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Like many neighborhoods in cities throughout the nation, Atlanta’s Outdated Fourth Ward is altering.
Rental 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 Middle, a 460-bed Degree 1 trauma heart, would be the subsequent fixture to alter.
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, not too long ago 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 beneath the Reasonably priced Care Act, and hospital officers throughout the state say inaction has damage their backside traces as a result of they nonetheless deal with excessive numbers of uninsured sufferers, lots of whom can not pay for remedy.
The Wellstar announcement shocked metropolis officers, together with the mayor, Andre Dickens, in addition to different members of the group.
On a latest weekday morning, Teresa Smith, 60, who lives within the neighborhood, stated she ceaselessly receives care there for a power digestive problem. “This hospital can be missed by the entire group,” she stated.
Liliana Bakhtiari, the Atlanta Metropolis Council member whose district consists of the hospital, was sharp in her evaluation. “There can be lack of life and demanding 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 College of Public Well being, sees connections between the Atlanta scenario and hospital closures in different main cities.
Many have been acquired by giant well being care firms as a part of package deal offers, and served largely low-income, minority populations.
“When you purchase a hospital, it is best to have an obligation to repair it up,” stated Kane. “Wellstar has the funds to take a position on this hospital. It is a selection.”
Some group members wonder if the hospital closure will result in a dear actual property growth on the roughly 20 acres Wellstar owns within the neighborhood.
Randy Pimsler, an architect whose agency has designed tasks within the space, stated “it might develop into a clean slate, both for redevelopment or for brand spanking new growth.”
Politicians have been fast to show the closing right into a marketing campaign problem. And on the heart of the talk is Gov. Brian Kemp’s well being care coverage.
The Kemp staff 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 may help capital wants at Grady Memorial Hospital, a Degree 1 trauma heart a few mile from Atlanta Medical Middle.
Grady is anticipating as many as 2,500 further emergency room visits a month after Atlanta Medical Middle shuts its doorways.
“We will soak up all of the trauma,” stated John Haupert, CEO of Grady Well being System. Nonetheless, the added ER crunch can be a problem with extra sufferers arriving, stated Ryan Loke, chief well being coverage officer for Grady.
State funding would speed up Grady’s present 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 discipline 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 may supply 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 amenities attributable to Georgia’s refusal to develop Medicaid. Wellstar officers have stated that Medicaid enlargement alone would not have saved the Atlanta facility open.
Earlier this yr, Wellstar stopped offering emergency room and inpatient providers at its hospital in East Level, simply southwest of Atlanta. On the time, it stated these sufferers could possibly be seen at Atlanta Medical Middle, about 8 miles away. Haupert estimated it will price lots of of thousands and thousands of {dollars} to modernize the soon-to-close Atlanta hospital, which is what made a rescue troublesome.
The closures only a few 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 difficulty 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, similar to inflation, crime, and abortion, are more likely to be extra motivating to Georgia voters.
Wellstar, primarily based 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 group board for AMC, stated the system put extra assets into its suburban amenities.
“Wellstar’s suburban hospital-oriented administration strategy sadly has resulted in giant parts of Atlanta’s black and brown communities not accessing proximate and demanding well being care providers,” 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 reducing income and rising prices for workers and provides as a result of hovering inflation.”
The choice to shut the hospital did not come as a shock to some employees members, stated Dr. Sulieman Wazeerud-Din, an emergency medication doctor on the hospital, who stated medical doctors “have been conscious of economic losses.”
However the abrupt announcement brought on a profound sense of grief amongst medical doctors, nurses, and different nonmedical workers, he stated.
Within the days because the closure announcement, Grady has provided jobs to a variety of Atlanta Medical Middle 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 Middle has been an enormous a part of his life.
His grandfather died in a nursing dwelling 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 rework from a “forgotten” a part of the town to at least one that is develop into a lightning rod for brand spanking new growth.
“It boggles my thoughts that an establishment like that may simply shut down nearly in a single day,” he stated.
This text was reprinted from khn.org with permission from the Henry J. Kaiser Household Basis. Kaiser Well being Information, an editorially impartial information service, is a program of the Kaiser Household Basis, a nonpartisan well being care coverage analysis group unaffiliated with Kaiser Permanente.
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