Sequatchie County hopes to return emergency room

Sequatchie County hopes to return emergency room

January 7th, 2011 by Emily Bregel in Healthlocal

Staff File Photo by Juliette Coughlin/Chattanooga Times Free Press Grandview Medical Center opened its doors in 1998. The hospital used to operate an emergency room in Dunlap, Tenn., but it has closed.

Staff File Photo by Juliette Coughlin/Chattanooga Times Free...

Sequatchie County leaders still are holding out hope of resurrecting emergency medical care for local residents following the September loss of the county's sole emergency room.

The conversion of the North Valley Medical Plaza ER in Dunlap into a walk-in clinic was a blow, local leaders said. The nearest emergency rooms are 20 to 30 minutes away at Grandview Medical Center in Jasper or Erlanger Bledsoe in Pikeville.

"Any of us could need that service and not have it, and that's when you really miss it -- when you need it and don't have it," said Winston Pickett, executive director of the Sequatchie County-Dunlap Chamber of Commerce.

Leaders of Erlanger Health System are considering whether to take over Grandview's lease and re-establish emergency services at North Valley.

Sequatchie County Executive Michael Hudson said the hospital has until the end of the month to decide, though that deadline could be extended.

The decision could hinge in part on whether the county can secure federal "rural status" as a medically needy population, which would give local providers higher reimbursements from Medicare.

The emergency room was on track to lose $1 million in 2010, said Jamie Lawson, spokesman for Grandview Medical Center.

"No business can sustain those types of losses," he said.

The new clinic operates from 8 a.m. to 8 p.m., including weekends.

But even after the conversion, "patient volumes at the clinic are disappointing, with the facility continuing to see significant monthly financial losses," Lawson said.


Between 2000 and 2009, Sequatchie was the fastest-growing county in Southeast Tennessee, with a 22 percent population increase. But with 13,915 residents, it's one of the smallest counties in the region, according to U.S. census data.

On the heels of a decade of growth, Sequatchie County now more than ever requires reliable emergency care, Pickett said.

"In this day and time, those services are needed. We're growing like crazy," he said.

Sequatchie EMS chief Danny Sain said the ambulance division averaged 50 or 60 calls a month in the late 1990s. Today the service gets more than 200 calls a month, he said.

And Hudson said it's a strain for ambulance crews not to have the emergency room to stabilize patients.

Pickett said adequate medical facilities are a major draw for potential residents.

He recently took a call from a new resident, a retiree with a medical condition who was distressed to learn the emergency room was gone.

"Without one, he was afraid to stay," Pickett said. "It is a major concern, and it's a major priority within the county."


The walk-in clinic provides lab testing and non-urgent primary care that will cover most local residents' needs.

Dr. Rogelio Carrera, director of Grandview's emergency department, said a 28-mile ambulance ride to Grandview's emergency room is "not a tremendous distance for rural health care."

"Obviously the more [services] you can provide, the better off you are, but there are realistic limitations based on economic reality," Carrera said.

But for some patients, getting an evaluation within a few minutes rather than 20 or 30 minutes can be critical, said Smith of Sequatchie County EMS.

"Especially in life-saving events, you get somebody stabilized and it can mean a lot," he said.

Contact staff writer Emily Bregel at ebregel@timesfree or 423-757-6467.