Worries about Grady’s viability come after word of AMC closure

Credit: JOHN SPINK / AJC

Credit: JOHN SPINK / AJC

A week after learning Atlanta Medical Center will close, a whiff of anxiety about the viability of Atlanta’s sole remaining full-service trauma center, Grady hospital, caused concern among government officials this week.

There’s a low chance that Fulton County won’t make its annual $60 million payment to cover indigent patient care at Grady Health Systems, but that small worry was recently magnified. A week ago Wellstar announced without warning its plan to close the city’s only other high-level trauma facility Atlanta Medical Center in November.

Fulton Commission Chair Robb Pitts said in a Thursday news release that neither he nor DeKalb County CEO Michael Thurmond has been contacted by Wellstar about the closure. He added that Fulton has found no legal recourse to stop the shuttering.

“There is an immediate need for a plan to absorb the 200 current staffed beds at Atlanta Medical,” Pitts wrote. He added that Fulton officials have been in constant contact with Grady staff about the influx of patients.

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“We look forward to continued collaboration with the County in the coming days to strategize ways to continue serving our community, which will be heavily impacted once AMC closes its doors,” according to Grady’s public affairs office.

Following the news of Wellstar closing its in-town facility, Fulton County commissioners received a presentation Wednesday indicating the county could face a $103 million deficit — leading Commissioner Khadijah Abdur-Rahman to doubt that Fulton could pay Grady this year.

Abdur-Rahman, a Democrat, issued a press release saying “Grady Hospital may be on life support next year.” Fulton’s county manager Dick Anderson said there’s “almost a zero probability” that Fulton doesn’t make its annual payment.

Abdur-Rahman still disagrees that Grady is safe, saying: “Grady is not immune from that, and anyone telling you otherwise isn’t being honest.”

Commissioners showed this week they know Grady needs help by approving an $11 million payment to Grady in Federal Emergency Management Agency reimbursement dollars.

There have long been doubts about Grady surviving partially because it depends on a disproportionate amount of public assistance given the number of indigent and Medicaid patients it serves. Anderson said Fulton could lower its deficit in several ways, including closing half the gap by not filling the county’s 650 vacancies.

Like Fulton, DeKalb County helps subsidize Grady with annual payments provided through tax funds. In recent years, those DeKalb payments have amounted to roughly $20 million.

A DeKalb spokesman confirmed Thursday the county was “definitely considering some kind of payment to help” Grady in the wake of AMC’s expected closure and that talks were underway. But no further details were provided.

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During Thurmond’s tenure, DeKalb’s government has built up a “rainy day fund” in excess of $120 million.

More than half of Grady’s patients in 2020 were either uninsured (25%) or receiving Medicaid (28%) benefits, according to a 2020 fact sheet. About 60% of the hospital’s patients were from Fulton and 27% from DeKalb.

Fulton Commissioner Lee Morris, a Republican, said the county’s finance staff are tasked with giving them the worst case — including when they would need to draw from the county’s savings.

“The last thing I want to do as one of the fiscal conservatives on the Commission is to tap into the reserve,” Morris said, “but one of the reasons it’s there is tough times.”

Considering nearly one out of every five Georgians lives in Fulton or DeKalb, he said he expects his fellow Republicans at the state level to help out the Democrat strongholds of Fulton and DeKalb.

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Morris said he knows there are always divides — urban versus rural, Democrat versus Republican — “but we’ve got some really thoughtful people in the state and the General Assembly, and I think the governor is thoughtful.”

Anderson said he has been in talks with the state to help the remaining hospitals but that he couldn’t give details to safeguard the negotiations.

He said Fulton remains committed to Grady, as evidenced by the $2.8 billion the county has given Grady since 1975.

As for what Anderson wants: “We believe it’s more likely that existing providers would expand their operations in existing facilities. Certainly they’ll be challenged to find the staffing.”

AJC staff writer Tyler Estep contributed to this story.