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Rural Hospital Closures Climb Rapidly

For a brief time, the number of rural hospital closures seemed to have stalled. Despite a rising number of hospitals operating at a loss, and regardless of Congressional inaction, rural hospitals were managing to hold on. Then the summer brought a rush of hospital closures, a landslide that’s continued into the fall. Now, as of October, 89 rural hospitals have closed since 2010, leaving millions of rural Americans without access to quality, local care.

Pauls Valley Regional Medical Center, Oklahoma, October 2018
A rural Sole Community Hospital in Oklahoma, Pauls Valley Regional Medical Center has shut down. The nearest hospitals to the Pauls Valley Community, in Arbuckle and Purcell, are each about 30 minutes away. Emergency services will be provided by the hospital in Purcell for the time being.

More than 130 employees will be losing their jobs following the closure. Pauls Valley already had an unemployment rate above the national average and health care jobs represented a greater percentage of the economy. Even before the closure, the median income was already below the national average by $18,302. Susan Reeves Gullion, a now unemployed medical receptionist told local news, "Us employees really worked hard to save the hospital and our jobs. Not only is there no hospital to go to, we also do not have a job."

Ripley County Memorial Hospital, Missouri, October 2018
A rural Medicare Dependent Hospital, Ripley County Memorial in Doniphan, a southeast Missouri community, closed on October 15, 2018, the fifth hospital to close in the state since 2010. Local news sources report that the hospital will continue to provide outpatient services until a new operator, Missouri Highlands Health Center, assumes responsibility in December. That being said, emergency services in the area will not return, as Missouri Highlands plans to convert the Emergency Department to an Urgent Care Clinic that’ll provide service from 10 a.m. to 10 p.m. Poplar Bluff is the next closest hospital providing emergency services, 39 miles east of Doniphan.

McKenzie Regional Hospital, Tennessee, September 2018
A rural PPS Hospital, McKenzie Regional Hospital shut its doors in September, after an announcement in July that its closure was imminent. 5,000 people in the community relied on the hospital, which provided essential emergency services in the community for more than 44 years.

Mayor Jill Holland told local news that she is seriously concerned that without the hospital, businesses will choose not to relocate to McKenzie, a rural town already struggling economically. Mayor Holland's biggest fear is for patients who need critical medical care and will now be forced to drive significantly further when suffering from a stroke or heart attack. In her words, "there will be people that die as a result of this.”

Chestatee Regional Hospital, Georgia, July 2018
Chestatee Regional Hospital, another rural PPS hospital, in Dahlonega, Georgia, shut its doors on July 26. Northeast Georgia Health System, located in Gainesville, has agreed to purchase the hospital. Still, it may take up to a year before the hospital reopens to provide services to rural Georgians in the area, where it was the only emergency room in the county.

Stamford Regional Hospital, Texas, July 2018
Texas, a state with some of the most rural hospital closures in the country, lost another rural PPS hospital in early July. The cause of Stamford’s closure, according to those working in the hospital, were declining patient volumes and inflexible federal policies. In a statement, Stamford Healthcare System said its board and staff had "worked tirelessly over the past few years to keep inpatient and emergency room services available as long as possible… Unfortunately, the plan did not move forward. Recent Medicare laws require an average of two inpatients per day to continue Medicare funding… The decision was made to discontinue the hospital inpatient services due to a steady decline in hospital inpatients over the past 10 years." According to the statement, Stamford’s average inpatient number for the hospital was 2.6 in 2007 declining steadily to 0.48 for the first half of 2018, well below the Medicare requirement of 2 daily patients.

The hospital was responding to the needs of the community by providing predominantly outpatient care, however, Medicare does not currently recognize such a facility as a hospital though multiple bills introduced in Congress such as the Save Rural Hospitals Act would have allowed this community to keep their hospital. The community lost 54 jobs and emergency care.

Twin Rivers Regional Medical Center, Missouri, June 2018
Twin Rivers Regional Medical Center, a 116-bed rural PPS Hospital in Kennett, Missouri, closed June 30. Twin Rivers closure became one of the biggest hospital closure stories of the summer when New York Times writer Jack Healy wrote on the effects of the hospitals closure, and the community’s subsequent loss of obstetrics services, on expecting mothers. The medical center’s 259 employees lost their jobs, and thousands of local residents are now forced to travel miles to care. Expecting mothers are 100 miles away from the nearest hospital offering obstetrics services.

Coalinga Regional Medical Center, California, June 2018
This California Sole Community Hospital announced its closure in early June, beginning the onslaught of rural hospital closures. The hospital cited a decline in inpatient volumes and significant financial losses as the primary reasons for its closure. The hospital closed its rural health clinic in late May, prior to the hospital’s closing. At the time of closing, approximately 40 residents remained in the hospital's skilled nursing facility and had to be transferred to other nursing homes. 200 people lost jobs in the hospital’s closure.

It’s Time to Save Rural
In rural America, health care is a pillar of the community. It helps to create and foster a sustainable and livable environment for rural Americans, and without health care, without a hospital, a rural community will crumble. As John Henderson, CEO of Childress Regional Hospital in Texas explains, “Hospitals, schools, churches. It’s the three-legged stool. If one of those falls down, you don’t have a town.”

A multifaceted approach is necessary to address the struggles of rural hospitals. All of these pieces are included in the Save Rural Hospitals Act.
  • Ensure rural providers reimbursement rates are sufficient to allow them to keep their doors open.
  • Support measures that reduce the cost of providing care including through regulatory relief efforts that reduce costs without negatively impacting patient care.
  • Create new models that allow communities to retain necessary access to local care including a local emergency room while right sizing their facilities to flexibly meet the needs of the specific community.

Together, these policies can all begin to bring rural health care into the 21st Century and ensure its successful future. Now is the time for Congress to take action to stop more rural hospitals from closing. Ask your member to co-sponsor H.R. 2957, the Save Rural Hospitals Act today.

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