While many hospitals are struggling to keep the lights on, few are thinking of expansion, and even fewer have plans for a new facility, especially in rural communities.
According to the Georgia Hospital Association, six hospitals have closed in Georgia since 2013, mostly in rural areas.
In Adel, located off I-75 between Valdosta and Tifton, the future of Cook Medical Center (CMC) has been a topic of discussion for several years, and for a while, many residents wondered if the hospital would remain open.
The fear of closure escalated in January, with the announcement that CMC would close its emergency room effective Feb. 28.
Michael Purvis
According to Michael Purvis, CEO for CMC, the exact opposite was true.
“The decision to close the emergency room actually enables us to look at a new model of delivering healthcare,” Purvis said. “This new model allows us to be more profitable and reinvest in our future.”
According to hospital officials, CMC was losing approximately $2.6 million a year, mostly through emergency room costs.
“Rural hospitals in Georgia and across the country are closing,” Purvis said. “The federal government has issued a mandate to all hospitals and healthcare providers to offer higher quality at less cost. We had to find a different way of doing business.”
Purvis said the question became, “How do you save money in a rural market where 30 percent of your patients are uninsured?”
“Our patient mix is heavily dependent on Medicare and Medicaid payments,” Purvis said. “What we have seen in healthcare reform over the past five to six years is that reimbursement from the government has been reduced by about 25 percent. When you have a rural market where about 75 percent of your patients are dependent on the government [for healthcare coverage], it makes it difficult for those hospitals and providers to remain viable.”
Purvis said this brings about a cause and effect relationship with healthcare reform.
“If all the rural hospitals close their doors, there aren’t enough tertiary hospitals to take care of the patients,” Purvis said. “Then patients will have bad healthcare outcomes and not be able to get the treatment and medications that they deserve.”
Since closing the emergency room, Purvis said the transition of patients using Cook Family Wellness Center and Cook Primary Care has proven to be successful. The hours of operation at Cook Family Wellness Center have been extended, with providers rotating from Cook Primary Care.
“There is a myth that you can’t have a hospital without an emergency room,” Purvis said. “Even though the emergency room is closed, the hospital is open.”
Cook Family Wellness Center and Cook Primary Care clinic see approximately 95 percent of the patients who would have previously been seen in the emergency room.
“It is a win-win for both sides. There are savings for both the patient and hospital,” Purvis said. “Our new model allows us to make Cook Medical Center profitable. We can reinvest and have growth that allows us to have a new state-of-the-art facility for our community.”
A Promising Future for Healthcare Delivery
After being purchased by the Tift Regional Health System (TRHS) in 2012, CMC began the process of evaluating the healthcare needs of residents within its six-county service region.
“We looked at options to renovate or build a replacement facility,” Purvis said. “The numbers showed it would be more efficient to replace the current facility.”
The original hospital was constructed more than 50 years ago, with expansions completed in 1976 and 1983 and a major renovation in 2008.
In addition to the 60-bed acute care hospital, CMC operates the Sylvia Barr Center; Cook Senior Living Center, a skilled nursing facility; and convenient care through the Cook Family Wellness Center and Cook Primary Care.
Vincent Valencia, MD, Cook Primary Care
Two years ago, the TRHS began negotiations with the City of Adel and the Cook County Commission to help fund a replacement facility for Cook Medical Center.
A major economic contributor, CMC has more than 300 employees and is the second largest employer in Cook County, which has a population of approximately 18,000.
According to Lisa Collins, executive director of the Cook County Economic Development Commission, CMC has an annual economic impact of $21.1 million.
“Without a hospital, you can’t attract industry,” Purvis said, “and if you don’t provide local medical needs, then people start to move out of your community. Most people want to live 15 to 20 miles from a hospital.”
According to Purvis, the 108,000-square-foot replacement facility will cost approximately $35 million.
Purvis said the new hospital would not be possible without financial support from the Adel and Cook County community.
Lisa Collins
Collins said the Cook County Board of Commissioners is providing $5 million and the City of Adel is contributing $4 million for construction of the new hospital. The Hospital Authority of Tift County will provide the rest of the funding.
Collins also stated that the Cook County Economic Development Commission and the Adel Industrial Development Authority are contributing $600,000 each toward land purchase and relocation of the Georgia Forestry Commission office, which is currently located on the selected site for the new hospital.
“We had about 300 community members attend the Cook County Commissioners’ meeting, where we discussed the future of the hospital,” Purvis said. “The community came out resoundingly to say ‘yes’ to a new hospital.”
In addition to a new acute inpatient center (hospital), the replacement facility will include a 95-bed skilled nursing facility, an ambulatory surgical center with three operating rooms, and an endoscopy suite.
The new hospital will also have outpatient ancillary services, including medical imaging; laboratories; a sleep center; respiratory therapy; pharmacy; outpatient infusion services; behavioral health services; and physical, occupational, and speech therapy.
Cook Family Wellness Center and Cook Primary Care will also relocate to the new facility. Cook Family Wellness Center will share space with specialists in orthopedics, spine, pain management, gastroenterology, obstetrics and gynecology, general surgery, cardiology, nephrology, and psychiatry.
Purvis said that having access to primary care seven days a week, plus expanding surgery options, gives CMC a new model of healthcare delivery.
“We are focused on quality of care and reducing costs,” Purvis said. “Patients will start in the primary clinic and, if needed, be admitted to the hospital for surgery. For those needing rehab, that will be done in our skilled nursing facility.”
Purvis said providing continued care is important to Cook Medical Center’s future.
“I think we have a nice continuum here that will make us successful well into the future,” Purvis said. “We have developed a unique model that I think can be replicated, not only in Georgia but across the nation. We are showing that, as a rural facility, we can be successful and keep communities from losing their hospitals.”