Articles

Ailing hospital reopens, but just barely

By Craig Schneider
Atlanta Journal-Constitution
May 27, 2008

This is a hospital as a ghost town.

The doors are open, doctors and nurses stand at their stations, but there are virtually no patients in the rooms, and the halls and intensive care units are silent.

The emptiness, however, belies a surprising amount of action going on behind the scenes.

Southwest Atlanta Hospital is a place haunted by its past; the biggest surprise may be that it is open at all.

For the second time in three years, the small hospital has opened with new owners. After two bankruptcies and several lawsuits, the historically black hospital is again trying to win the faith of a community that has largely abandoned it.

To do so, it will have to exorcise the ghosts and tame the financial demons that plague all small community hospitals.

The ghost busters may include Morehouse School of Medicine and Southwest's most bankable asset: a certificate of need. That state-issued certificate, a requirement to operate a hospital, can take up to three years to obtain, and much of the current effort is aimed at preserving it.

Morehouse, meanwhile, is talking to the hospital about providing expertise and doctors for surgical programs. But Morehouse officials heartily deny the school might buy the hospital.

Many people in the community say the area needs a hospital, and they want to preserve Southwest's historic role here. They remember this as the place 40 years ago where black people could find care and black doctors could find work at a time when that was not easy.

But years and competition and neglect drove people away. Even now, community hope for the hospital is guarded.

"I just hope it's not one of those flip-flop deals where it opens and closes," said C.T. Martin, an Atlanta city councilman who has rallied the community around the facility in the past. "I just hope it has some stability."

The hospital opened again last month with a new owner, Georgia Medical Provider Financial Corp. The company purchased the hospital last year after the prior owners, a group of local doctors and investors called Southwest Doctors Group, declared bankruptcy.

Late last year, the new owners brought in hospital-turnaround specialists Alvarez & Marsal. The new owners dropped $7 million providing a new CT scanner, ultrasound equipment, new operating room equipment, pharmaceutical equipment and a fresh coat of paint all around.

"We're starting small," said Southwest CEO Sandra Crayton, one of a handful of Alvarez & Marsal staff. "We want to let the community know that we're open and different."

Just barely open. The six-floor facility is operating on one floor and has reduced its 125 beds to about 20. The hospital is not listed when you call information assistance. Virtually all the 75 staff members are contract workers.

Some people worry that the firm's plans don't speak to stability. Crayton acknowledged the company hopes to sell the place within two to three years. The plan, she said, is to fix it up, qualify for Medicaid, Medicare and medical insurance networks, and move on.

The hospital occupies 65 acres in southwest Atlanta, but its most attractive asset may be its still-active certificate of need. The often-criticized CON program tightly controls who can provide hospital medical services, so a CON may be more valuable than real estate to anyone who wants to run a hospital.

In the meantime, Crayton said the company is dedicated to providing quality hospital care to this economically diverse community just south of the intersection of I-20 and I-285. Predominantly African-American, the community is home to well-off residents around Cascade Road and the destitute walking Martin Luther King Jr. Boulevard.

The well-off abandoned the hospital years ago, as Southwest suffered the fate of many smaller hospitals trying to compete with bigger, better-equipped hospitals. That left Southwest with a patient base of uninsured and underinsured. Some federal funds didn't come through, money started running out, the equipment aged and the doctors moved on.

The hospital closed in January 2005, unable to meet payroll.

But local hospitals are important to communities. The initial effort to resurrect Southwest in 2005 was spurred in part by community elders who reminded younger black doctors of the debt they owed a black-run facility where many received their early training.

The hospital became a touchstone for a set of community values: respecting the past, preserving its lessons and coming together, as some said, to protect something they viewed as their own.

More than a thousand people attended a rally to save the hospital in 2005, and a group of local black doctors and investors bought the place. But after about a year, the effort descended into money problems, internal acrimony, lawsuits and shouting at a hospital board meeting.

The hospital closed for the second time in April of 2007.

Johnnie Clark, who was the chairwoman of the hospital before its first bankruptcy, said she welcomes a new life for the hospital but cautioned it must avoid the mistakes of the past.

Crayton, the new CEO, said the hospital is still crafting a strategy, but she has some ideas. She doesn't want to compete with Atlanta's giant hospitals. The physicians will perform "basic community-level hospital services," she said, mending broken bones, treating pneumonia and diabetes, and performing outpatient surgeries. The staff can take CAT scans but send people elsewhere for MRIs.

While the hospital will continue to do "its share" of care for the area's poor, Crayton stressed, "We're going to have to be attractive to patients with insurance."

Over time, she hopes the hospital will develop specialities that cater to the largely African-American community.

We've heard it before, experts say.

Michael Rovinsky, a health care consultant in Atlanta, said the hospital will have to invest a lot more than $7 million to convert the community's nostalgic support into regular business. Southwest must shake its reputation as an outdated facility with rickety equipment, he said. Rovinsky believes the owners need to put a new face on Southwest, eventually replacing the old building with a "more attractive setting."

A powerful community partner would boost their credibility, he added.

Crayton said talks are under way to rebuild the relationship with Morehouse, which had provided physicians in the past. The hospital's current chief of staff is Dr. William Lynn Weaver, who heads Morehouse medical school's surgery program.

Crayton also said there have been "very preliminary" talks with Morehouse on the prospect of the medical school one day taking ownership of the hospital. Morehouse President John Maupin said that while the school wants to help Southwest, it has no interest in purchasing it.

"We will continue to work with them to find opportunities that are mutually beneficial to both parties," Maupin said.

Meanwhile, Southwest sees a handful of patients a day and has treated a half dozen inpatients. It recently passed a state licensing inspection, but Crayton says getting approvals for Medicaid and other insurance providers could take until the end of the year.

In truth, Southwest doesn't want a lot of patients now since, without those approvals, it loses money on virtually everyone who walks in the door.

But that handful gets a level of attention that would be the envy of any patient anywhere.

"We get so excited when a patient comes in," said Tiffany Manning, an ICU nurse.

One recent day, the staff brought a meal to its only patient. When she declined the spaghetti, the head of food services, Charles Thomas, visited her.

What would you like? Thomas asked.

Meatloaf, she said.

He went back to the kitchen and produced meatloaf.

Staff researcher Richard Hallman contributed to this story.

Copyright 2008 The Atlanta Journal-Constitution

Source: http://www.ajc.com/search/content/
metro/stories/2008/05/27/hospital.html

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