Peach Tree Times

Doctors Hospital's longtime struggle to bring a full-size hospital to Columbia County is at an end following a Georgia Supreme Court decision earlier this month, but plans for a free-standing emergency room in Evans, Georgia, will move forward.

"For many years, Doctors Hospital has been the provider of choice for our friends and neighbors in Columbia County," the hospital said in a statement. "Our physicians and team members have a reputation for providing safe and compassionate care and for giving back to the community."

There's no remedy for the decision by the state's highest court, which rules that plans for a 100-bed hospital on Gateway Boulevard off Exit 190 in Grovetown cannot move forward without the certificate of need required by Georgia law.

"While we strongly disagree with the court's decision, it is final," Doctors Hospital said in its statement.

The free-standing emergency room announced late last spring is still a go.

"We were approved to build a free-standing emergency room in Evans and will look to further expand access to care across Columbia County, so residents can continue to receive health care from their hospital of choice," the statement concluded.

On June 1, the Georgia Supreme Court announced, without explanation, that it denied the petition for certiorari in Doctors Hospital's long-running litigation with the state's Department of Community Health.

Presiding Justice David Nahmias and Justices Michael Boggs, Charlie Bethel and Shawn Ellen LaGrua, along with DeKalb County Superior Court Judge LaTisha Dear Jackson who was sitting on the court in this case, concurred with the decision to deny the petition. Chief Justice Harold Melton and Justices Nels S.D. Peterson and Sarah Hawkins Warren did not participate in the case. Justices John J. Ellington and Carla Wong McMillian were disqualified from the case.

Certificate of need requirements are part of Georgia's official code. It says health care facilities less than a year old must apply for and receive the certificate before building or expanding the facility. Hospitals, podiatric care units, skilled nursing facilities, intermediate care homes, health maintenance facilities, intermediate care facilities, personal care homes, ambulatory surgical or obstetrical facilities, home health agencies, diagnostic, treatment, and rehabilitation centers are all regulated under Georgia’s 1979 certificate of need laws requiring government approval to open or expand these facilities.

Doctors Hospital has long argued it was not governed by the code and questioned whether the provision was constitutional.

The Georgia Supreme Court's decision to deny certiorari upholds the certificate of need provision and the code's constitutionality.

At least 12 states have repealed certificate of need laws, according to a blog posted in September by Michigan-based Mackinac Center for Public Policy.

The federal government repealed certificate of need laws more than 30 years ago and there's a push to repeal similar regulations in South Carolina, according to a news story published earlier in May by CBS 7 News in Spartanburg, South Carolina.

Certificate of need laws have been extremely onerous during the still ongoing COVID-19 pandemic, Americans for Prosperity expert Candace Carroll said in the CBS 7 News report.

"For hospitals to be able to increase that capacity rapidly without having to go through this archaic system of getting a permission slip from the government and competitors allowed them to care for more patients," she said.

Certificate of need laws repel health care investment, said Bill Rutherford, chief financial officer and executive vice president of Nashville-based HCA Healthcare in a Fierce Healthcare news story published last month.

Rutherford said his company sold their investments in Georgia in favor of “dedicating a reasonable amount of capital” to grow inpatient rehabilitation units in Florida, citing recent relaxation of certificate of need in that state as "an immediate opportunity" to match the footprint HCA has already built in Texas and other states with no such laws.