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Piedmont Mountainside Hospital's Freestanding Emergency Department

Summary 
  • Need: The North Georgia Medical Center (NGMC) of Ellijay, Georgia had been slowly losing money and patients for years. Many residents living in Ellijay were seeking hospital care elsewhere, leaving NGMC treating an average of only 6 patients per day in the year prior to closing their doors in 2016.
  • Intervention: With approval from the state, Piedmont Mountainside Hospital (PMH) leased the space from NGMC and opened the state's first freestanding emergency department (ED). Medical services were again made available for patients in Ellijay and surrounding areas.
  • Results: After one year of being open, the freestanding ED continues to average 30 patients per day and has reached over 11,000 emergency room visits.

Description

Over the past decade, the North Georgia Medical Center (NGMC) of Ellijay, Georgia, had been slowly losing money and patients. Many residents were seeking hospital care elsewhere, leaving NGMC with an average of only 6 inpatients per day. NGMC chose to close their emergency department on March 1, 2016 before closing their inpatient unit on June 5, 2016.

Piedmont Mountainside Hospital Logo

Piedmont Mountainside Hospital (PMH) approached SunLink Healthcare, owner of the Ellijay hospital, with an offer to lease the NGMC space as a freestanding emergency department (freestanding ED). SunLink agreed to the arrangement and the Georgia Department of Community Health approved the request.

After undergoing renovations, adding new imaging equipment, and expanding laboratory services, Piedmont Mountainside Hospital Emergency Services opened on April 3rd, 2017 as a freestanding ED. It was one of the first in the state of Georgia. Emergency department services were available again for patients in Ellijay and surrounding areas. In addition to the 5-year lease of ED space, Piedmont leased the use of the NGMC's medical office building. Once their space was fully leased, NGMC sold their buildings.

Piedmont Mountainside Hospital's Freestanding ED Ribbon Cutting Ceremony
Piedmont Mountainside Hospital Emergency Services opened as a freestanding emergency department in April 2017.

Services offered

Piedmont Mountainside Hospital Emergency Services operates in a similar way to a hospital's emergency room, addressing medical needs ranging from emergency situations (heart attack, stroke) to minor trauma with 24-hour access to:

Piedmont Mountainside Hospital's Freestanding ED CT Scanner
CT scans are just one of many services offered (photo taken by Thomas Watkins).
  • Emergency physicians
  • Nurses
  • Radiology technicians
  • Laboratory technicians

Services and equipment reflect that of a hospital ER:

  • Moderate-complexity blood testing
  • Advanced imaging
  • CT scanner
  • X-ray and ultrasound machine
  • Pharmacy
  • Lab

Results

Piedmont Mountainside Hospital has hired 35 new employees and transferred 15 more from a different Piedmont hospital to man the freestanding ED. After one year of being open, it continues to average 30 patients per day and has reached over 11,000 emergency room visits. Piedmont now runs the ER with 50 employees to cover the 24/7 operation.

PMH works collaboratively with Gilmer County's EMS/ambulance service to ensure patients requiring a higher level of care are transported to the most appropriate facility to meet their needs.

Piedmont Mountainside Hospital Emergency Services is mentioned in the following publications:

Piedmont Mountainside Hospital's Freestanding ED Interior
Piedmont Mountainside Hospital Emergency Services operates in a similar way to a hospital's emergency room (photo taken by Thomas Watkins).

Challenges

The following were the main difficulties Piedmont Mountainside Hospital faced when setting up Ellijay's freestanding ED:

  • Initial distrust in the community – Despite their existing medical presence in Ellijay (cardiac imaging center, outpatient diagnostic center, MRI services, and a sleep center), the motivation behind PMH's move to start a freestanding ED was questioned by members of the community and caused uncertainty in staff who sought jobs elsewhere after the closure.
  • Bureaucratic and legal obstacles – Because of freestanding ED regulations, PMH needed to go through evaluations and approval processes from state agencies (for instance, the State Fire Marshall) and federal agencies (for instance, the Centers for Medicare & Medicaid Services).
  • Appeals from competitors – WellStar Health Systems, representatives from Ellijay, several Gilmer County commissioners, and the Greater Joint Development Authority appealed the freestanding ED request granted by the state. But Georgia House Speaker David Ralston, an Ellijay native, helped build trust in the community and bridge the communication gap between the county and the new operators.

Replication

Open communication with the local community and important representatives is key to success.

Contact Information

Lindsay Gard, Chief Financial Officer
Piedmont Mountainside Hospital
706.299.5110
Lindsay.Gard@piedmont.org

Topics
Closures of healthcare facilities and services
Emergency department and urgent care services
Hospitals
Service delivery models

States served
Georgia

Date added
December 5, 2017

Date updated or reviewed
December 17, 2018

Suggested citation: Rural Health Information Hub, 2018. Piedmont Mountainside Hospital's Freestanding Emergency Department [online]. Rural Health Information Hub. Available at: https://www.ruralhealthinfo.org/project-examples/993 [Accessed 14 June 2021]


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