City Council members didn't speak much last night. They asked a few questions, sure, but no one gave much of an idea as to which way they'd be voting when the Middlebook Pike rezoning on which Tennova wants to build a new hospital comes back before them in a few weeks.
Mark Campen, who represents North Knoxville, has already made his position known -- he's against it. Marshall Stair has said he'll abstain from voting -- one of the partners at his law firm, John King of Lewis, King, Krieg, and Waldrop, is representing Tennova. (Why Stair sat through last night's almost two-hour workshop anyway we aren't quite sure.) George Wallace wasn't there. Neither was Mayor Madeline Rogero, who could have a tie-breaking vote if Council splits 4-4 on the project, since Stair is abstaining. (Two of Rogero's chief deputies, Bill Lyons and Bob Whetsel, were, however, in attendance.)
What was clear after last night is that the two sides are bitterly in disagreement with each other. Tennova, which bought Mercy (which bought St. Mary's), and which is currently in the process of being bought out by Nashville's Community Health Systems, says Physicians Regional Medical Center, the North Knoxville hospital complex that will forever be known as St. Mary's even if that's not its official name, now needs to be replaced, and it needs to be replaced further west. But West Hills residents say they don't want a hospital near their neighborhood, and North Knoxville residents don't want their nearest medical center to leave.
Judging from the presentations last night, both sides seem to have valid points. Sure, it's easy for opponents to dismiss Tennova's Melanie Robinson after she claimed it was hard for the company to make the decision to leave North Knoxville. "We love that neighborhood. We've been there 84 years," Robinson said. Well, a hospital has, but Tennova sure hasn't. And when Robinson showed the costs Tennova sucks up for uninsured patients in Knoxville -- $58.4 million at St. Mary's, versus $20.8 million at their North Knoxville Medical Center and $16.8 at their facility in Turkey Creek -- it's easy to to jump to the conclusion that a for-profit hospital might totally want to move to a neighborhood with less poor people, because, you know, profits.
But when Tennova's architect, Marc Rowland of Thomas, Miller & Partners in Brentwood, spoke, he sounded convincing. "I've been designing hospitals for almost 30 years, and I've never seen one this dysfunctional," Rowland said. He called the site layout "a nightmare" and pointed out that operating rooms are underground.
We spoke to Rowland after the meeting and asked him why it was that St. Mary's was so un-renovatable. After all, Erlanger in downtown Chattanooga still has its original 1891 building in use on its campus, and hospitals in other cities have done the same. If other hospitals can preserve old buildings and make them work, why has St. Mary's "outlived its lifespan," as one critic had stated earlier in the evening?
"It really has to do with decisions that were made over the years," Rowland said. "Most older hospitals still in use have what I like to say are good bones. St. Mary's does not." He said because the hospital is built into the hillside, turned at an angle, it would be "very, very hard" to renovate. "The bottom line is they could spend more money on the old campus, and it'd still be a compromise," Rowland said. He estimated it'd take a lot more than the $250-300 million Tennova is planning on spending for its new facility.
Yet opponents of St. Mary's closure made good points, too. Why not wait for the state to issue its Certificate of Need (CON) before approving any rezoning? Why not wait and see if the CHS acquisition goes through? Why not wait to see how financially stable the merged business is?
"There is so much uncertainty it would be irresponsible for Council to rezone for a hospital that may very well be a mirage," said Rocky Swingle, the head of the opposition group Friends of Middlebrook. "I ask you to stand with us, the residents, the people who voted you into office, who live here, work here, are retired here, who aren't going anywhere, who pay taxes. Not with a company based in Florida, effectively controlled by a New York hedge fund and soon to be -- maybe -- merged with another company from Nashville. ... Stand with us and say no to this rezoning."
But the point Old North Knoxville resident Lauren Rider made is one that no one can deny is true. "A loss of this size would be substantial to our neighborhood," Rider said. "Pharmacies will struggle. Businesses will lose customers."
When the former Baptist Hospital on the banks of the river in South Knoxville closed, everyone knew something would eventually happen to the site. It's prime real estate. And it's taken years, but redevelopment is finally on the way. But in North Knoxville? Sure, Happy Holler and Old North Knox are gentrifying, but is some developer really going to want to swoop in and handle the cost of tearing down all those old (probably asbestos-filled) buildings to build student housing or town homes on them? Not likely, not for a long time.
Meanwhile, the sizable non-gentrified population of North Knoxville, a large chunk of who don't have reliable transportation, would be stuck taking the bus for a hour or longer to get to doctor's appointments. It's not a great situation. But if as many doctors are leaving St. Mary's because of the facilities as Tennova says, then there might not be any doctors for them to visit anyway. (It should be noted here that Dr. A.B. Kliefoth, a neurologist who has practiced at St. Mary's, said last night that most of the doctors have left due to crummy administrative practices by Mercy and Tennova. Another St. Mary's doctor, speaking on behalf of Tennova, said this wasn't true.)
In any case, you should expect a heated Council meeting whenever this gets set on the agenda, which could be Sept. 17. We honestly have no idea how this will turn out.