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City approves request for annexation for ER
Only a step toward annexation, officials say
New emergency room rendering
A rendering of the freestanding ER. Photo provided.

Editor's note: Corrects name of Memorial CEO to Shayne George.

Richmond Hill’s city council voted unanimously Tuesday night to accept a Savannah hospital’s request to annex and rezone 46 acres off Port Royal Road to build a free standing emergency room.

Tuesday’s vote is the first in a series of steps toward annexation, officials said, and additional rezoning hearings have to take place later this month, again in September and again in October for it to be complete.

The 4-0 vote to accept the petition by Savannah Health Services LLC, or Memorial Health University Medical Center, was surprising given a number of questions, statements and requests directed at Memorial officials from first-term Councilman Mark Ott, who has been critical of the proposed facility.

Ott, a former B-52 navigator, questioned everything from the timeline of the project to whether HCA officials recognized the names of lobbyists working on a house bill that opened the door for freestanding emergency rooms in Georgia.

He also cited past issues involving Memorial’s parent company, HCA Healthcare, which in 2003 as HCA Inc. settled a $1.7 billion case in what the U.S. Justice Department then called in a June 2003 press release the largest health fraud case in U.S. history.

Questioning Memorial CEO Shayne George and Attorney Rusty Ross at Tuesday’s council meeting, Ott listed a number of fines and settlements paid by HCA, which bought Memorial in 2018 and now owns more 184 hospitals and 2,000 “sites of care” in the U.S. and United Kingdom, according to a company fact sheet.

George said “HCA did go through a dark period with the federal government,” in the past but had since signed what is known as a corporate integrity agreement with the U.S. Inspector General’s office and now routinely is named among the world’s most ethical companies.

That statement was an apparent reference to listings by the Ethisphere Institute, an Arizona-based for-profit that annually runs a list of the “World’s Most Ethical Companies” and has included HCA in its listings as recently as 2019.

That aside, Ott also questioned whether free standing ERs provided more than routine services and overcharged patients for health care. He also asked whether freestanding ERs were aimed at attracting wealthier suburban customers rather than providing health care in rural areas.

The councilman also questioned the number of “conversations” HCA representatives may have had in the past with other council members and Mayor Russ Carpenter, as well as the hospital’s plans for the remaining 390 acres in the tract it purchased in February for $9 million.

Ott also repeatedly stressed his political inexperience and said his questions were to understand the issue and provide transparency for constituents.

“I know you want to provide health care, and I want to protect citizens as well,” he said. “But it sounds like approving a free standing ER is not the same as approving an oil change or a pizza place, as has been said. My problem with this facility is that I don’t want companies to come here taking advantage of citizens when they’re most vulnerable, and many people are most vulnerable when they’re sick or injured.”

Councilmembers Robbie Ward, Steve Scholar and Kristi Cox were more welcoming, with Ward asking the company to follow through with its plans to build the ER.

“Thank you very much for choosing Richmond Hill,” Ward said. “Thank you for spending your money here. Thank you for coming here if we vote to annex this tonight. Please don’t walk away from Richmond Hill. We need you here, we want you here.”

In response to some of Ott’s questions, George stressed the state’s approval of its application for a certificate of need, the difference between an urgent care and a free standing emergency room – the latter is open 24 hours a day, seven days a week and can handle more serious medical issues, such as heart attacks and strokes while also being required to treat patients regardless of ability to pay.

He also said Memorial hadn’t decided what to do with the remaining acreage on the site, or whether the hospital would ask the city to annex that property as well.

George said the company will help pay “its fair share” toward infrastructure improvements, such as a possible traffic at Port Royal Road.

And, he said the ER could be built within two years if all goes as planned.

When Ott asked why HCA was seeking annexation, Memorial attorney Ross said Assistant City Manager Scott Allison had already given the reason earlier Tuesday night.

“It’s water and sewer. The city has it and we’re willing to pay for it, and we’re willing to come into the city and be subject to your millage rate,” Ross said. “What we’re trying to do here is we are trying to come into Richmond Hill and provide a much higher level of care than you’ve ever had in this county.”

Before that discussion took place, Allison presented the annexation and rezoning request to the council outlining the steps by which the process would go.

At one point, Scholar, a former planning and zoning director for Richmond Hill, questioned Allison in what he said was an effort to set the record straight and “correct misinformation people have put out online,” he said.

Scholar asked whether developers were given preferential treatment or if there had been agreements, incentives or other arrangements in exchange for their request to be annexed.

Allison said no.

Scholar followed up with questions about whether it would take additional firefighters or police, and Allison noted the property is next to city property and “those guys are responding there anyway,” so there were no additional needs for public safety equipment. There’s already water and sewer in place, Allison added, noting the ER will instead bring additional taxes, as well as fire fees and stormwater fees to help fund improvements to public safety.

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