Fulton chairman floats tax increase as South Fulton hospital exit looms

Fulton County Commissioner Robb Pitts, center, calls a meeting with Grady Hospital executives, including John Haupert, right, Grady Health System President and CEO; as well as Fulton-DeKalb Hospital Authority board members and other commissioners including Natalie Hall, left, on Tuesday, April 12, 2022 to discuss the upcoming closure of hospital beds and the ER at Wellstar Atlanta Medical Center South, the only acute care hospital within Fulton County south of I-20.  (PHOTO by Jenni Girtman for The Atlanta Journal-Constitution)

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Fulton County Commissioner Robb Pitts, center, calls a meeting with Grady Hospital executives, including John Haupert, right, Grady Health System President and CEO; as well as Fulton-DeKalb Hospital Authority board members and other commissioners including Natalie Hall, left, on Tuesday, April 12, 2022 to discuss the upcoming closure of hospital beds and the ER at Wellstar Atlanta Medical Center South, the only acute care hospital within Fulton County south of I-20. (PHOTO by Jenni Girtman for The Atlanta Journal-Constitution)

County Board of Commissioners silent on the issue at meeting Wednesday

Facing the looming closure of a hospital in East Point, Fulton County officials and Grady Health System representatives are discussing ways to continue providing for emergency and hospitalization needs in the underserved south county area.

Among the options: Raising the amount of money Fulton County taxpayers provide to the nonprofit Grady Health System. County Commission Chairman Robb Pitts said he hopes to learn whether raising more money could enable Grady to run a scaled-down version of the current hospital, keeping the emergency room and a couple dozen hospital beds open, or even offer the same services in a nearby location.

“I know there’s a need,” said Pitts. “So what do we do?”

Wellstar announced its plans April 6 to close the emergency department and inpatient beds at Wellstar Atlanta Medical Center South in order to convert it into a 24-hour walk-in clinic and outpatient rehabilitation center. The East Point facility is the only acute care hospital that exists south of I-20 within Fulton County.

The Atlanta Journal-Constitution was the only media inside a Tuesday afternoon meeting called by Fulton Commission Chair Robb Pitts to discuss a response to Wellstar’s plans.

The conversion of the East Point location into an outpatient facility will occur early next month, Wellstar’s CEO, Candice Saunders, said. People with serious emergencies or other hospital-level cases will be served by other nearby hospitals, she said. Those include Southern Regional Medical Center in Clayton County, or Wellstar Atlanta Medical Center’s main campus in Atlanta, or Grady.

Some members of the county commission and hospital authority said they would like Grady to take over the East Point hospital and continue running it. Grady CEO John Haupert, also present at the meeting, said that was not possible with Grady’s current finances and the state of the East Point hospital building.

Grady looked into the possibility previously when Wellstar put out a request for proposals to sell that hospital and another, Atlanta Medical Center in Atlanta. Ultimately it was deemed too costly, Haupert said. The East Point building required significant modernization of its utilities that would cost $130 million.

The pandemic has so damaged Grady’s own finances that what would have been a 2% margin of profit in the current fiscal year is instead currently projected to be a 5% loss, Haupert said.

During the pandemic, Haupert said, labor contracting companies have doubled the price of hiring temp nurses. In addition, according to Grady, the money that Fulton and DeKalb pay to fund the care of uninsured county residents who are patients at Grady has not kept up with the cost of caring for them.

Pitts raised the possibility of a county tax increase for Grady and having Grady run the south Fulton facility. Pitts also said he would ask Wellstar if it would delay the changes to give the county more time to develop a plan.

Haupert said Grady couldn’t commit to any of the proposals without learning more.

Fulton and DeKalb counties jointly own Grady Health System, whose main hospital in downtown Atlanta and network of clinics serve medically needy and indigent residents. Local funding is generally split between Fulton and DeKalb on a ratio to reflect the patient mix at Grady. Fulton and DeKalb are already hoping to meet soon with the city of Atlanta and the governor’s office to discuss Grady’s finances.

Each county commission must vote to approve their county’s portion of Grady’s funding. Fulton County currently pays $42.5 million per year and DeKalb County pays $12.9 million per year.

Pitts attempted to add a discussion about the hospital to the agenda of the Fulton County Board of Commissioners meeting Wednesday, but did not have the votes to do that.

When Wellstar announced the closure, it said too few of the patients who walk in the door of the East Point hospital ended up getting admitted for full hospital care. Wellstar could not provide statistics on those who needed emergency department-level care and then left without staying overnight. But officials said that only 7 in 140 emergency room patients a day on average ended up getting admitted to the hospital.

Most importantly, the hospital is not a destination for lucrative medical services. When Wellstar bought the troubled East Point facility in 2016 along with other hospitals, it was the North Fulton Hospital in Roswell that was the prize. The East Point hospital would have required investment to make it a draw for specialists and operations.

Wellstar Health System in recent years has been exploring options — including a sale or partnership — for its Atlanta Medical Center and the affiliate hospital in East Point.

Last year, a Wellstar advisory board said Wellstar had not invested sufficiently in the East Point hospital and called for the nonprofit system to inject more resources and more effort into invigorating it.

A letter to the chairman of the Wellstar Health System board of trustees from Lisa Medellin, chairman of the volunteer board, obtained by Georgia Health News, stated, “The evidence of an authentic plan and appropriate strategy appears non-existent for revitalizing the AMC Downtown and East Point hospitals.’’

Both of the Atlanta Medical Center hospitals have been struggling financially. American Hospital Directory, in data reported earlier this year, listed the two combined with a slight $850,000 profit on $2 billion in revenues. The two hospitals had long suffered problems with aging infrastructure.

Wellstar told the AJC that in 2021 alone, the Wellstar health system overall provided $915 million worth of care that it never got paid for, or got underpaid for, “reflecting its promise to serve all people in our communities.”

Wellstar Health System has 11 hospitals, including the East Point facility at the moment, as well as more than 300 medical office locations, cancer centers, rehabilitation centers, and a retirement village. It listed its 2020 net assets at $1.8 billion. Grady Health System is metro Atlanta’s main safety net hospital, seeing more than 700,000 patient visits a year in both the main hospital and other clinics and offices. It hosts the state’s premier trauma center.

AJC Reporter Ben Brasch contributed to this article.

EDITOR’S NOTE: This article has been changed to note that Fulton County Commission Chairman Robb Pitts did not add the hospital issue to the agenda for the Wednesday county commission meeting after all.