Grady Memorial Hospital officials are considering closing the outpatient dialysis clinic, a move that two years ago erupted in controversy and contributed to the firing of the hospital CEO.
The outpatient dialysis clinic serves about 90 people, most of whom are poor and cannot pay for care. About half are undocumented immigrants without health insurance, officials said.
The clinic loses about $4 million a year, adding to the financial difficulties of a hospital that runs a $50 million deficit annually.
Patients who receive the lifesaving service needed for kidney disease say they are afraid they will not find free services elsewhere and their health will spiral downward.
"That will be sad," Chris Charles of DeKalb County, whose mother receives dialysis at Grady, said of the prospect of closing the clinic. "It will be hard."
Her mother has been coming to Grady for about a year and is awaiting approval for government assistance for her condition. When that approval comes through, she plans on finding a private dialysis clinic closer to home, Charles said.
But if the clinic closes before then, Charles worries that the private clinics won't accept her mother.
Grady Board Chairman Pete Correll said the board wants to make sure the patients are taken care of, should the clinic close.
"We're not going to let people die on the street," he said.
Many of Grady's dialysis patients come to the charity hospital as they await approval for Medicare, then take their business elsewhere. It presents a financial burden on the hospital, said hospital CEO Michael Young, who assumed the job in September.
He said metro Atlanta has more than 100 privately operated dialysis clinics, and they should step up to help these patients. Grady is discussing options with some dialysis providers that would ensure the hospital's patients receive care.
Young stressed that no final decision has been made regarding the future of the clinic, and that ultimately the hospital may choose not to close it. Inpatient dialysis services will remain.
Many of the forces that fought the proposal two years ago are coalescing for another fight. They don't believe the private sector will pick up poor and often uninsured patients.
"Dialysis is a life and death situation, and you don't play with that," said the Rev. Timothy McDonald, a leader of the advocacy group called the Grady Coalition.
Sen. Vincent Fort (D-Atlanta) said closing the unit would result in more emergency room visits, longer intensive care stays and more deaths.
Dialysis uses machines to remove waste from the blood of patients with chronic kidney disease. Some patients must receive treatment several times a week.
The undocumented immigrants who use the dialysis clinic are not eligible for federal assistance, so they often stay with Grady for the duration of their disease.
When Grady moved to close the clinic in late 2007, the Fulton-DeKalb Hospital Authority reversed the decision after public opposition. The authority fired CEO Otis Story early last year, and it pointed to his handling of the dialysis clinic among other issues.
Grady has since turned over control of hospital operations to a corporate board, called the Grady Memorial Hospital Corp.. That board discussed the potential closure at its last meeting this month and expects to discuss it again at its next meeting in July.
Discussion on closing the dialysis clinic comes after Grady announced the closing of three of its nine neighborhood clinics. That move stirred opposition from some county commissioners in Fulton and DeKalb counties.
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