Lifelong Catoosa County resident Angie Stiggins has ridden the rollercoaster of North Georgia's health care market since she started working in respiratory care at Fort Oglethorpe's community hospital in 1987.
Stiggins built her career at what was once Tri-County Hospital and later became Hutcheson Medical Center - a name not easily forgotten by local residents.
Hutcheson faced a common fate of community hospitals outside of major metropolitan areas in the Southeast. Once a point of pride and mainstay of North Georgia's tri-county region, which encompasses Catoosa, Walker and Dade counties, Hutcheson struggled to compete with the larger systems in Chattanooga and eventually filed for bankruptcy in 2015.
While Hutcheson's closure represented the end of an era, it was also the beginning of Chattanooga-based CHI Memorial's ascent to market share dominance in the North Georgia region - which was solidified in July, when Memorial announced plans to build a new hospital in Catoosa County on Battlefield Parkway between Ringgold and Fort Oglethorpe.
Memorial began offering primary care services in North Georgia in 1994 but has significantly expanded its presence since 2015 when the health system took over Hutcheson's old medical clinics in Trenton and Chickamauga.
"That means the world to us here, because when we have to shut down anything, it is truly heartbreaking. We chained the doors and put plywood on the windows, and it is my life mission we will never allow that to happen," said Stiggins, who is now administrator of CHI Memorial Hospital-Georgia.
In late 2017, Memorial acquired operations of the hospital in Fort Oglethorpe, naming the facility CHI Memorial Hospital-Georgia. Memorial also acquired Hutcheson's old ambulatory surgical and cancer center on Battlefield Parkway, 2 miles from Interstate 75, as well as an adjacent 27-acre plot of land that will be home to the new hospital in a growing area that's become the local hub for commerce and development.
"Where this hospital campus sits today is not where the growth is happening. Growth is out there on Battlefield Parkway, and we've got to get out where the growth is occurring," Stiggins said.
Memorial restored cancer treatment at the Battlefield Parkway facility in 2018 and imaging in 2020, and so far in 2021 has opened a sleep lab at the hospital, a sleep clinic at the Parkway and outpatient surgery on the Parkway.
"When Hutcheson Medical Center closed down their cancer center, we had patients that were undergoing chemo or radiation that told us point-blank, 'I'm not taking any more treatments. I will not drive to downtown Chattanooga for my treatment,'" Stiggins said. "That's how important it is to be able to provide services at home for our community."
But as Hutcheson was going under, the community's needs were also growing, and many patients did wind up seeking care at Chattanooga's hospitals instead.
Hospital records from the Georgia Department of Community Health show that only a small percentage of Catoosa and Walker County residents travel south to Hamilton Medical Center in Dalton, Georgia, meaning Chattanooga hospitals were the main beneficiaries of Hutcheson's demise and remain the largest competitors to CHI Memorial Georgia.
In 2019, 4,419 hospital admissions at Erlanger Medical Center in downtown Chattanooga and Erlanger East Hospital combined came from Catoosa and Walker counties, compared to 3,028 admissions from those same counties in 2014, according to the most recent hospital joint annual reports filed with the Tennessee Department of Health.
Parkridge Medical Center downtown and Parkridge East - the closest hospital to CHI Memorial's Georgia hospital - saw a combined 4,254 admissions from Catoosa and Walker counties in 2019 compared to 3,524 in 2014.
The hospital reports only include data for non-Tennessee counties that represent at least 1% of admissions, so there are no specific numbers for Dade County or any other Georgia county.
Stiggins said Memorial has been gradually regaining market share that Hutcheson lost by restoring community confidence and services that were lost.
In February, Memorial took over as the ambulance service provider for Walker and Dade counties, which she said has been a "game-changer" in increasing the hospital's volume, because ambulances are no longer bypassing the Georgia hospital in favor of Chattanooga ones.
Memorial's new hospital, projected to be complete in mid-2024, is the next step in improving health care access in the tri-counties and overcoming the negative perception associated with the old hospital that belonged to Hutcheson.
"There are people who still do not know that this hospital [in Fort Oglethorpe] is open, but there are also people who have let their health care go because they will not drive to Chattanooga," Stiggins said. "Travel is limited if you don't have access to a car or access to travel arrangements - you can't get to Chattanooga - and it's difficult for some of our residents. That's why it's so important that we offer every single service that we can offer here at home for the community here - that's what they want, they've made it loud and clear."
The new hospital will also be more conducive to today's health care in that it caters to more outpatient services. The old hospital is more difficult to navigate and has 179 inpatient beds compared to the approximately 64 inpatient beds Memorial plans to start with when it opens the new hospital.
"When Hutcheson was in its heyday, if you had your gallbladder removed, you literally were in the hospital for 10 days. It's now a day surgery procedure. You're in and out in a few hours," she said. "But if you do have to stay in the hospital, we obviously will provide inpatient services along with surgical services and a higher level of care. Currently, we do not have an [intensive care unit] on the Georgia campus."
Georgia state Sen. Jeff Mullis, R-Chickamauga, said the significance of Memorial's new hospital brings more to the community than better health care access.
"It creates jobs and career paths," said Mullis, who is an economic developer in addition to his role as a state senator. "Whenever we're trying to recruit business and industry to the area, or existing industry expanding instead of moving off, they always want a good medical facility in the area, and CHI Memorial Georgia will provide that."
Mullis said he believes that Memorial has been able to find success in a region where others have failed because of its strong leadership and reputation. However, Memorial's North Georgia takeover represents a larger health care trend of major health systems acquiring smaller community hospitals across the country.
Memorial is part of Chicago-based CommonSpirit Health, which formed in 2019 when Catholic Health Initiatives (CHI) and Dignity Health merged to form the largest nonprofit health system in the United States, affording it the resources to build a new hospital that the ever-shrinking number of small, independent hospitals typically lack.
"The only thing that is constant in health care is change. That is a fact," Stiggins said. "Unfortunately for Hutcheson Medical Center, if you're not changing, you're dying."
Contact Elizabeth Fite at firstname.lastname@example.org or follow her on Twitter @ecfite.