EXCLUSIVE: Grady, Augusta University abruptly end ambulance contract

Less than halfway into its contract with Grady Emergency Medical Services for transport of premature babies and patients to other medical facilities, Augusta University Health has replaced the ambulance company.

The abrupt end of the relationship between an arm of the iconic Atlanta-based facility and one of Georgia’s largest academic health centers was “mutually agreed,” according to officials with Grady EMS.

But the Augusta region is notorious for political skirmishes between city and county leaders vying for power over ambulance contracts. And it appears that Grady’s involvement in Augusta also was mired by controversy, including accusations of contract violations and unprofessional conduct by a Grady EMS executive.

“I don’t think it was very good experience from my understanding,” Richmond County Commissioner Brandon Garrett said.

Grady has been aggressively expanding medical transport services throughout Georgia through its ambulance company, in a move to bring in new revenues. Its dismissal from Augusta, however, is a set-back to its efforts and follows criticism elsewhere that it hasn't delivered on promised EMS services.

In Augusta, documents obtained by the Atlanta Journal-Constitution under the Georgia Open Records Act and interviews with local leaders show tensions were high between Grady and top officials at the hospital months before the ambulance provider’s departure June 15.

Records show that on at least two occasions since January, the medical transport company was accused of violating its contract, including failing to supply adequate equipment, altering dispatch logs to give the appearance of on-time performance, and allowing employees with expired licenses to transport patients. One concern was that the provider couldn’t reliably transport twins in a neonatal vehicle because it didn’t have the proper equipment to transport two isolettes.

In a scathing letter to Grady Senior Vice President Bill Compton, Augusta University Chief Medical Officer Dr. Phillip Coule expressed frustration over a continuation of problems. Among the issues, Coule wrote, was a “significant concern” about difficulties with the ambulance dispatch center, including unanswered and dead-end phone calls. “When I notified you of these defaults on January 4, 2020 your response was to deny the existence of any problem and tout the performance data that we now know to be false,’’ Coule wrote.

Further, Coule told Compton on April 21, “You will also recall that your response to me was to deny that there was a problem, including using some unprofessional language.”

Less than two months later, the situation took an unexpected turn.

Coule sent a carefully worded note to Compton that apparently backtracked some of his previous comments. “It has been determined that there has been no falsification of data nor is Grady in default under the contract. AU Health formally retracts those particular concerns raised in the letter,” the chief medical officer wrote June 3.

Then, less than two weeks later, Grady was gone.

Coule declined a request for an interview. “AU Health and Grady mutually signed a non-disclosure related to the termination of services,’’ an AU spokesman told the AJC.

Compton also declined requests for interviews.

In response to AJC questions, Grady officials denied any misconduct. They explained many of the issues as a miscommunication regarding data systems and employee licensure information that was contained in their human resources department that had not been available to the hospital. All employee licenses were up to date, Grady said.

‘It didn’t make a lot of sense’

When Grady was awarded its contract for general transports in Augusta, it was expanding services all over the state. By 2018, it had snatched up 911 and specialty transport agreements with dozens of local jurisdictions, making it among the largest EMS providers in Georgia.

The AU contract was a bonanza for Grady because it represented an opportunity to make the largest profits. Most patients who need services are paying customers, represented by private insurance or federal reimbursement. In contrast, contracts for 911 service typically draw lower reimbursements because people who need emergency transport don’t always have insurance or often can be under-insured.

Wayne Guilfoyle, a member of the Richmond County Board of County Commissioners at the time Grady was hired, said he and others had lots of questions when Grady received a contract to operate non-emergency ambulance services in a metropolitan area of the state it had never served.

At the time it was meeting with AU officials, Guilfoyle said, Grady was also meeting with county commissioners to make a bid for an exclusive contract for emergency services in Richmond. Guilfoyle said he blocked the effort.

“It didn’t make a lot of sense” to hire a provider from Atlanta, the former commissioner told the AJC.

He told the AJC he wasn’t surprised to learn of Grady’s dismissal from AU, saying the allegations about its service were alarming.

Augusta isn't the only region of the state where Grady has faced criticism for failing on a pledge to provide adequate services.

In south Fulton County, it has yet to deliver on a promise to provide a nine-minute response to life-threatening calls. A committee of metro Atlanta area EMS officials was set up last year to evaluate the provider’s performance and make recommendations for improvement.