20 S G M A G A Z I N E | FA L L 2 0 1 7 B U S I N E S S + C U LT U R E 21 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 announce- ment that CMC would close its emergency room effective Feb. 28. 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.” Michael Purvis CEO Cook Medical Center As rural hospitals struggle, CookMedicalCenter FindsSolutionsto PreserveHealthcareAccess 20 S G M A G A Z I N E | FA L L 2 0 1 7 B U S I N E S S + C U LT U R E 21 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. Vincent Valencia, MD, Cook Primary Care We looked at options to renovate or build a treatment facility. The numbers showed it would be more efficent to replace the current facility. –Michael Purvis