Like many neighborhoods in cities across the country, Atlanta’s Old Fourth Ward is changing.
Apartment buildings and modern minimalist homes feature city blocks of low-income housing. Many longtime residents of the historic Martin Luther King Jr. birthplace have been removed and pushed to other parts of the city.
Atlanta Medical Center, a 460-bed Level 1 trauma center, will be the next change.
Despite banners touting the hospital’s commitment to the area — “120 years of caring for Atlanta,” reads one — its nonprofit owner, Wellstar Health System, recently announced plans to close the hospital’s doors Nov. 1.
Several rural hospitals have closed in Georgia over the past decade, but this year Atlanta joined other urban centers in closing facilities, including a previous cut at a facility in nearby East Point.
Wellstar’s announcement reignited 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 in the state say the inaction has hurt their bottom line because they still treat large numbers of uninsured patients. many of whom cannot afford treatment.
Wellstar’s announcement shocked city officials, including Mayor Andre Dickens, as well as other community members.
On a recent weekday morning, Teresa Smith, 60, who lives in the neighborhood, said she often receives care there for a chronic digestive problem. “This hospital will be missed by the whole community,” she said.
Liliana Bakhtiari, the Atlanta City Council member whose district includes the hospital, was scathing in her assessment. “There’s going to be loss of life and critical injuries that we’re not going to take care of, and I wish that mattered more to Wellstar,” she said.
Wellstar declined KHN’s request for an interview about the closing.
Nancy Kaneassistant professor at Harvard’s TH Chan School of Public Health, sees connections between the situation in Atlanta and hospital closings in other major cities.
Many were acquired by large health care companies as part of package deals and served primarily low-income minority groups.
“If you acquire a hospital, you should have an obligation to fix it,” Kane said. “Wellstar has the means to invest in this hospital. It’s a choice.”
Some community members wonder if closing the hospital will lead to expensive real estate development on the roughly 20 acres Wellstar owns in the neighborhood.
Randy Pimsleran architect whose firm has designed projects in the area said it “could become a blank slate, either for redevelopment or new construction.”
Politicians were quick to make the shutdown a campaign issue. And at the center of the debate is Governor Brian Kemp’s health care policy.
Kemp’s team is working to put together a long-term plan to strengthen health care in the area after the closure, said Andrew Eisenher, a Kemp spokesman. Kemp, a Republican running for a second term in November, unlikely to try to keep the facility open.
But officials with the nonprofit Grady Health System said this week they have met with Kemp’s office, Dickens and officials from Fulton and DeKalb counties about a financial infusion of state funding that will help with capital needs at Grady Memorial Hospital, a center for level 1 trauma about a mile from the Atlanta Medical Center.
Grady expects up to 2,500 additional emergency room visits a month after the Atlanta Medical Center closes its doors.
“We can absorb all the trauma,” said John Haupert, CEO of Grady Health System. Still, the added crisis in the emergency room will be a challenge as more patients arrive, said Ryan Locke, chief health policy officer for Grady.
The state funding will accelerate Grady’s existing plans to convert offices into inpatient facilities, which will add more than 180 beds for adults as soon as one year from now. The hospital is also adding 40 to 45 beds over the next six weeks and plans to install a 24-bed field hospital to help handle the influx of patients from the closed hospital.
The shutdown puts Medicaid expansion “at the center” of the political conversation, Haupert said. Kemp has proposed a limited plan that would offer access to the state-federal insurance program to people who can meet a work requirement or similar obligation.
His challenger, Democrat Stacey Abrams, has long made Medicaid expansion a major campaign issue.
“It’s not a surprise anymore,” Abrams said. “It’s expected to happen because the Kemp administration refuses to act.”
U.S. Sen. Raphael Warnock (D-Ga.), pastor of Ebenezer Baptist Church, which is less than a mile from the hospital, also condemned the closure and pointed to the strain on health care facilities caused by Georgia’s refusal to expand Medicaid. Wellstar officials said Medicaid expansion alone would not keep 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 it would cost hundreds of millions of dollars to upgrade the soon-to-be-shuttered Atlanta hospital, making a rescue more difficult.
Closings just a few months apart could help Abrams’ arguments for Medicaid expansion resonate with voters, said Andra Gillespie, associate professor of political science at Emory University. “An issue that was probably more tailored to rural Georgia is now suddenly becoming an Atlanta-area issue,” she said.
Gillespie warned that other issues, such as inflation, crime and abortion, are likely to 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 2016part of a $575 million deal that includes three other hospitals in the metro area.
Todd Green, a former Wellstar community board member for AMC, said the system is putting more resources into its suburban facilities.
“Wellstar’s suburban hospital-centric management approach has unfortunately resulted in a large portion of Atlanta’s black and brown communities lacking access to nearby and critical health care services,” he said in a written statement.
At Wellstar’s announcement of closureit said it had invested more than $350 million in capital improvements at the facility since 2016 and suffered “$107 million in losses in the last 12 months alone, amid declining revenue and rising personnel and supply costs due to growing inflation.’
The decision to close the hospital did not come as a surprise to some employees, said Dr. Suliman Wazeerud-Dinan emergency medicine physician at the hospital who said doctors “were aware of the financial losses.”
But the sudden announcement caused a deep sense of grief among doctors, nurses and other non-medical staff, he said.
In the days following the closing announcement, Grady offered jobs to a range of Atlanta Medical Center employees, from doctors and nurses to housekeeping and security staff.
David Patton has lived in Atlanta’s Old Fourth Ward for 30 years and said the Atlanta Medical Center has been a big part of his life.
His grandfather died in an on-campus nursing home, he received care in the emergency room, and his son took swimming lessons at the hospital’s athletic club as he watched the neighborhood transform from a “forgotten” part of the city to a part of the city . it became a lightning rod for new development.
“It amazes me that an institution like this would just close literally overnight,” he said.
KHN (Kaiser Health News) is a national newsroom that produces in-depth journalism on health issues. Along with policy analysis and polling, KHN is one of three major operational programs in the KFF (Kaiser Family Foundation). KFF is a charitable, non-profit organization providing information on health issues to the nation.
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