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Sty e Ahuattce
The ADVANCE, July 14, 2021/Page 11A
Kent
continued from page 2A
quite a large hospital for a
community this size.” His
second thought was, “They
are going to need a new one
sometime soon.”
In 2000, Meadows
Hospital was almost 40
years old. “Aging health
care facilities and modern
medicine don’t match up,”
Kent said, explaining that
it is very difficult to trans
form a facility built in the
mid-20th century into the
flexible type of environ
ment with the large pieces
of equipment, traffic flows
and patient requirements
existing in the 21st century.
“That is why you saw a lot
of hospitals in this country
being replaced (in the early
2000s). The life cycle of a
hospital is 40 years and we
were right up on that. It was
time to start thinking about
a new one.”
Kent allowed, “We
needed more circulation
space and we were land
locked in the old location;
there was not enough room
to expand.” The original
plan was to try to utilize
parts of the old facility, build
a new hospital, and over a
period of time transform.
“We brought in engineers
to do feasibility studies, but
basically, they indicated our
best bet was to find a new
site and to build a new facil
ity,” Kent recalled.
Built as a federally-
funded Hill Burton hospital
and opened in 1963, Mead
ows Hospital was named
in honor of Dr. John M.
Meadows, the first physi
cian in Toombs County. It
was built on donated land,
subsidized with grants and
contributions, and invigo
rated by a lot of community
support.
Before Meadows, there
were several, physician-
owned facilities in Lyons
and Vidalia, including the
Gross-Mercer Hospital.
In the 1980s as hospital
payments changed from
cost-based to prospective
payment-based platforms,
hospital beds all over the
country emptied out and
hospitals got smaller and
many closed. At Meadows,
35 beds were converted to
a skilled nursing facility that
became Meadows Nursing
Center. By that time, Mead
ows had expanded several
times, but as Kent observed
when he came on board in
2000, changes had to be
made to create opportuni
ties for upgrades in medical
services.
“We had a ton of
growth in the hospital be
tween 2000 and 2010. The
thing about Vidalia was
that we had really excellent
doctors here who had great
reputations and delivered
quality results, but we did
not have a wide range of
specialty medicines,” Kent
said.
Toombs County is a
regional hub for several
surrounding counties with
a concentrated popula
tion in Vidalia and Lyons.
“We knew (part of the area
population) was going else
where to see specialists. We
wanted people to get qual
ity care right here instead
of going outside our service
area.” To support the phy
sician base already estab
lished in Toombs County,
Meadows started recruiting
cardiologists, urologists,
general surgeons, ENTs,
pulmonologists, additional
obstetricians and gynecolo
gists, and others.
Kent explained that the
growth of the medical staff
and the hospital established
the need for a new medi
cal facility. “As we added
medical specialists and in
vested in new technology,
we started outgrowing the
old facility,” Kent said, add
ing, “And, along the way, we
built the wellness center.
It was a great step toward
building a new hospital.
It gave the community a
taste of preventive and re
habilitative medicine.” The
Meadows Health Wellness
Center housed a physical
therapy component and
fitness center. “We began
drawing people into Mead
ows with auxiliary services.
Physicians began keeping
more patients here. These
innovations earned Mead
ows more respect in the
community,” he said. The
purpose and commitment
of the community facility
evolved. “We had regional
in our name, but over time
we became regional in our
reach.”
Financed with a guar
anteed loan from the De
partment of Housing and
Urban Development—and
without local tax proceeds
or grants—the new $75
million Meadows hospital
opened in 2011. Soon, in
novations in oncology and
cardiac medicine came
along. A heart catheteriza
tion component was added,
and an oncology program
developed, ultimately re
sulting in a new cancer
treatment center. Meadows
came to be recognized as
one of the more sophisti
cated rural hospitals in the
nation thanks to its physi
cians and technology; in
fact, Newsweek counted
Meadows as one of the best
maternity hospitals in the
U.S., Kent said.
The community-
owned, not-for-profit facil
ity was growing and thriv
ing, but across the country,
the dynamics of health care
were shifting. “Hospital
consolidation is a reality of
the world these days,” Kent
said, pointing out that rural
hospitals are in even more
peril than the average com
munity hospital. Almost
200 rural hospitals closed
since 2005 and over 100
since 2010. Around 2015,
local hospital officials began
to evaluate the long-term
projections for the facility,
and in 2017 a consultant
was hired to help with an
objective analysis of the fa
cility's strategic options.
“When we started
looking around, it became
clearer how unusual we
were in our rural location. A
University of Georgia econ
omist who did a study for
us a few years back found at
that time Meadows was the
most isolated community
hospital with respect to car
diac care in the state. It was
90 miles in any direction to
the next tertiary care hospi
tal.”
He observed, “We had
to ask ourselves what we
could do to offer the best
opportunity to have a hos
pital operating 50 years
from now at least at the level
Meadows operates today.”
Kent pointed out that
by 2020, revenues at Mead
ows were declining and
projected to continue to
decline. “COVID made al
most every hospital in the
nation unprofitable dur
ing 2020, and there is un
certainty as to how it will
affect long-term viability.
All these factors drive con
solidation in industry. Most
hospitals in Georgia already
belong to a system because
of the power of scale. It is
very difficult for any inde
pendent hospital to remain
so for much longer.”
He reinforced his point.
“Anybody that is follow
ing the industry has seen
the marked transforma
tion of health care over the
last 20 years. Hospital care
is extremely expensive. If
you look at the percentage
health care consumes of the
gross domestic product, we
will be to 20 percent before
long. That is absolutely un
sustainable.”
A three-year search de
termined that HCA was the
best option for Meadows,
and in March, 2021, HCA
bought Meadows Hospital
and most of its assets for $73
million. The sum was less
than what it cost to build
Meadows, but was still con
sidered a good deal because
of Meadows’ declining prof
its. The sale agreement was
approved by the Secretary
of State’s Office after pub
lic hearings since Meadows
was a community-owned,
not-for-profit facility.
HCA agreed to assume
the hospital’s existing HUD
debt of $52.8 million in its
entirety. Net proceeds after
the assumption of the debt
were expected to be $30
million. These funds are to
be managed by a newly-cre
ated Meadows Foundation,
a not-for-profit organiza
tion that will directly ben
efit the community. Kent
said that $10.3 million will
be placed in escrow against
potential future liabilities.
In addition to the purchase
price, HCA has committed
to capital expenditures of at
least $10 million over the
five-year period following
closing.
Becoming a part of the
HCA health care system
made sense for Meadows,
Kent said. “We have espe
cially been supported by
Memorial Health in Savan
nah (owned by HCA), our
state designated trauma and
peri-natal center. Over 80%
of our transfers for higher
levels of care already go to
Memorial.” Being part of a
regional health care team
can provide a network of
services. “We especially
see strength in patient care
management systems, pur
chasing at the highest levels
and integrated informa
tion systems and electronic
health records. There is
group synergy from having
a lot of people working on
the same issues.”
When it was purchased
by HCA, Meadows was
an organization with $130
million of net revenue. An
individual piece of equip
ment can cost up to $1.5
million to $2 million and
an upgrade to an electronic
health record can cost up to
$15 million to $20 million,
Kent said, adding, “Those
things quickly become be
yond the capability of any
stand-alone organization.
The economies of scale
that come from partnership
enable you all to be better
together because you can
share overhead and resourc-
es.
Kent opined, “I have
always said that people
should not get poorer qual
ity health care because of
where they five. But often,
your zip code does deter
mine the level of health
care you get.” While Mead
ows was still in a position
of strength, it was the right
time to find a new partner.
“We considered several op
tions, including merging
with other not-for-profits.”
Kent observed, “Book
ing back, I love how we
went through this pro
cess. Our board managed
this in a textbook manner.
They approached it at the
right time. They evaluated
past and current financials
and operation projections
about the future, they did
due diligence about options
and developed a mission-
driven set of criteria.” Kent
added, “It was never about
the money, it was not about
how big we get to be, it was
about the mission of serv
ing patients in the region
we take care of. It was about
protecting that mission for
the long term.”
Although HCA comes
in as a for-profit operator,
they are mission driven,
Kent emphasized. “As it
turns out, the fines between
for-profit and not-for-profit
have been blurring over
the years because a not-for-
profit that is not financially
accountable will fail,” he
said, adding that a for-profit
that is not community driv
en will fail. “The real fine
between them is that a not-
for-profit does not pay taxes
and a for-profit does. Those
taxes are going to support
this community for many
years to come.”
Kent’s Career in Hospital
Administration: HCA
Bookends
The negotiations that
resulted in the sale of Mead
ows were not Kent’s first
encounter with HCA. Dur
ing his career, he actually
worked for the corporate
giant in its early days.
After earning an under
graduate degree from Tech,
Kent pursued a master’s
degree in health admin
istration at Georgia State
College in Atlanta. As part
of that degree program,
Kent participated in a nine-
month residency at a 400-
bed facility in Bellville, Illi
nois. He actually ended up
spending two years at that
facility where he learned
about hospital operations.
Following this experience,
Kent joined a relatively new
health care organization
called Hospital Corpora
tion of America, which had
been founded in 1968. He
was assigned by HCA to dif
ferent roles in several states
before joining another
company and moving back
to Georgia, his home state,
and starting his own con
sulting business.
Kent has spent about
40 years in the hospital
business. His first job in
health care was as an emer
gency room clerk in his
hometown of Griffin in
1979. He worked nights
and weekends while earn
ing his undergraduate de
gree. “HCA has furnished
the bookends to my career,”
Kent said. “My career pretty
much started with HCA,
and I became an HCA CEO
at end of my hospital busi
ness career.”
One of the biggest
challenges Kent has faced
as a hospital administrator
happened in 2020 with the
international health pan
demic. “It was one of the
strangest and most stressful
experiences of any of our
careers and one we hope we
will never repeat.”
By Dave Williams
Bureau Chief
Capitol Beat News Service
Georgia energy regula
tors have authorized Geor
gia Power Co. to move for
ward with plans to buy 970
megawatts of solar power
from five other utilities.
The state Public Ser
vice Commission (PSC)
voted unanimously Tues
day in favor of five power
purchasing agreements
(PPAs) Georgia Power in
tends to pursue during the
next couple of years.
The 30-year PPAs are
among Georgia Power’s re
newable energy programs
the PSC signed off on
when it approved the util
ity’s 2019 Integrated Re-
During the pandemic,
Kent recalled facing the
daily reports of COVID
admissions and the patient
census, which reached ca
pacity in mid-summer of
2020. It would the spring
of 2021 before the “double
zeroes” were achieved when
there were no in-house CO
VID patients and no new
COVID admissions. “It was
the natural progress of the
pandemic,” he said, not
ing, “I was so proud of our
Meadows teams who were
right at the forefront. When
everyone else was staying
home and sequestering,
they came out at great risk
and put their own fives on
the fine.”
Kent said the staff
stayed on top of the lat
est technology and infor
mation and applied it in
Meadows’s approach to
treatment, which included
negative pressure treatment
that is regarded as one of
the best standards for car
ing for COVID patients.
Because it was a relatively
new facility, Meadows al
ready had several negative
pressure rooms, but with a
little design work, the facil
ity was able to set up several
negative pressure units.
“We got low on some
things, but were never ran
out of PPE for staff and
doctors. We had more than
enough respirators. We
were one of the best posi
tioned hospitals in the state
with regard to facility and
ventilation equipment,”
Kent said. “It was a bless
ing that our board had the
foresight to build a new fa
cility and recruit physicians
which stood as the front
fine against COVID in this
community. I think it saved
countless fives.”
Kent has retired from
his role at Meadows, but
he is not planning on aban-
source Plan (IRP.)
Georgia Power is re
quired to submit an IRP
to the commission every
three years showing what
sources of electrical gen
eration it intends to rely
on to meet customer needs
during the next 20 years.
Here is a breakdown of
the new PPAs:
Utility Megawatts to
be purchased
CED Timberland So
lar — 140
Decatur Solar Energy
Center — 200
Double Run Solar —
220
Wadley Solar — 260
Washington County
Solar — 150
TOTAL — 970
doning his work in health
care. “I feel like I am a little
too young to retire from ev
erything. I will probably do
some consulting down the
road.”
He observed, “But this
became such a natural point
for leaving my job here, of
having shepherded the hos
pital through a 3-year pro
cess to find a strategic part
ner and organize a change
of ownership. “ Kent and
his wife now plan to relo
cate to her home state and
take a little time off during
the summer.
“I have always been
drawn to hospitals,” he said
of the path he chose, offer
ing that, ironically, there are
no other health care profes
sionals in his family. “I feel
so blessed to have worked
in hospitals. I love working
in this environment.”
He observed that the
role of a hospital CEO
means being a player on the
greatest of teams. “It is re
warding every day. It doesn’t
matter what job you have in
a hospital, from employees
who do the billing, to main
tenance, to the medical
staff, people’s fives are bet
ter because of the work you
do every day. This is a role
of stewardship and I hope
I have been a good steward,
but it is time to hand off to
the next generation.”
Kent insisted that his
success is shared with the
communities he has served.
“The success we have had
here likely could not have
happened in any other
community. The civic and
volunteer organizations, the
churches, the community
leadership made it possible.
I really believe our hospital
board was a north star and
had the courage to make the
difficult but right decisions
to ensure the hospital’s con
tinued growth.”
Georgia Power’s pur
chase of 970 megawatts
of solar power is enough
to serve roughly 165,000
homes.
“Georgia Power has
one of the largest voluntary
renewable portfolios in
the country and expects to
continue as a leader in solar
energy production by con
tinuing to grow its renew
able generation resources,”
Georgia Power spokesman
John Kraft said.
The company plans to
have about 5,400 mega
watts of renewable energy
resources in its portfolio by
the end of 2025, account
ing for about 22% of its
power generation mix.
NEWEST CASA SWORN IN — Juvenile Judge Sherri Mc
Donald (L) recently swore in April Worth (R) as TLC CASA's
(Court Appointed Special Advocates) newest CASA in
the Middle Judicial Circuit. CASAs are community citi
zens trained by CASA staff to speak up for the best inter
ests of children who have been abused and neglected,
Multiple training sessions, now with both virtual and in-
person options, begin in June and July. Contact CASA
at 912-663-0131 or ljenkins@tlcchildrensservices.org for
more information,
Georgia PSC gives green light to
Georgia Power solar energy purchases