as it has stressed. But other factors that have battered the hospital and still put its future in doubt. Over a six-year period, the hospital suffered a dramatic decline in patient admissions, including losing about half of its paying patients as well as some losses of Medicare and Medicaid patients. What's more, a hospital inspection last year found that the hospital was dirty and unsanitary, and half of all patients surveyed said they wouldn't recommend the hospital to others. KENT D. JOHNSON/ KDJOHNSON@AJC.COM

Credit: Lois Norder

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Credit: Lois Norder

On Feb. 22, AJC reporter Tammy Joyner looked at how those decisions, as well as Gov. Deal's decisions not to expand Medicaid, added to the struggles of the only hospital in one metro-area county. Taxpayers already have bailed it out, but that may not ensure its future, she found.

Her story explains how the hospital's mounting losses have affected patients, doctors, nurses and the community. You can read her story here.