And then there were three again.
Doctors Hospital of Augusta filed its letter of intent Friday to seek a certificate of need to build a hospital in Columbia County, the state’s largest county without one.
University Hospital filed its letter of intent April 30, and Georgia Regents Health System filed Tuesday. State law requires such a letter 30 days before seeking a certificate of need.
Doctors Hospital said it would seek to build a 100-bed hospital at 745 N. Belair Road in Evans. It estimated the cost at $150 million.
Both University and Georgia Regents Health also are seeking a certificate to build a 100-bed hospital, but University pegged the cost at less than $144 million and Georgia Regents Health said it would be $195 million.
A Georgia Regents Health official said if it were granted a certificate it would seek an additional one to add beds for other services, such as pediatrics and obstetrics.
Doctors Hospital would seek to use an exception to the normal needs standards that would allow a project to proceed if the county supplies 20 percent of its cost, spokeswoman Lindsay Thetford said.
Doctors Hospital hopes to gain a trauma center designation this summer, in which case it might use an exception that allows existing trauma centers to circumvent the needs standards, she said. The other exception is for existing teaching hospitals.
Georgia Regents Health said it will use the trauma and teaching exceptions; University has said it would use the 20-percent exception but cover the county’s portion through property taxes on the new hospital.
Officials have acknowledged it would be difficult to meet the normal needs standards because of the number of beds licensed for Augusta hospitals. The 20 percent exception has been used by other hospitals to justify a larger hospital expansion, but not for a new hospital.
Because the certificates of need will be filed within 30 days of each other, the Georgia Department of Community Health likely will rule on the applications together.
After the last application is deemed complete, which might take a couple of weeks, the department will have 120 days to rule, making a decision on the bids likely before the end of the year.
The state used a similar process with separate applications from University and Doctors hospitals to build freestanding emergency departments in Columbia County, but the state rejected them last year because it ruled the county is adequately served by hospitals in Augusta.
The Columbia County Commission has voted to support all three applications and said it will work with the one that is awarded a certificate of need.