Impending hospital closure rattles Atlanta's health care landscape

Like many neighborhoods in cities throughout the nation, Atlanta’s Outdated Fourth Ward is altering.

Apartment buildings and trendy minimalist houses punctuate metropolis blocks of low-income housing. Many longtime residents of the historic neighborhood the place Martin Luther King Jr. was born have been priced out and pushed to different components of city.

Atlanta Medical Heart, a 460-bed Degree 1 trauma heart, would be the subsequent fixture to vary.

Regardless of banners proclaiming the hospital’s dedication to the realm — “120 Years Caring For Atlanta,” one reads — its nonprofit proprietor, Wellstar Well being System, just lately introduced plans to shut the hospital’s doorways on Nov. 1.

Georgia has seen a number of rural hospitals shutter previously decade, however this yr Atlanta has joined different city facilities with facility closures, together with a earlier downsizing at a facility within the close by metropolis of East Level.

The Wellstar announcement has stoked the political debate over Medicaid enlargement forward of the Nov. 8 midterm elections. Like 11 different states, Georgia has not expanded eligibility guidelines for its Medicaid program underneath the Reasonably priced Care Act, and hospital officers throughout the state say inaction has harm their backside strains as a result of they nonetheless deal with excessive numbers of uninsured sufferers, a lot of whom can’t pay for therapy.

The Wellstar announcement shocked metropolis officers, together with the mayor, Andre Dickens, in addition to different members of the neighborhood.

On a current weekday morning, Teresa Smith, 60, who lives within the neighborhood, stated she continuously receives care there for a power digestive problem. “This hospital will probably be missed by the entire neighborhood,” she stated.

Liliana Bakhtiari, the Atlanta Metropolis Council member whose district consists of the hospital, was sharp in her evaluation. “There will probably be lack of life and important accidents that won’t be taken care of, and I want that mattered extra to Wellstar,” she stated.

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

Nancy Kane, an adjunct professor at Harvard’s T.H. Chan Faculty of Public Well being, sees connections between the Atlanta scenario and hospital closures in different main cities.

Many had been acquired by massive well being care firms as a part of package deal offers, and served largely low-income, minority populations.

“In case you purchase a hospital, it’s best to have an obligation to repair it up,” stated Kane. “Wellstar has the funds to speculate on this hospital. It’s a selection.”

Some neighborhood members wonder if the hospital closure will result in an expensive actual property improvement on the roughly 20 acres Wellstar owns within the neighborhood.

Randy Pimsler, an architect whose agency has designed initiatives within the space, stated “it might turn out to be a clean slate, both for redevelopment or for brand spanking new improvement.”

Politicians have been fast to show the closing right into a marketing campaign problem. And on the heart of the controversy is Gov. Brian Kemp’s well being care coverage.

The Kemp workforce is working to place collectively a long-term plan for strengthening well being care within the space after the closure, stated Andrew Isenhour, a Kemp spokesperson. Kemp, a Republican who’s working for a second time period in November, is unlikely to try to keep the facility open.

However officers on the nonprofit Grady Well being System stated this week that they’ve met with Kemp’s workplace, Dickens, and officers from Fulton and DeKalb counties a few monetary infusion of state funding that might help capital wants at Grady Memorial Hospital, a Degree 1 trauma heart a few mile from Atlanta Medical Heart.

Grady is anticipating as many as 2,500 further emergency room visits a month after Atlanta Medical Heart shuts its doorways.

“We will take in all of the trauma,” stated John Haupert, CEO of Grady Well being System. Nonetheless, the added ER crunch will probably be a problem with extra sufferers arriving, stated Ryan Loke, chief well being coverage officer for Grady.

State funding would speed up Grady’s current plans to transform places of work into inpatient care areas, which might add greater than 180 grownup beds as quickly as a yr from now. The hospital is also including 40 to 45 beds over the following six weeks, and is planning to put in a 24-bed area hospital to assist deal with the affected person circulation from the closed hospital.

The closing places Medicaid enlargement “entrance and heart” within the political dialog, Haupert stated. Kemp has proposed a restricted plan that might provide entry to the state-federal insurance coverage program to individuals who can fulfill a piece requirement or comparable obligation.

His challenger, Democrat Stacey Abrams, has lengthy made increasing Medicaid a high marketing campaign problem.

“That is not a shock,” Abrams stated. “It’s anticipated to occur as a result of the Kemp administration refuses to take motion.”

U.S. Sen. Raphael Warnock (D-Ga.), pastor of Ebenezer Baptist Church, which is lower than a mile from the hospital, has additionally decried the closure and cited the pressure on well being care services attributable to Georgia’s refusal to broaden Medicaid. Wellstar officers have stated that Medicaid enlargement alone wouldn’t have stored the Atlanta facility open.

Earlier this yr, Wellstar stopped offering emergency room and inpatient companies at its hospital in East Level, simply southwest of Atlanta. On the time, it stated these sufferers might be seen at Atlanta Medical Heart, about 8 miles away. Haupert estimated it might price tons of of thousands and thousands of {dollars} to modernize the soon-to-close Atlanta hospital, which is what made a rescue troublesome.

The closures just some months aside might assist Abrams’ arguments for Medicaid enlargement resonate with voters, stated Andra Gillespie, an affiliate professor of political science at Emory College. “A problem that was in all probability tailor-made extra in the direction of rural Georgia now impulsively turns into an Atlanta-area problem,” she stated.

Gillespie cautioned that different points, equivalent to inflation, crime, and abortion, are prone to be extra motivating to Georgia voters.

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

Todd Greene, previously a member of Wellstar’s neighborhood board for AMC, stated the system put extra assets into its suburban services.

“Wellstar’s suburban hospital-oriented administration method sadly has resulted in massive parts of Atlanta’s black and brown communities not gaining access to proximate and important well being care companies,” he stated in a written assertion.

In Wellstar’s announcement of the closure, it stated it had invested greater than $350 million in capital enhancements on the facility since 2016 and sustained “$107 million in losses in simply the final 12 months, amid lowering income and rising prices for employees and provides on account of hovering inflation.”

The choice to shut the hospital didn’t come as a shock to some workers members, stated Dr. Sulieman Wazeerud-Din, an emergency drugs doctor on the hospital, who stated docs “had been conscious of economic losses.”

However the abrupt announcement brought on a profound sense of grief amongst docs, nurses, and different nonmedical workers, he stated.

Within the days for the reason that closure announcement, Grady has provided jobs to a variety of Atlanta Medical Heart workers, from physicians and nurses to housekeeping and safety staffers.

David Patton has lived in Atlanta’s Outdated Fourth Ward for 30 years and stated Atlanta Medical Heart has been a giant a part of his life.

His grandfather died in a nursing house on the campus, he has gotten care on the ER, and his son took swimming classes on the hospital’s athletic membership, all whereas he has seen the neighborhood remodel from a “forgotten” a part of the town to at least one that’s turn out to be a lightning rod for brand spanking new improvement.

“It boggles my thoughts that an establishment like that might simply shut down nearly in a single day,” he stated.

KHN (Kaiser Well being Information) is a nationwide newsroom that produces in-depth journalism about well being points. Along with Coverage Evaluation and Polling, KHN is among the three main working packages at KFF (Kaiser Household Basis). KFF is an endowed nonprofit group offering data on well being points to the nation.