Shocking news of downtown hospital closure turns to dread

Atlanta Medical Center’s impending closure “is incredibly tragic and disruptive to the patients,” said Grady Health System CEO John Haupert.

It will create “a public health emergency,” said Dr. Mark Waterman, president of the medical staff at AMC.

“People need this hospital,” said Demetrius Ward, a warehouse worker visiting his mother there Thursday before her surgery.

Across Atlanta and beyond, Wednesday’s shocking news that Wellstar Health System means to close the century-old downtown hospital turned to dread for the situation to come.

Patients used to AMC’s services, from regular medical ailments to its links with midwife clinics, scrambled to ask each other for options. Doctors who serve emergency trauma patients spoke in fear about the closure of the only other designated “Level 1 trauma center” besides Grady, capable of treating severe injuries from car wrecks, gunshots or head injuries from falls. Even worse than the loss of the neighboring trauma center will be the loss of its emergency room, which has functioned a relief valve for Grady’s constantly overcrowded ER.

“Every day, every single one of our inpatient beds is full and there’s patients waiting,” Grady’s Haupert said. The brunt of the overflow will land in Grady’s emergency room along with Emory University Hospital Midtown and Piedmont Atlanta Hospital, he said. Haupert spent part of the day Thursday talking to those CEOs to figure out what to do.

“To the patients that they (AMC) have been serving — I don’t see any evidence that there were intentional plans put in place to assure that those patients had a smooth transition to another care environment. And so I am very concerned about patients who are going to be left without a source of care or source of access.”

Waterman also said the doctors who give care to Wellstar’s patients were blindsided. The AMC doctors had spent a year preparing for Thursday and a scheduled visit from experts on emergency trauma care in hopes of upgrading the hospital’s Level 1 certification from state to national. That visit was abruptly canceled and he was instead juggling the closure fallout.

“It’s unfathomable to think of the stress on the system with a big, big community hospital closing in the city of Atlanta,” Waterman said. “You may be hearing my outrage.”

AMC’s closure is the second shutdown those other hospitals are dealing with in the space of four months, after Wellstar also closed its smaller hospital, Atlanta Medical Center South in East Point, in April. At that time, Wellstar CEO Candice Saunders told the Atlanta Journal-Constitution that sending East Point patients to other hospitals including AMC in Atlanta was part of the plan to transition to a better model of care. The East Point facility provided the only ER located south of I-20 in Fulton County.

In its statement on the closure Wednesday, Wellstar said financial losses were driving its decision, citing $107 million lost in the most recent year.

That operating loss is not unusual this year as prices of nurses and other workers have tripled or worse in the pandemic. More recent years have shown smaller but still significant losses, such as $41 million for the year ending 2021. That is driven in large part by the more than $300 million in indigent and charity care the hospital provides on an annual basis.

Eddie Hardin, a 59-year-old Marine veteran, was interviewed at the hospital Thursday, the day after the announcement. He said he paid $42 for a Lyft ride to bring his 35-year-old daughter to Atlanta Medical Center. Knowing the hospital would close, he said he worried about any follow-up visits she might need, because she’s covered by Medicaid and many health facilities don’t take Medicaid. “I’ve had family and friends come here over the years and nearby you’ve got senior citizens, low-income housing and homeless folks,” he said.

The abrupt news of Atlanta Medical Center’s impending closure had a swift and sudden impact on Georgia’s campaign trail, bringing new attention to urgent calls by Democrats for the state to expand Medicaid.

Eight rural hospitals have shut down in Georgia over the past 10 years, and more than a dozen others face dire financial struggles, but news of the Atlanta closure brought the trend to the capital city — and the thick of the campaign trail.

“This is just latest consequence of Republicans’ failure to expand Medicaid,” said state Sen. Jen Jordan, the Democratic nominee for attorney general. “It’s not just the rural hospitals anymore.”

Stacey Abrams and U.S. Sen. Raphael Warnock used their first joint political rally to renew a pledge to bolster healthcare access – and to blast Gov. Brian Kemp for refusing to expand Medicaid, a prospect he has said is too costly in the long run and too inflexible.

“It’s a choice to cost Atlanta 460 hospital beds in an overstretched, underfunded system. It’s a choice to reject money that we’ve all paid for with our federal taxes,” said Abrams, adding: “It’s a choice to pretend there’s nothing to be done.”

Kemp was muted on the subject. He said through a spokesman he’s concerned about Atlanta’s already fragile healthcare safety net and touted his policies, such as a planned work requirement for a more limited Medicaid expansion.

While Abrams and other Democrats laid blame on the GOP for refusing to expand Medicaid, executives with Wellstar painted a different picture.

In a statement, Wellstar said it decided to shutter the hospital by Nov. 1 because it couldn’t find a “sustainable solution” to mounting costs. Executives added that Medicaid expansion alone would not have saved the facility from closing.

“While expanding Medicaid may have helped Atlanta Medical Center’s financial sustainability, it would not have changed this outcome,” the health system said in a statement to The Atlanta Journal-Constitution.

Many public officials indicated they were blindsided by the decision. Atlanta Mayor Andre Dickens said it leaves an “open wound” in Atlanta’s heart.

“The City of Atlanta received no advance notice of this decision and had no opportunity to engage with you to understand or help mitigate the factors leading to this closure,” Dickens fumed in a letter to Wellstar’s chief executive. “I require immediate information about your company’s plans, what you are doing to mitigate the enormous health and economic impacts the closure will have on our community...”

Thursday afternoon, Dickens’ office said they still had received no information from Wellstar.

Demetrius Ward, 45, arrived at Atlanta Medical Center Thursday afternoon to check on his mother, who was scheduled for a procedure there. He said he had taken two MARTA buses and a train to arrive there — a 1 hour, 40 minute trip. “People need this hospital. I’m an Atlanta native. You know this is the land of gentrification now, but before Atlanta flipped we still had 20% who need this, who use public transportation,” Ward said, referring to low-income residents.

Ward said he’s a warehouse worker who earns about $20 an hour and supports 4 small children, and called himself a “real blue-collar worker.” “I saw on the news they’re losing money. Let me ask you: why don’t they have access to cash like Emory?” He said he had a $6,000 bill forgiven by Emory earlier.

Wellstar is a major health system across the northwestern part of the state. It purchased AMC and AMC South in 2015 as part of a package of five hospitals, from the private hospital company Tenet.

As a nonprofit hospital system, Wellstar pays no taxes with the expectation it will work for the public good.

However, Wellstar still makes a profit, and it makes more money from its hospitals outside of downtown.

[This article was originally published by The Atlanta Journal Constitution.]

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