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RMC sale raises concerns over inmate care

CONYERS - Concerns that the county will have to absorb the cost of indigent inmates' health care once the sale of Rockdale Medical Center is complete were raised by some members of the public this week.

At a joint meeting of the Rockdale County Hospital Authority and RMC Inc. Board of Directors, Rockdale resident Garvin Haynes asked how the hospital's agreement with the county to provide indigent care for jail inmates would be affected once Signature Hospital Corp. completed its purchase of RMC.

Ethel Boyle, chairwoman of the Hospital Authority, told Haynes that agreement would end when the hospital's bond debt, which is secured by Rockdale County, was paid off - something that is expected to happen immediately following the completion of the sale to Houston-based Signature. RMC writes off services provided to jail inmates as part of the county's 2006 agreement to back part of the hospital's bond debt.

However, when Haynes asked Rockdale County Board of Commissioners Chairman Roy Middlebrooks the same question during a work session Friday, Middlebrooks said it was his understanding that the county's agreement would continue as a contract with Signature.

Boyle could not be reached for comment Friday. Laura French, attorney for the RMC board of directors, did not return a message left at her office late Friday.

Inmates' general health care needs are taken care of through contracted services at the jail's clinic. The Rockdale County Sheriff's Office has a contract with a private health care company to provide services in the jail's clinic.

In the event that an inmate becomes seriously ill or injured, however, the agreement between the county and the hospital states that RMC will provide the emergency health care services - a cost that would otherwise be a part of the county's general budget. If RMC cannot provide care and the inmate is transported to another hospital, RMC would pick up the first $50,000 of costs incurred, Sheriff Jeff Wigington said Friday.

The actual cost Rockdale Medical Center incurs for providing health care services to inmates under the agreement is not known, the sheriff said, because the hospital has never billed the county or jail to account for those services.

But should the agreement between the county and RMC change, the financial impact on the jail to provide inmate health care would be significant and could amount to several hundreds of thousands of dollars a year, Wigington said.

Wigington said inmate health costs were cut in the 2008 county budget from $884,400 last year to $820,000. The sheriff said he requested $962,845 this year in anticipation of an increase in the jail's inmate population, especially when the expanded portion of the jail opens later this year.

The potential sale of the public hospital to privately held Signature was expected to be completed by the end of 2007. In December, however, Signature proposed a change in the payment terms. The state Attorney General's Office was scheduled to issue a finding on Dec. 14 stating whether the public would receive fair market value from the sale of the hospital. However, the amendment to the purchase agreement has delayed that decision.

The Rockdale Hospital Authority agreed this fall to sell RMC to Signature Corp. for $87.7 million - most of which would be used to offset the hospital's debt obligations.

According to the recently revised payment agreement, Signature would pay $62.7 million in cash, with the remaining $25 million to be paid in the form of a promissory note. The terms of the note stipulate that the payment would be made in one lump sum with both principal and interest due on the five-year anniversary of the sale's closing date.

To back the note, Signature plans to take out second mortgages on its three other hospitals, as well as RMC.

The Hospital Authority and RMC Board of Directors met Thursday in executive session for about two and a half hours hammering out a resolution confirming changes made in the purchase agreement by Signature Hospital Corp.

All parties - the Hospital Authority, RMC Inc. and Signature - have requested that the Attorney General's Office hold a second public hearing much like the one held in November in light of the revisions made to the original agreement.

Feb. 12 has been tentatively set as the date for this public hearing. A legal notice will be published in The Citizen once the location and time have been determined.

The resolution, along with other revised financial documents, were due to the Georgia Attorney General's Office on Friday.

Jay Jones can be reached at jay.jones@rockdalecitizen.com.