Three years ago, to get a mammogram at Morgan Memorial Hospital on South Main Street, you had to walk into a trailer parked near a parking lot and a trash dumpster. It was a double-wide, to be sure, but still.
To get an X-ray you were ushered into a small room using 1980s technology. The facility wanted more, wanted better, but the room wouldn’t hold updated technology. The room was just too small, says Ralph Castillo, CEO, Morgan Medical Center.
Castillo took the reigns of the struggling Morgan Memorial Hospital in 2012 after the facility had been run by a consortium of hospital staff and two members of the Morgan County Hospital Authority for a year prior. The facility, which opened in Madison in 1959, had continued to serve the citizens from a compressed capacity defined by space and outdated technology.
But, says Castillo, the outdated building and the staff of more than 100 healthcare professionals served the community.
“We all knew we did good work,” he says of his time at the old hospital. “We just never got much credit because of the perception of the facility, how the building looked.”
Three years ago, on Dec. 19, after a ribbon cutting ceremony celebrating the completion of the $37 million Morgan Medical Center, the staff and ideas behind providing cutting edge medical care came to fruition when the new Morgan Medical Center, built on farm land donated by Pat and Natalie Reams off the Madison bypass, began accepting patients.
The opening ceremony, held inside the expansive lobby of the 74,000-square-foot facility, recognized a wide swath of community members who donated more than $3.5 million in private wealth, including a $1 million matching grant by the Conrads family, on the belief that Morgan County needed a hospital.
After a more than 10-year battle, the Morgan County Hospital Authority, with a $1 million a year pledge of assistance by the Morgan County Board of Commissioners, had secured a United Stated Department of Agriculture (USDA) loan to pay for a new building and new technology and, maybe more importantly, helped foster a new culture of medical care.
“You have to have a hospital presence in Morgan County,” says John Moore, the local owner of an automotive repair shop and the chairman of the Morgan County Hospital Authority. “Think about how many lives this place has saved. If you added up the number of people who have been saved because of this hospital you would be shocked.”
It hadn’t been easy.
Well before 2015, the Morgan County Hospital Authority was in the middle of a pitched battle to convince the community that the construction of a new hospital was both a good financial and civic idea.
The concept, while embraced by many, was also anathema to some. Castillo and then Hospital Authority Chairman Terry Evans were leading a charge to create interest in the project. “A new hospital for the citizens of Morgan County is a project that has been in the works for over a decade,” Castillo said at the time. “Our patients deserve quality care locally with all of the services that a modern facility will enable.”
Also, in 2015, a group determined to stop the construction of the new facility had secured more than 500 signatures on a local petition asking for a referendum on the concept. The group claimed the facility was “too expensive, untenable in a community of Morgan County’s size and the driving force behind recent county tax hikes,” it was reported in the Morgan County Citizen.
However, the Morgan County Board of Commissioners stayed steadfast in its belief that the facility was needed. Then Commissioner Ellen Warren told the Citizen that, “I make it a point to talk with anyone and everyone about the hospital, and I find that once the correct information is given, people walk away understanding why we need this.”
Morgan County Commissioner Andy Ainslie said in 2015 that, “We support our hospital board because of how thorough the hospital authority has been on this.” The end result was a 25 year commitment to the facility.
The other end result, after years of study, debate and wrangling public opinion, was that in September 2017, members of the Morgan County Hospital Authority, Morgan County Board of Commissioners and others gathered on the farm land and broke ground.
Has it worked?
Prior to the first shovel of earth being ceremoniously tossed into the September sunshine, Castillo and the hospital authority had the facility running on a positive cash flow basis, including the county’s contribution.
“The hospital has been in the black the last six years,” says Moore.
“This year will be no different,” says Castillo. Average net revenue at the old facility was approximately $12 million. Average net revenue at the new facility for the past three years has been more than $23 million, says Castillo.
The county contribution, says Moore, while vital for helping the facility receive funding, is far less than the facility gives the community in “uninsured” healthcare.
Thus far in 2021 Morgan Medical Center has provided $4.5 million in uninsured healthcare to community members. With the county’s contribution and another nearly million dollar payment from the state of Georgia for uninsured patients, the Morgan County Hospital Authority “has a $2.5 million hole in uninsured health care that we have to dig out of.”
Monthly, Morgan Medical Center is aiding an average of 750 patients in its emergency room, up considerably from the average 600 persons Morgan Memorial Hospital was treating in its ER. Castillo says 25 percent of the emergency room patients are uninsured and 75 percent of the total uninsured patients are Morgan County residents.
The county’s contribution, Moore says, “pays for the uninsured. It does not pay for the actual facility. That gets lost.”
Since it opened, Morgan Medical Center has increased its employee count to 250 from 150 at the old facility in large part because the level and options for service at the new facility has risen.
With space and technology, Morgan Medical Center now provides ultrasound guided biopsies, plastic surgeries, nuclear stress tests, podiatry surgery, coronary calcium scoring, orthopedic surgery and 3D digital mammograms in a dedicated room with the latest diagnostics. Morgan Medical Center has the lowest dose X-ray equipment on the market and can provide on-site MRIs.
Emergency Room doctors, once farmed out, are now a task-specific group of doctors. “They are specifically trained to provide emergency care,” says Castillo.
The new facility has 25 patient rooms, new surgery capabilities and doctors beating down the doors to join. Dr. Dan Zant, the chief medical officer of Morgan Medical Center and a member of the Morgan County Hospital Authority, says physician recruitment with the facility has been seamless.
“It definitely is an easier sell. In most cases we don’t have to reach out. They come to us. They have been coming to us.”
With revenue rising and finances solid, Moore says, managers and the authority are able to devote energy to culture and care. “Finance used to be the focus,” he says. “Now the focus is on quality of care, what doctors we are bringing in… it (finances) is one of the last things we talk about because it’s not a stress point now.”
Castillo says employees today are constantly reminded of the importance of focusing on the patient and to the patient’s care. “Everybody is responsible for the patient,” he says. “Whether you are a clinician or not.”
Dr. Zant says the positive morale that flowed from Morgan Memorial to Morgan Medical Center was amped by the efficiencies of a new hospital. “We have become a highly reliable organization.”
“It started with the new building but patient’s experience with the new facility has increased community confidence in the hospital.”
Then came COVID.
Nobody saw it coming. Administrators and staff at Morgan Medical Center had a year to fit in a new facility, a year to work out kinks of any new project and a year to drive.
Then a pandemic like the world has not seen in more than 100 years changed the dynamics of everything. When COVID hit, and hit hard, there were days when the facility was full, when all 25 beds were being used and options were few. Without the new hospital’s capacity, says Dr. Zant, “we would have been on diversion.”
What that means, explains Moore, is that with a facility incapable of handling the influx of seriously ill patients, sick people would have been directed to healthcare facilities out of county. “You would have found your wife, if she was sick, in Savannah,” Moore says.
“It would have been a mess,” says Dr. Zant.
Instead, here’s what the new facility accomplished during a pandemic trial by fire. During the height of COVID, Morgan Medical Center provided 6,000 COVID tests, distributed more than 800 doses of vaccine and operated a monoclonal antibody infusion clinic. It did this, says Dr. Zant, at a time when it also provided care for more than 8,000 patients and performed more procedures than ever in its emergency room.
“We were on the cutting edge of treatment during COVID,” says Dr. Zant. “This hospital really came through during COVID. It was a community leader.”
“You only have to look at the pandemic to realize the importance of bringing a new facility to Morgan County,” says Castillo. “We were here when the county needed us the most.”
Not done yet.
Moore says there is work to be done. The availability of services at Morgan Medical Center continue to increase, from cardiology to, soon, gynecological care.
Of the $35 million loan taken to build the facility, $4,186,350 has been paid back and Castillo hopes the payment schedule will eventually drop the time commitment by two years. One of the authority’s goals is for Morgan Medical Center to become noted as one of the Top 100 Hospitals in the country.
Dr. Zant says the way the staff and facility responded to the COVID pandemic and the stress load it placed on its resources, he is confident the hospital will thrive. “It is all about quality of care,” he says. “It (the pandemic) just kind of gave us a blueprint for how to sustain and build a great organization.”
Moore says, “It’s hard to argue with something successful and building and it’s a need in the community.”
But that, he says, is not enough. He wants the facility to serve a local community that needs and will always need quality healthcare. “I want people to have healthcare options 10 minutes down the road. We’re not there yet but we are a lot farther along that I thought it would be.”
For Dr. Zant, the entire, sometimes frustrating process, has been one focused on allowing both care and access. “Before we had all these services, a lot of people had to do without,” he says.
“It’s a huge improvement to local healthcare.”