Tuesday, June 15, 2004


From the Athens Banner-Herald: Minnie Boswell closing: Greene County left in limbo

Come the end of June, Beth Watkins will be out of a job. But she's not so concerned about herself. The perinatal unit manager at Minnie G. Boswell Memorial Hospital knows that another hospital position won't be too hard to find. She's more worried about the patients she's been serving at the small, non-profit Greensboro hospital for the last two years - many of them uninsured and poor.

Minnie Boswell, as it's known familiarly in Greene County, will close its doors within a month, ending 55 years of service after Greene County leaders say they have exhausted efforts to maintain the funding necessary to keep the 15-bed hospital and 29-bed nursing home open.

With continuing budget problems forcing the hospital to close, local residents needing medical care will now face a long drive to a large medical facility like Athens Regional Medical Center or smaller hospitals like Putnam General in Eatonton or Morgan Memorial in Madison.

And while Greene County officials say they've done all they can - shelling out $6 million in subsidies over the past five years, including $700,000 earlier this month - some people associated with the hospital say the county hasn't done enough and passed up a viable chance to save Minnie Boswell in May.

Poor management and a difficult payer mix led to the current situation:

A heavy load of indigent patients and poor internal management have both contributed to the hospital's woes. Currently, 60 percent to 65 percent of the patients showing up at Minnie Boswell are indigent or utilize Medicaid or Medicare services, one of the reasons the hospital's struggled so much financially, said Phil Carpenter, the hospital's interim administrator.

Greene County is home to Lake Oconee and such resorts as Port Armor, Harbor Club and Reynolds Plantation. There has been a massive influx of money into the community, but it hasn't rubbed off on to the hospital:

Authority member Tom Mayers said he's confident that if and when Minnie Boswell finally does close, an entirely new hospital will open in the area within five years.

Lombard said any new hospital should be located at the Greensboro interchange on Interstate 20, where Georgia Highway 44 intersects the east-west freeway.

But Watkins worried that a for-profit hospital located near new upscale communities on Lake Oconee - what some fear will move into the vacuum created by Boswell's closing - won't help the county's poorer citizens.

According to census data, 70 percent of Greene County residents already travel outside the county for medical care - but those are the people with money, according to interim administrator Carpenter.

It seems that Minnie Boswell has fallen victim to the plight of many smaller hospitals. Frequently specialists don't want to practice in smaller towns so patients who require care from cardiologists or orthopedic surgeons, for example, travel to the larger facilities. This feeds the perception of the local hospital as "inadequate".The lack of such specialists means the income that could be realized from cath labs or operating rooms is not available to provide for improvements of the hospital. The hospital can't improve so the perception of it as a dangerous place worsens, and fewer people utilize it, and so goes the vicious cycle. You are then left with the situation that patients that can go somewhere else, do so and take their insurance with them.

I agree with the assumption that a new hospital will be built. The main reason that one has not been built so far was the inability to get a new certificate of need from the state. With the hospital closing one may be easier to come by.
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