Its been 20 years since Savannahs two oldest hospitals joined in a remarkable journey to expand their provider network throughout the region and better serve their communities.

The merger of two faith-based hospitals St. Josephs in southside Savannah and Candler in midtown avoided potential hurdles in what Paul P. Hinchey, president/CEO of St. Josephs/Candler Health System Inc., called really a great Savannah success story that provided a textbook model for such collaborations.

It was remarkable, Hinchey said. There was no acrimony. (Trustees) just cared about what was good for the merger and the community.

The combination, driven by a common philosophy and vision, provided a springboard to rapid growth that is still vibrant, Hinchey said.

Today, the system has 87 provider locations spanning 33 counties in southeast Georgia from Wayne County to Statesboro and Hilton Head, S.C. There are 714 patient beds St. Josephs Hospital with 330 and Candler Hospital with 384 beds in what Hinchey called the largest health care provider in the region.

It employs 4,000 people and last year provided almost $75 million in community assistance, including $27 million in traditional charity care and $2.4 million in community health improvement service and community benefits, according to its 2016 Community Benefits Report.

Were still growing, Hinchey said.

Most recently St. Josephs/Candler unveiled a planned $62 million micro-hospital in Pooler with the first step to open in early 2019 on an 18-acre parcel on Pooler Parkway near the intersection with Interstate 16.

When built out over a 10-year period, the 170,000-square-foot facility will provide a health care campus that addresses the needs of west Chatham County and surrounding communities.

Pooler Mayor Mike Lamb said in February that the St. Josephs/Candler Pooler Campus is the type of expansion of services he has sought since he became mayor in 2004.

We constantly are looking for more and more medical facilities and doctors because it helps our citizens not to have to travel all the way to Savannah, Lamb said. Any steps that will help our citizens has got to be a big plus for our community.

The mergers goals

From the start, Hinchey said the merger, technically a joint operating agreement, is built on three goals:

Consolidating clinical services to pool talented caregivers in one location rather than have them fragmented

Eliminating duplication of services to provide care more efficiently

Creating a more robust community outreach to the underserved

It worked seamlessly, Hinchey said, adding the boards of the respective hospitals quickly moved from a St. Josephs Hospital, Candler Hospital mentality and morphed into a single entity. The two words became one word.

It required some shifts in programs between the hospitals. For example, St. Josephs moved its obstetrics and pediatrics programs to the Mary Telfair Hospital at Candler. Most cardiology moved to St. Josephs Heart Hospital as well as orthopedics.

The April 1, 1997, agreement came at a time when the three major local hospitals Memorial Medical Center (now Memorial University Medical Center) within blocks of Candler were involved in revolving talks to restructure the local health care provider systems.

Candler and St. Josephs began their talks about possible collaboration in March 1996, shortly after and partly because of Memorials announcement that it would enter into exclusive affiliation talks with Columbia/HCA, the nations largest for-profit hospital chain.

Shortly afterward, Candler ended its 18-month-old talks with Memorial and opened talks with St. Josephs and, on Jan. 7, 1997, formally approved creation of a proposed unified health system that would rival the countys largest health care provider in size.

Everybody had to give up something

Cecil Abarr, a retired Braniger Organization executive and community volunteer, was chairman of the Candler Hospital board of trustees when discussions began on joining with St. Josephs.

The environment for hospitals was bad all over the country at the time, he said. There were just too many of them. We were starting to feel the pinch here.

A group of hospital board members began kicking around what the future held, and a series of meetings followed. Among the concerns were the proposed merger of the Catholic and Methodist hospitals and how it would work, he said.

A lot of things about the structure (of the merger) had to be worked out, he said.

A series of frequent meetings involving Abarr, Harvey Granger, who chaired the St. Josephs board, Walton Nussbaum Jr. and Archie Davis, among others, resulted in the merger within 16 months.

After getting along with the discussions, they decided they needed to meet with Sister Margaret Beatty at St. Josephs and get her approval, Abarr said.

She wasnt a part of the final planning, she just approved it, Abarr said. She was very excited about how we got along.

Beatty then was president of the Baltimore Regional Community of the Sisters of Mercy in the Southeast and a board member at St. Josephs Hospital. She now is vice president for mission services at St. Josephs/Candler. St. Josephs is a Sisters of Mercy hospital.

Everybody had to give up something, Beatty said of the merger. Everybody was taking a risk. We formed these human relationships where it didnt make any difference which hospital was involved.

Board members were all prominent citizens of Savannah all extraordinary leaders, she said. We came at it as a team, I think.

Another key issue was who would be named to head the new entity, and Abarr said Hinchey was named by agreement of both boards.

This is a real merger because were all really intertwined with key department officials all working for the benefit of both hospitals.

I think thats one of the key things that worked, Abarr said. Really we look at it as one operation now. Its pretty much a joint deal.

He said concerns of working two faith-based groups has long since past, he said.

That hasnt impacted the whole situation, Abarr said. Oh, it has been a tremendous success. They really work well together. Theres no question.

The stars were aligned

The Catholic Church- based St. Josephs and United Methodist Church-based Candler shared very similar cultures. Both are faith-based with a common philosophy and vision, Hinchey said.

It was, he said, a textbook example of a board-driven operating agreement rather than a CEO-driven agreement.

He said such collaborations should proceed not too fast, but dont drag your feet either.

You lose momentum through delay, he said. You need to start acting like a good married couple.

And Hinchey said the local agreement allowed for a rapid consolidation with the first steps completed within six months, not the 18-24 months commonly seen in similar mergers nationally.

Hinchey, who had been president of St. Josephs since May 1993, became president/CEO of St. Josephs/Candler on April 1, 1997.

A new 19-member board of trustees was elected with seven by Candler, six by St. Josephs and three by the Sisters of Mercys Baltimore Community. After six years it became a self-perpetuating board representing everybody.

The stars were aligned in this deal, Hinchey said. We had the right people here at the right time a perfect governance match. They (trustees) thought St. Josephs/Candler, not St. Josephs and Candler.

Looking back, Hinchey said, I wouldnt change a thing about it. I never had any doubts about it, but I do have a healthy respect for the amount of work it takes to do it.

As I start my 25th year as CEO, I was blessed to be there from day one and am gratified to see where it is 20 years later.

Timeline:

Since St. Josephs/Candler was created in an April 1, 1997, joint operating agreement, the health system has expanded across the region and increased services to include 87 provider locations spanning 33 counties in southeast Georgia and South Carolina in addition to the 714 patient beds at St. Josephs Hospital and Candler Hospital. The locations span from Wayne County to Statesboro to Hilton Head Island.

The St. Josephs/Candler Medical Group has added primary care practices in Claxton, Abercorn-Southside, Pooler, Plaza D by St. Josephs Hospital, the Islands, Metter, Hilton Head Island, Bluffton and the office of Dr. Jose Rendon.

1997: Consolidation of Obstetrical Service. Mary Telfair Womens Hospital Birthplace is expanded at Candler Campus.

1998: Surgical Services at both hospitals are consolidated. Home Health agencies are consolidated - CareSouth/Advantage and CareSouth/Quality were formed. Health System begins management of Appling HealthCare System, Baxley, Ga. S.A.N.E. (Sexual Assault Nurse Examiner) program formed at Candler Hospital to help preserve forensic evidence in sexual assault cases. CareCall Center, a telephone health information, community resource and physician referral hotline, begins operations. Opened The Childrens Place, a comprehensive pediatric acute care program tailored to serve the special needs of children who are sick as well as the concerned parents.

1999: Earned the rigorous Network Accreditation from the Joint Commission on Accreditation of HealthCare Organizations. At the time, SJC was one of only 3 networks in the state to be accredited and one of only 55 in the country. Opened the African-American Health Information and Research Center to help improve the health of African Americans in Chatham County and address health disparities.

2000: Opened the St. Marys Community Center in the Cuyler-Brownville neighborhood

2002: Became the first in the region and second in Georgia to earn the Magnet Designation for Excellence in Nursing Service from the American Nurses Credentialing Center. Opened a Level II neonatal intensive care unit called the Special Care Nursery. The Screen Machine, a mobile cancer screening vehicle, begins operations to reach local and outlying populations.

2004: Completed $2 million renovation and expansion of the Georgia Infirmary. The St. Marys Community Center earned the prestigious Achievement Citation from the Catholic Health Association for connecting people in need with vital and life-changing services.

2006: Nancy N. and J.C. Lewis Cancer & Research Pavilion opens.

2007: The Lewis Cancer & Research Pavilion is named to the National Cancer Institutes Community Cancer Centers Program, now called the Community Oncology Research Program, to bring the latest research and treatments to Savannah.

2007: Opened the Good Samaritan Clinic in Garden City to serve patients without insurance.

2008: Was the first to bring the da Vinci Robotic Surgical System to the region. Opened the St. Marys Health Center on Drayton Street to serve those without insurance.

2009: Opened west Chathams first hospital-operated imaging center in Pooler, located next to the Medical Group Pooler practice. Acquired radiation oncology practice in Hilton Head.

2010: Acquired the regions first CyberKnife. Nancy N. and J.C. Lewis Cancer & Research Pavilion became the first institution of its kind to become a member of the Eastern Cooperative Oncology Group (ECOG), a cooperative network of cancer researchers, physicians, and health care professionals at public and private institutions across the country offering state of the art clinical cancer trials.

2011: Begins major expansion into the Bluffton and Hilton Head area with the addition of a wound and hyperbarics practice and later adding an imaging center and a specialty physician office space in addition to the primary care doctors already there.

2012: Partnered with a chemotherapy and infusion oncology practice in Hilton Head and Okatie to create the St. Josephs/Candler SC Cancer Specialists practice. Collaborates with Wayne Memorial Hospital to open a physician.

2013: Earned the Foster G. McGaw Prize for Excellence in Community Service. The Heart Hospital becomes the first in the region to receive full accreditation as a Chest Pain Center. St. Josephs/Candler becomes the first in the region to complete a Transcatheter Aortic Valve Replacement.

2014: $15 million renovation to the tower at St. Josephs Hospital completed.

2017: Completed a $21.6 million expansion and renovation of St. Josephs Hospital. Announced plans for a Pooler micro-hospital to open in 2019.

2016 St. Josephs/Candler Community Benefits

TRADITIONAL CHARITY CARE

Charity Care: $26,516,391 (Outpatient and inpatient services provided at cost for indigent patients)

Unreimbursed Care: $12,812,265 (Medicaid uncompensated care at cost for the underinsured and GA hospital tax)

TOTAL TRADITIONAL CHARITY CARE: $39,328,656

Other benefits

Community Health Improvement Services & Community Benefit Operations: $2,430,578

Health Professions Education: $53,761

Subsidized Health Services: $961,341

Financial and In Kind Contributions: $844,798

Community Building Activities: $282,844

TOTAL OTHER BENEFITS: $4,573,322

TOTAL COMMUNITY BENEFITS: $43,901,978

In addition to the nearly $44 million dollars in formal community benefits, St. Josephs/Candler provided $30,929,422 in uncollected service cost and uncompensated Medicare cost in Fiscal Year 2016.

TOTAL COMMUNITY ASSISTANCE: $74,831,400

2015 Total Community Assistance $67,932,941

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St. Joseph's/Candler still growing health care 20 years later - Savannah Morning News