Rockdale Medical Center’s Emergency Room has seen a spike in visits over the last year as more and more uninsured or underinsured patients without access to primary medical care are turning to the ER instead.

From 2011 to 2012, RMC’s ER saw a 14.6 percent increase in visits — a much bigger increase than in past years. There were 48,708 visits in 2012 and 42,490 visits in 2011.

In comparison, ER visits actually decreased slightly the previous year by 1.7 percent. The years before that saw slight increases of about 2.6 percent for 2009-2010 and 5.7 percent for 2008-2009.

Although the last month of December, the ER was hit hard as the flu swept through Rockdale, the increase was steady throughout the year, said RMC CEO Debora Armstrong.

Health Safety Net

Facie Goodman, who has been the project coordinator for the Health Safety Net since last January, works with area doctors, clinics and RMC to find medical care for the uninsured and underinsured. 

“The majority (of patients) who I’ve dealt with are in the 35-60 age group, who are unemployed or in a minimum wage-type jobs,” said Goodman. “Most of them don’t have insurance and don’t qualify for Medicaid.” 

She explained that many people have the misconception that anyone below a certain income level can qualify for Medicaid. Medicaid only goes for certain groups and situations, such as youth, adults with disabilities, adults over the age of 65 and those with certain behavioral issues. 

The patients are often referred to her from RMC’s ER when the patients are not in an emergency situation but are going there for regular medical care.

Often, there are other factors contributing to the patient’s inability to access care. “In addition to having the health issues, there’s other things going on with them. They might be having difficulty paying rent. They have high water bills because they’ve gotten behind in those,” said Goodman. “It becomes compounding.”

Some of the people she works with have never had to ask for assistance and need moral support in getting to a free clinic or doctor’s office, and others have gotten medical aid before but have never navigated the process on their own, she said. 

The Health Safety Net program, which is funded through grants from the United Way, Kaiser Permanente, and AETNA, has served about 65 people since last spring. 

RMC

Along with the increasing visits, the hospital is also seeing an increasing amount of indigent patients or charity and bad debt.  About $24.5 million was charged in bad debt and $11.7 million in charity care in 2012, a 4.4 percent and 14.2 percent increase from the previous year. 

Armstrong said the hospital was operating in the black, but if indigent and bad debt charges continue to increase that could mean looking at reducing services or cutting jobs.

RMC, a 138-bed acute care hospital, was purchased by Lifepoint Hospitals and became privately owned in 2009. The hospital will soon be opening a renovated Neonatal Intensive Care Unit, which doubled from eight beds to 16 beds. It also recently purchased a $2 million Da Vinci surgical robot and built an $8 million outpatient imaging center. 

Free clinics

Mercy Heart Clinic for uninsured and indigent patients opened in 2010 partly with the hope that it would be able to alleviate some of the visits to the ER. The clinic treats patients with diabetes, high blood pressure, COPD, chronic heart disease, and provides basic dental care – all situations that can be managed with regular care and visits and prevented from turning into an emergency.

“Our hope was to be able to benefit the overall community by helping to alleviate people in the ER that did not be there. And to better service indigent care by preventing those diseases from becoming far more involved than they need to be,” said Mercy Heart President Darlene Hotchkiss. “We are thrilled with the outcome.”

Last year, the clinic saw 903 patients. This year, it is expanding to three days a week where it can see patients. In its first year, appointments were available only once a week.

In 2012, the clinic’s operating budget was about $83,380, funded mostly by foundation grants, including a grant from the Hospital Authority that counts for about 60 percent of its revenue, and by individual donations. 

Goodman also touted the opening of the combined Oakhurst and ViewPoint Health clinic at the JP Carr complex, which will offer physical medical services and mental and behavioral health services in the same office.  Oakhurst Medical Centers have a sliding pay scale for patients. 

Janice Morris, co-founder of the Helping Hands free clinic located by the Lakeview Estates community and the Outreach Service Coordinator for Oakhurst's Conyers clinic, said the Helping Hands clinic sees about 260 patients a month.

Morris, who works for Oakhurst during business hours and works on Helping Hands during her off hours, said there were enough willing volunteers but the challenge is in finding funding for the free clinic, especially for supplies and building maintenance.

"Most patients don't have just one set of symptoms," said Morris. Many have multiple health issues going on at the same time, she said. 

The clinic is open Wednesdays, 9 a.m. - 12 p.m., second and fourth Fridays of the month 2 p.m. - 4 p.m. and second and fourth Saturdays of the month, 9 a.m. - noon. The clinic is open additional days depending on demand.

For more information:

Rockdale Medical Center: www.rockdalemedicalcenter.org

Mercy Heart Clinic: www.mercyheartclinic.org

Helping Hands Clinic: helpinghandsoutreach.org

Oakhurst Medical Center: oakhurstmedical.org

ViewPoint Health: www.myviewpointhealth.org