Wellmont to build state's first stand-alone emergency department

Rick Wagner • Nov 9, 2007 at 12:00 AM

An artist’s rendering depicts the planned Wellmont Emergency Care and Diagnostic Center, a stand-alone emergency department, to be built in Boones Creek.


Tennessee’s first stand-alone emergency department would be built in the Boones Creek community of Washington County under plans unveiled by Wellmont Health System on Friday.

During a morning news conference aboard a Learjet 17,000 feet in the air en route to a stand-alone “ED” in Raleigh, N.C., Wellmont officials announced to reporters the health system will seek state approval to construct Wellmont Emergency Care and Diagnostic Center at Boones Creek.

The 30,000-square-foot, single-story facility would compete with Mountain State Health Alliance hospital emergency departments in Johnson City. It would be located on 17 of the 42 acres Sullivan County-based Wellmont recently purchased for $5.78 million. The parcel adjoins Christian Church Road, Boone Station Road and Lake Park Drive, near the Jonesborough exit of Interstate 26. Wellmont officials said that community is among the fastest growing in the Tri-Cities.

Diagnostic services there would serve the ED was well as Cardiovascular Associates, Holston Medical Group and Wellmont Physician Services, which plan to establish offices in an adjacent 20,000-square-foot, two-story building to house up to 12 physicians ranging from primary-care doctors to cardiologists.

The facilities would mostly serve residents of Washington County and the area of Sullivan County south of Interstate 81, Wellmont officials said.

“We’re just totally convinced it’s the right thing to do,” Ron Prewitt, senior vice president of business development for Wellmont, said during Friday’s visit of media and Wellmont officials to WakeMed North Healthplex, a nonprofit WakeMed Health & Hospitals facility that houses North Carolina’s first and so far only stand-alone ED. “It (Boones Creek) is the most logical place.”

Prewitt said Wellmont will file a certificate-of-need application for the ED project Nov. 15. The diagnostics and doctor’s offices require no certificate of need (CON).

“We’re not asking for beds. We’re going to be providing services,” Prewitt said.

Pending state approval of a CON at the Tennessee Health Services and Development Agency meeting in February, construction of the ED and diagnostics facility would begin in early summer of 2008, with a projected opening in the late summer of 2009.

“Seven years ago, the people and physicians of Washington County invited Wellmont to meet the community’s health care needs,” said Dr. Richard Salluzzo, Wellmont’s president and chief executive officer. “In growing areas between Johnson City and Kingsport, it is clear the need for emergency, diagnostic and physician services has become more pronounced.”

Wellmont failed to get a CON for a proposed hospital on State of Franklin Road, a site it still owns. Wellmont also owns property in Piney Flats and in front of MSHA’s Indian Path Medical Center in Kingsport, and MSHA owns the driving range in the MeadowView area of Kingsport and property near the entrance to Holston Valley Medical Center.

The new medical complex would represent a $41 million investment in Washington County over 15 years.

Reporters on Friday toured the WakeMed North stand-alone ED, which has operated since mid-2005 in a 2002 building retrofitted for an ED.

The Boones Creek center would be home to a fully equipped, 24-hour emergency department, a state-of-the-art diagnostic center and a medical office building for physicians.

Carolyn Knaup, vice president of ambulatory services for WakeMed and a registered nurse, said the center opening in 2005 helped increase market share for WakeMed in Wake County by about 28 percent. Two health systems, associated with Duke University and the University of North Carolina, compete with WakeMed.

“People don’t want to travel, so we have to figure out how to get to them,” Knaup said.

The five-mile radius around the center has 150,000 people, and Wake County all told has about 880,000. Knaup said some folks drive 45 minutes to the North center because waits there can be three hours compared to waits of six to eight hours at the main WakeMed emergency department about 12 miles away.

WakeMed, which also has a community hospital with an ED in Cary, N.C., is building a second stand-alone ED in Apex, N.C., to open in February, with plans for two others to be associated with WakeMed — one in Greensboro and the other in the eastern part of Wake County.

The initial projection was 14 patients a day. But Knaup said the center ended up serving 23,000 patients its first year and 28,000 the fiscal year ended Sept. 31 of this year. She said it generated about $12 million in income to the health system this year.

Jeff Hammerstein, district chief and public information officer for Wake County Emergency Medical Services, said the additional ED helps maximize efficiency of ambulances.

“That greatly reduces the time any one ambulance is tied up,” Hammerstein said. “This is very much another option for us.”

Officials emphasized the new Wellmont ED, operating as a service of Holston Valley Medical Center’s emergency department and Level I trauma center, would not be an urgent care center.

However, unlike Holston Valley and MSHA’s Johnson City Medical Center, it would be a Level I trauma center.

Prewitt said patients requiring hospital admission will be transported via ground or air to Wellmont or other facilities, including MSHA’s Johnson City Medical Center, based on patient preferences.

The new ED would be staffed by board-certified emergency physicians and would feature emergency exam rooms for emergency patients, four dedicated trauma bays for the critically injured, and facilities and equipment for specialized pediatric, obstetric and gynecology treatment.

The emergency department will be supported by an on-site diagnostic center that will offer laboratory services and a broad array of imaging services that will include CT scanning, ultrasound and mammography. Those would serve the ED as well as patients of physicians located next door.

With more than 80,000 patient visits annually, Holston Valley is Tennessee’s third-busiest ED.

However, Wellmont reports that fewer than 3 percent of the hospital’s ER patients ever see the waiting room — instead, the vast majority of patients are taken immediately to a treatment area. And, the health system says, 90 percent of Holston Valley’s ER patients are seen by a physician within 40 minutes.

The nonprofit Wellmont does business in Northeast Tennessee, Southwest Virginia and Southeast Kentucky. It lays claim to 13 owned and affiliated hospitals and may develop more stand-alone EDs in the future.

“We believe this is something that we will do in the future,” Prewitt said.

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