Georgia Trauma Network Loses Hospital

DeKalb Medical Center, losing millions of dollars overall in recent years, is leaving Georgia's already fragile trauma network, officials said Wednesday --- a move that will put an unknown number of patients in the care of other Atlanta-area hospitals.

The emergency room will remain open, according to Cheryl Iverson, DeKalb Medical's vice president of business development and marketing. But most trauma patients carried by ambulances --- those from car accidents, shootings, stabbings and the like --- are expected instead to be taken to Grady Memorial Hospital, Gwinnett Medical Center and Atlanta Medical Center.

Iverson said the hospital was also leaving the trauma network to focus more on other services and "to recruit and retain physicians." She explained that the current trauma network designation obligates certain physician specialists to be on call, and that many doctors are reluctant to do that.

She said DeKalb's emergency room is already on trauma diversion status an average of 22 days a month, meaning that the hospital does not have staff available to provide adequate trauma care. That sends ambulance patients to other nearby hospitals.

As many as 600 trauma patients are seen each year in DeKalb's Level 3 trauma center, 150 of them severely injured, Iverson said.

She could not estimate how much money the hospital would save with the move. For fiscal year 2006, the hospital posted a $26 million operating loss with a $1.3 million net loss; for fiscal 2005, the operating loss was $31 million with a $15 million net loss. Losses are also expected for fiscal year 2007.

News of the DeKalb pullout was "disheartening" to Dr. Leon Haley, chief of emergency medicine for Grady Health System, "because we need as many institutions to participate in the network as possible to make it work." And, he said, Grady's emergency room has been struggling in recent years to handle a rising trauma patient load. For 2006, he said, Grady saw about 4,000 Level 1 trauma patients, those needing the highest level of care ---up 500-600 from the previous year.

"We can anticipate that there will be more trauma patients and more major trauma patients," Haley said, a greater burden not only for Grady but for the other hospitals remaining in the system. "This will be very challenging for us."

State lawmakers have been working on several proposed fee increases to benefit the state's 15 trauma care centers and to increase the number of centers, currently four, that can handle the most severe injuries. A bill to establish a trauma care network commission passed the Senate in February and is pending before the House.

Outside metro Atlanta, most Georgians live far from trauma centers, and the long distances put victims of car and other accidents and shootings at risk of dying before they can receive medical care.

DeKalb Medical has been forced in recent months to cut staff to help get back in the black, officials said Wednesday. In March 2006, the hospital laid off 127 people in a variety of departments, both clinical and nonclinical. Another 15 mostly administrative jobs were cut in December and 15 more administrative jobs were axed last month.

With about 3,800 remaining employees, the hospital remains one of DeKalb County's largest private employers, according to county officials.

Overall, DeKalb Medical remains in good financial health, with about $180 million in savings and investments, Iverson said. The hospital has used interest on that investment to offset losses in 2005. The problem, hospital officials said, is one many hospitals are facing: Expenses are going up along with the number of uninsured patients. At the same time, government reimbursements for Medicare and Medicaid continue to get cut.

"Every hospital in America is chasing that dwindling number of people who have insurance, and that's what this is all about," said DeKalb Medical CEO Eric Norwood, who took his post in 2003 with a mandate to get the hospital in better financial shape.

DeKalb Medical officials are putting the finishing touches on a "major rebranding" campaign to streamline operations and attract more paying customers, Iverson said. Details of the campaign will be made public in May.

No more layoffs are expected, and the hospital is expected to turn a profit in the next few years, Iverson said.

"I feel good about where we are," said Norwood, the hospital's CEO. "But we've still got a lot of work to do."

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