Monroe County residents will decide the fate of their hospital in a March vote, but it’s just the latest rural Georgia hospital facing bleak prospects due to financial trouble.
Five hospitals have been forced to close in Georgia since 2013, while others have reduced services in cost-saving measures. And the Monroe County Hospital, in operation since 1957, could be the next one to shut down without an infusion of money, officials say.
The hospital, like many other rural ones, has a larger percentage of uninsured patients or ones covered by Medicare or Medicaid than some of its urban counterparts. Those types of insurance may only pay 88 to 96 percent of actual health care costs, often leaving hospitals trying to recoup the remainder, said Chuck Adams, executive vice president of the Georgia Hospital Association.
$26.4 millionNumber of employees
$4 millionCost to keep open
$10 millionCost to close
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“If you go back and look at hospital closings since 2013, they were all in rural communities, which are the hardest hit when it comes to reimbursements and indigent care, so the cost of running as a full-service hospital was too much,” he said.
On March 21, Monroe County voters will decide whether to approve a 1-mill property tax increase that would go to the hospital. The increase, if approved, would generate about $1.2 million in revenue, while bonds may be issued to cover remaining expenses to keep the hospital’s doors open.
It will cost about $10 million for the hospital to continue operations and to fund some improvements. Shutting down the hospital would be about a $6.5 million expense. Both estimated costs include paying off a $2 million loan, officials said.
“Not only do we need more patients, we need more patients that are paying,” said Tony Ussery, chairman of the Monroe Hospital Authority.
In response to the peril that some hospitals face, the Georgia Legislature has enacted a rural hospital tax credit to helping struggling medical facilities. The tax credit allows people to donate to hospitals listed by the Department of Community Health as in most financial need.
Monroe County was listed at No. 3 on the list. Another Middle Georgia medical center, Irwin County Hospital, was ranked No. 1, while six other Middle Georgia hospitals made the list as well: Dodge County Hospital; Bleckley Memorial Hospital; Crisp Regional Hospital; Jeff Davis Hospital; Putnam General Hospital; and Jasper Memorial Hospital.
“We’re here to support communities like Monroe County where they’re looking at this solution. ... Access to health care is very important,” Adams said. “If that means going to the (county) and asking for financial help, we applaud them for that. We applaud them for looking at new models for health care.”
When a dedication ceremony was held for the Monroe hospital on Sept. 15, 1957, county leaders celebrated the facility — built for less than $400,000 — and cited it as a key to a growing, but more agriculturally based community between Macon and Atlanta.
“It’s one of the biggest things that ever happened in Monroe County,” Commission Chairman James Tribble said at the time. “And it will not only mean a lot to us but to our surrounding area.”
The hospital moved to a new building in 1976, and over the decades, hospital officials say, it remained an important resource from a health care standpoint and economic impact.
Monroe hospital had a $26.4 million state and local impact in 2014, and it provided $1.4 million in unpaid care. The hospital also directly and indirectly generated 342 full-time jobs, according to a Georgia Hospital Association report.
Now, Monroe hospital employs 120 people and has a $4 million annual payroll, Ussery said.
“Obviously quality of life and having health care accessible is important,” he said. “On the flip side is the economy. The hospital helps keep personal taxes low. Having a hospital here is a important question from companies looking to relocate here.”
The hospital is also using the expertise of Navicent Health, which took over management in 2016, to help improve efficiencies.
If it remains open, the number of hospital beds will drop from 25 to 10 in order to cut some costs, and technology will be improved.
“There’s a lot of potential to become what the community needs for health care,” Monroe Hospital CEO Darren Pearce said.
Without the tax increase funds, the hospital will continue with a controlled shutdown as services are reduced over a period of time.
“A controlled shutdown would be over probably a six month time frame,” Monroe County Commission Chairman Greg Tapley said. “We would still have the emergency room and hospital rooms available for county residents.”
But at least one county commissioner opposes using more public funds to support a hospital that also owes about $600,000 to the Internal Revenue Service. Commissioner John Ambrose said the county can’t afford to continuing subsidizing a hospital that’s losing money.
It’s possible an urgent care center could open in Monroe County if the hospital closes, he said.
“I don’t want us to lose health care altogether, but it needs to be done in a better way to where we’re not throwing money down a drain,” Ambrose said.
Newly appointed Hospital Authority member Todd Tolbert has started a save-the-hospital campaign. The Monroe County Republican Party member said that he believes the GOP organization will also support keeping the hospital open.
“I’ve looked at the plan that Navicent worked on with the Hospital Authority to come up with and looked at the long-range opportunities and felt this is something we can do,” he said.
The Monroe County Democratic Party is also in favor of the tax increase, party chairman Galen Jacobs said.
“I don’t mind paying pennies on the dollar to save someone’s life,” he said. “That’s not a Democrat or Republican issue. That’s just common decency.”