After letters of opposition were submitted in February, the Department of Community Health has finally issued its reply on election day, May 24th. The decision by the Department of Community has moved the Letter for Determination forward in its process pending several issues.

Wednesday, May 25, saw the Commissioners in a special meeting to talk about Piedmont CEO Greg Hurst asking for a Letter of Support from the Board. At the time the Board had not been given notice of the Department of Community Health’s reply. While the letter was never written, the Dept of Health went ahead with its confirmation in spite of several letters of opposition including the Board of Commissioners, the Ellijay City Councils, East Ellijay, the Board of Education, and the Joint Development Authority. In fact, the letters of opposition were only mentioned once in the reply and only in a single sentence stating, “Opposition to the project was received by several independent parties.”

During the meeting, Chairman Charlie Paris discussed the intentions of Piedmont as stated by CEO Hurst, was to operate the new stand-alone Emergency Department. Hurst was reported by Paris to have said they don’t even believe they can operate the Emergency Department at a profit. Relying on their size and presence they hope to “break even” with the Ellijay location as they look for a profit to come from the flow of patients to Jasper’s Piedmont Hospital location.

If allowed to move forward, Piedmont will operate its Ellijay stand-alone Emergency Department under a lease. Without actually purchasing the property, Piedmont will not be actual owner which would leave an opening for Piedmont to abandon its Emergency Department at a later date. Piedmont’s establishment of the Department will have already removed Gilmer County’s Certificate of Need if they abandoned the building leaving Gilmer County to rely on Jasper’s Hospital for all of its healthcare needs causing further problems for not only the community, but for Gilmer County’s Nursing home as Gilmer’s EMA would be required to transport every resident via ambulance service to Jasper instead of having the convenience of a wheelchair ride to an adjacent building. 

Further, Governor Nathan Deal’s own Rural Hospital Stabilization Committee agreed that stand-alone Emergency Departments were not only a bad idea for the communities, but also financially unviable.

“One of the main areas of focus for the Rural Hospital Stabilization Committee was to address Emergency Department (ED) stressors in rural hospitals that can contribute and lead to their closure. In an effort to address this issue, a process to scale down hospital operations and create a stand-alone ED was proposed. After testimony and research it was determined that stand-alone EDs are not financially viable, due to several reasons. There are issues with the reimbursement mechanisms and there are extremely high labor costs and capital investments. National trend data also shows most of these being developed in wealthier, suburban areas as opposed to rural areas. It was determined that it takes approximately 15,000 ED visits to break even which equates to a needed population of approximately 35,000. However, Georgia has virtually no rural hospitals in counties capable of supporting an ED without outside subsidies.”

Post Commissioner Travis Crouch, also Chairman of the Greater Gilmer Joint Development Authority, is also looking for the long term future of Gilmer county. With close to 25% of Gilmer County being 65 or older, healthcare facilities are critical to our community. While many mention the previous facilities and their loss of over one million dollars a year, Crouch states, “It’s not the marketplace. This market will support a hospital that is run well and maintained well.”

As the county has been seeing economic growth recently, the loss of medical facilities could devastate the efforts of the county as a whole and march us backwards. As former JDA Executive Director Chuck Scraggs stated in a previous interview potential business owners always ask to see the school systems and the hospitals when they visit.

Additionally, Piedmont is not the only hospital service option in Gilmer County as continuous reports from Commissioner Crouch involve another interested party stating, “I am optimistic for the possibility of a hospital in Gilmer and that will be key to our future development,” and “It’s worth the time and effort for a strong possibility of a hospital in our community versus the certainty there there will not be.”

Indeed, the whole of the situation comes down to Gilmer County’s Certificate of Need. If lost, recovering a Certificate of Need is just short of impossible according to Chairman Paris.

Further, citizens need to understand that if Piedmont’s request is denied, the Certificate of Need would give Gilmer and its municipalities the power to search for a Health Provider to service the county with a full facility instead of just a stand-alone Emergency Department which the Governor’s office has already warned against.

Indeed, the county seems to be the only entity considering this as the lack of a full hospital and Emergency Room has already cost the county hundreds of thousands of dollars as they have reacted and responded to the citizens needs. They have increased there workforce and are still working on plans to increase the fleet of emergency vehicles to cope with the loss of facilities. Costs that could be redirected to other needs again with a full facility.

With so many issues and every major municipality of the county in opposition to Piedmont’s Emergency Department, citizen’s are asking what more can be done to tell the Department of Community Health that they want a stand alone Emergency Department, but a full facility to further Gilmer County’s economic, community, and healthcare growth, especially since we have an alternative company looking into our community and definitely wanting to support a full hospital. 

Follow up with more as FYN attends the Greater Gilmer JDA’s Meeting. Look below as FYN gets a chance to sit down with Post 2 Commissioner and Greater Gilmer JDA Chairman Travis Crouch and further down for a copy of the Georgia Department of Community Health’s Reply.