Impending hospital closings rock Atlanta’s healthcare landscape and politics

ATLANTA — Like many neighborhoods in cities across the country, Atlanta’s Old Fourth Ward is changing.

Condo buildings and modern minimalist homes punctuate city blocks of low-income housing. Many longtime residents of the historic neighborhood where Martin Luther King Jr. was born have been priced out and pushed to other parts of the city.

Atlanta Medical Center, a 460-bed Level 1 trauma center, will be the next fixture in the transition.

Despite banners proclaiming the hospital’s commitment to the area — “120 years of care for Atlanta,” one read — its nonprofit owner, Wellstar Health System, recently announced plans to close the hospital’s doors Nov. 1.

Georgia has seen several rural hospital shutters over the past decade, but this year Atlanta joined other urban centers in closing facilities, including a previous downsizing of a facility in downtown East Point.

The Wellstar announcement fueled the political debate over Medicaid expansion ahead of the Nov. 8 midterm elections. Like 11 other states, Georgia has not expanded eligibility rules for its Medicaid program under the Affordable Care Act, and hospital officials across the state say the inaction has hurt their bottom lines because they still treat large numbers of uninsured patients, many of whom can afford to pay. no treatment

The Wellstar announcement shocked city officials, including the mayor, Andre Dickens, as well as other members of the community.

On a recent weekday morning, Teresa Smith, 60, who lives nearby, said she often seeks care there for a chronic digestive problem. “This hospital will be missed by the whole community,” he said.

Liliana Bakhtiari, the Atlanta City Council member whose district includes the hospital, was scathing in her assessment. “There will be loss of life and serious injuries that won’t be taken care of, and I hope that’s more important for Wellstar,” he said.

Wellstar declined KHN’s request for an interview about the closure.

Nancy Kane, an associate professor at Harvard’s TH Chan School of Public Health, sees connections between Atlanta’s situation and hospital closings in other major cities.

Many were acquired by large health care companies as part of package deals and primarily served low-income, minority populations.

“If you acquire a hospital, you should have an obligation to fix it,” Cain said. “Wellstar has the funds to invest in this hospital. It’s a choice.”

Some community members wonder if the hospital’s closing will result in a valuable real estate development on about 20 acres owned by nearby Wellstar.

Randy Pimsler, an architect whose firm has designed projects in the area, said “it could become a blank slate, either for redevelopment or new development.”

Politicians quickly turned the closure into a campaign issue. And at the center of the controversy is Gov. Brian Kemp’s health care policies.

The Kemp team is working to put together a long-term plan to strengthen health care in the area after the closure, Kemp spokesman Andrew Eisenhour said. Kemp, a Republican running for a second term in November, is unlikely to try to keep the facility open.

But officials at the nonprofit Grady Health System said this week they have met with Kemp’s office, Dickens and Fulton and DeKalb county officials about a financial infusion of state funds that would support capital needs at Grady Memorial Hospital, a Level 1 trauma center. About a mile from the Atlanta Medical Center.

Grady expects 2,500 additional emergency room visits in the month after the Atlanta Medical Center closes its doors.

“We can absorb all trauma,” says John Haupert, CEO of Grady Health System. Still, the ER crunch associated with more patient arrivals will be a challenge, said Ryan Lok, Grady’s chief health policy officer.

State funding will accelerate Grady’s existing plan to convert offices into inpatient care space, which would add more than 180 adult beds within a year from now. The hospital is adding 40 to 45 beds over the next six weeks and plans to set up a 24-bed field hospital to help manage the flow of patients from the closed hospital.

Closing puts Medicaid expansion “front and center” in the political conversation, Haupert said. Kemp proposed a limited plan that would offer access to state-federal insurance programs for people who can meet work requirements or similar obligations.

His challenger, Democrat Stacey Abrams, has long made expanding Medicaid a top campaign issue.

“It’s not surprising anymore,” Abrams said. “This is expected to happen because the Kemp administration refuses to take action.”

US Sen. Rep. Raphael Warnock (D-Ga.), pastor of Ebenezer Baptist Church, located less than a mile from the hospital, also rejected the shutdown and cited pressure on health care facilities from Georgia’s refusal to expand Medicaid. Wellstar officials said Medicaid expansion alone would not have kept the Atlanta facility open.

Earlier this year, Wellstar stopped providing emergency room and inpatient services at its hospital in East Point, southwest of Atlanta. At the time, it said those patients could be seen at Atlanta Medical Center, about 8 miles away. Haupert estimated that it would cost millions of dollars to modernize the soon-to-be-shuttered Atlanta hospital, making recovery difficult.

Andra Gillespie, an associate professor of political science at Emory University, said just a few months apart could help Abrams’ arguments for expanding Medicaid resonate with voters. “A problem that was probably geared more toward rural Georgia is now suddenly an Atlanta-area problem,” he said.

Gillespie warned that other issues, such as inflation, crime and abortion, could be more motivating for Georgia voters.

Wellstar, based in suburban Marietta, acquired AMC and East Point Hospital from Tenet Healthcare during an acquisition push in 2016, part of a $575 million deal that included three other hospitals in the metro area.

Todd Green, formerly Wellstar’s community board member for AMC, said the system puts more resources into its suburban facilities.

“Wellstar’s suburban hospital-based management approach unfortunately leaves large segments of Atlanta’s black and brown communities without access to affordable and critical health care services,” he said in a written statement.

In Wellstar’s closing announcement, it said it had invested more than $350 million in capital improvements at the facility since 2016 and “lost $107 million in the past 12 months, amid declining revenue and increased costs for personnel and supplies. Rising inflation.”

The decision to close the hospital did not come as a surprise to some staff members, said Dr. Suleiman Wajirood-Deen, an emergency medicine physician at the hospital, who said doctors were “aware of the financial loss.”

But the sudden announcement has caused deep grief among doctors, nurses and other non-medical staff, he said.

In the days following the closing announcement, Grady offered a range of jobs to Atlanta Medical Center employees, from physicians and nurses to housekeeping and security personnel.

David Patton has lived in Atlanta’s Old Fourth Ward for 30 years and says the Atlanta Medical Center is a big part of his life.

Her grandfather died in an on-campus nursing home, she received care in the ER, and her son took swimming lessons at the hospital’s athletic club, while she watched the neighborhood transform from a “forgotten” part of the city into one that became a lightning rod for new development. .

“It boggles my mind that an institution like this would close virtually overnight,” he said.

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