EAMC-Lanier director talks new ‘rural community hospital’ designation

WEST POINT — Administrator Greg Nichols told members of the West Point Rotary Club at their Thursday meeting that a coming transition of EAMC-Lanier Hospital to a rural community hospital is something that will bring some changes but will not diminish a commitment to serve the people of Chambers County and the surrounding area.

The term rural community hospital is a relatively new one. Nichols explained that the designation was created in 2021 in response to rising expenses coming out of the Covic pandemic.

Rural community hospitals are those not located within a metropolitan area as designated by the U.S. Office of Management and Budget (OMB) and the Census Bureau. Community hospitals are nonfederal, acute care hospitals open to the general public. Rural hospitals offer traditional services such as emergency care, outpatient care and lab testing. Some rural hospitals offer rehabilitation, long-term care and primary care.

Nichols has been with EAMC for the past 22 years. He lives in the LaFayette area and raised his family there.

“I love this community,” he said. “Being part of it is important to me. I have lived here for 20 years. We love Chambers County. It’s our home.”

He’s an executive vice president with EAMC and has overseen construction projects.

“I have been blessed to have worked with many fine people in my career at EAMC,” he said. “I have been grateful to work with people like Dr. Joe Downs, who is a member of this club.”

Nichols said that EAMC-Lanier is in much better condition than it was ten years ago, before the current affiliation with the East Alabama Medical Center. “Lanier was about to close. They had run out of cash,” he said. “Their board approached EAMC about a possible affiliation, something that made good sense to both parties. It provided to be very successful for EAMC and Lanier.”

The COVID outbreak in the spring of 2020 changed everything locally, nationally and worldwide. Health officials believe that more than three million people died from it worldwide, almost half of that number in the U.S. alone.

Costs rose dramatically as the result of the pandemic.

“We are paying much more for labor costs than we were before COVID,” Nichols said. “Those costs have risen across the board, but the reimbursement levels haven’t gone up as much. That has put pressure on hospitals, especially those in rural areas. Many hospitals across the United States are struggling right now.”

Health care has changed in the wake of the pandemic. Much more of it is being done on an outpatient basis. Nichols said that EAMC-Lanier’s average admittance is six patients a day. The number of admissions are down, but those who are being admitted are much more ill than they were before COVID. The less serious cases are being treated in the emergency room and on an outpatient basis. “Health care is different now,” Nichols said. “In many cases, you are released on the same day you got there.”

Changing EAMC-Lanier’s designation to a rural community hospital isn’t something that has been taken lightly.

“We have been thinking about it for some time,” Nichols said. “We have been talking to other hospitals that have done this.”

EAMC-Lanier does have a fairly busy emergency room, seeing more than 16,000 patients per year. By comparison, EAMC in Opelika is much busier, seeing more than 40,000 in a year’s time. The Auburn-Opelika metro area has more than 100,000 people and Lee County around 175,000.

The Opelika campus needs EAMC-Lanier to remain open for no other reason than to help take the pressure off its emergency room. It’s important to continue other services as well.

“We are very busy with our outpatient services,” Nichols said. “We will continue to do that after the transition is made. We will also continue to do ambulatory services and our nursing home.”

There is a concern with local people having to go to Opelika for healthcare needs. “We know it’s a struggle for some local people to do that,” Nichols said.

EAMC-Lanier presently has three inpatient units. They will be moving to Opelika when the transition takes place in December.

“We are working on getting more beds at our main campus in Opelika,” Nichols said. “The geriatric psych unit will be moving. Next year we will open a 40-bed psychiatric hospital on the Opelika campus. This is something that is much needed in east Alabama.”

Another unit that will be relocating to Opelika is EAMC-Lanier’s acute rehab unit.

“We are really proud of it,” Nichols said. “They have been rated in the top 10 percent of all units in the U.S. in terms of quality outcomes.”

The transition started in early July and should be completed by early December.

Nichols is expecting a smooth process. “There will be very little change,” he said. “If you are admitted here over the next few weeks, you are really, really sick. You will be transferred to Opelika for an inpatient stay. Every employee who will be impacted will have the opportunity to go to Opelika.”

Nichols said there’s a trend in health care to be making this kind of transition. It’s becoming increasingly difficult for rural community hospitals to maintain traditional inpatient services. This is gravitating toward the hospitals in metro areas. Nichols wants the public to understand that the transition will be a big change for the hospital staff but that the quality of service will remain the same.

“The people who are receiving treatment will see no difference,” he said.

In December, EAMC-Lanier will become what’s known as a rural emergency hospital, or REH for short. With the hospital only averaging six inpatient admissions per day, the vast majority of those being treated are in the emergency room, ambulatory unit or outpatient unit. They will remain. In most emergency cases, the individual is usually there for three hours or less. They can be held longer for observation and transferred to EAMC in Opelika, if needed.

“We will still be providing 24/7 emergency room services and all of the outpatient services we provide now,” Nichols said. “We will still have the nursing home and outpatient services such as lab work, radiology, infusion services, physical therapy, cardiac rehab and procedures in the ambulatory surgery center.”

It can be complicated to make changes in medical care.

“It usually takes about six years to move from the planning stage to getting something open and serving the public,” Nichols said.

Nichols said that COVID was an unforgettable experience for anyone who lived through it.

“I will always remember the first call I got when our first COVID patient arrived back in March of 2020,” he said. “The first few waves were awful. I hope nothing like it ever happens again, but we are better prepared now.”

Nichols said he has no doubt that the commitment to have a hospital in Chambers County is very strong.

“It’s important to the community, and it’s important to me,” he said. “The hospital will look different, but the commitment to serve will still be there.”

A four-mill tax that was approved by county voters in 2012 and renewed two years ago was for capital improvements. That need continues, said Nichols.

“We have to upgrade our equipment all the time,” Nichols said.

It can cost in the hundreds of thousands of dollars to replace an MRI or a CT machine, and there is a critical need for them in a hospital.

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