rural hospitals

David Usher, chief financial officer for a 12-bed rural hospital in western Kansas, is sitting on $1.7 million he's scared to spend.

The money lent from the federal government is meant to help hospitals and other health care providers weather the COVID-19 pandemic. Yet some hospital administrators have called it a payday loan program that is now brutally due for repayment at a time when the institutions still need help.

A Miami entrepreneur who led a rural hospital empire was charged in an indictment unsealed Monday in what federal prosecutors called a $1.4 billion fraudulent lab-billing scheme.

By this time next week, Decatur County, Tenn., will have lost its only hospital, Decatur County General, which has been serving the rural community of about 12,000 people along the Tennessee River since 1963.

The hospital's human resources director, Melinda Hays-Kirkwood, has already begun laying off people, and she says by next week only a skeleton staff will remain.

"It's hard on these employees that have been here a long time. I've got people who have been here for 30 years," Hays-Kirkwood says. "For some people, this has been their only job out of college."

Rural hospitals face “catastrophic cash shortages” brought on by the COVID-19 crisis and need congressional action to save them, according to a Leawood, Kansas, advocacy group that represents hundreds of rural hospitals.

In a letter Monday addressed to the leaders of the U.S. House and Senate, the National Rural Health Association asks that 20% of the $100 billion in funding for hospitals in the CARES Act, the $2 trillion coronavirus response bill passed by Congress last month, be set aside for rural providers.  

Dr. Max Self grabs a sanitary wipe and cleans off the small flashlight in his hands. More than 20 years as a family doctor in rural Fort Scott, Kan., has taught him a few tricks for dealing with little kids: "I've got my flashlight. See? Look, you want to hold it?"

Though its Medicaid contract is still at stake, Aetna Better Health is making progress, Kansas lawmakers and state regulators said this week. 

“There has been a good response from them,” Kansas Secretary of Health and Environment Lee Norman told a panel of lawmakers Tuesday.

Go here to subscribe to the My Fellow Kansans podcast. This season, we look at the prospects of rural places.

ANTHONY, Kansas — Few things signal a rural community’s decline more powerfully than the closure of its hospital.

Like shuttered schools and empty Main Streets, an abandoned hospital serves as a tangible reminder of the erosive power of decades of population loss and unrelenting economic trends.

The Texas Tribune

Next Tuesday at West Texas A&M University, the Texas Tribune will be presenting a public event entitled "Underserved: A Conversation on Rural Health Care."

For decades, the populations of rural Texas have been stagnant or declining. Scores of rural hospitals have closed in recent years, and rural residents of the Texas Panhandle have seen their access to proper medical care become increasingly limited.

In the central Idaho community of Arco, where Lost Rivers Medical Center is located, the elk and bear outnumber the human population of a thousand. The view from the hospital is flat grassland surrounded by mountain ranges that make for formidable driving in wintertime.

"We're actually considered a frontier area, which I didn't even know was a census designation until I moved there," says Brad Huerta, CEO of the hospital. "I didn't think there's anything more rural than rural."

One Monday in February, 65-year-old Karen Endicott-Coyan gripped the wheel of her black 2014 Ford Taurus with both hands as she made the hour-long drive from her farm near Fort Scott to Chanute. With a rare form of multiple myeloma, she requires weekly chemotherapy injections to keep the cancer at bay.

She made the trip in pain, having skipped her morphine for the day to be able to drive safely. Since she sometimes “gets the pukes” after treatment, she had her neighbor and friend Shirley Palmer, 76, come along to drive her back.

Three Kansas hospitals are among six hospitals once run by a North Kansas City-based company that have filed for Chapter 11 bankruptcy protection.

This story was updated to add the comments of Kansas Gov. Laura Kelly.

Oswego Community Hospital, a 12-bed critical access hospital in southeast Kansas, abruptly closed down on Thursday, citing insufficient revenue to cover its operating expenses.

The hospital’s board released a statement saying the hospital had “weathered low patient volumes; high number of uninsured patients; low reimbursement rates; difficulty in getting payment from private insurance providers; low Medicaid and Medicare rates; and the state’s refusal to expand Medicaid.”

Rural hospitals aren’t just providers of medicine and health care, but also are often major employers and a massive part of a town’s tax base. However, mounting challenges are forcing these hospitals to merge and close in droves.

TexasExplorer98 / Flickr Creative Commons

On a recent report card comparing rural health care among states, Texas received a grade of D-.

The report card, published last month by researchers at Texas Tech University, compared several key metrics including mortality, quality of life and access to care.

This story was updated at 4:24 p.m. to include comments from the CEO of McPherson Hospital.

Two Kansas hospitals have been selected to take part in a federal demonstration program aimed at ensuring access to health care in underserved areas.

The two, McPherson Hospital in McPherson and Morton County Health System in Elkhart, were among 13 nationwide chosen for the demonstration project being conducted by the Centers for Medicare and Medicaid Services (CMS).

No one at the hospital in Fulton, Missouri (population 12,790) had ever heard of a management consultant named Jorge Perez until he showed up at its potluck in September.


$1.25 million.

That’s the size of the bill that could have shuttered the only public hospital in rural Pemiscot County, Missouri in August 2013.

$750,000 for payroll. $500,000 for a bond payment. $1.25 million total. One August day in 2013, the hospital’s CEO Kerry Noble had to face facts: The money just wasn’t there. It took an emergency bailout from a local bank to keep their doors open. For now.

Nyttend / Wikimedia Commons

More than half of U.S. rural counties have no hospital where women can give birth, according to MinnPost.com.

According to a new study by the University of Minnesota, over the past decade, the number of U.S. rural counties without obstetric units increased by 50 percent.

This means that rural women are at greater risk of birth-related complications than previously realized.

Public Domain

Washita county, in western Oklahoma, has given up on the Women, Infant, and Children program, The Oklahoman reports.

The WIC program provides nutrition services to young children and pregnant women. The announcement came from the Cordell Memorial Hospital, who administers the program. Officials said they can no longer afford to provide the nutrition for free to local mothers and children.

When evening falls, Brian Hunt makes his way to a comfortable chair in a sun room on the south side of his house near La Cygne, Kansas. But he’s not settling in to relax. He’s going to work.

Rural Western Oklahoma hospital will re-open

Jun 12, 2017
Dale Denwalt / The Journal-Record

Despite a years-long crisis that has led to dozens of rural hospital closures across the U.S., there are signs of life for at least one facility in Western Oklahoma.

RJ Sangosti / The Denver Post

Colorado Republicans have now pulled the plug on a bill that sought to repeal the state’s health care exchange, reports The Denver Post.

Meanwhile, rural hospitals received a bit of good news. The Colorado Legislature has passed a bill preventing $528 million in cuts to hospital funding. Some conservative lawmakers opposed the bill, as they say it will only lead to more spending and debt. Instead, they said the measure should have gone to the voters.

Creative Commons CC0

Colorado lawmakers heard testimony Tuesday about the financial difficulties facing much of rural Colorado, which helped a bill aimed at preventing cuts to rural communities in the state pass its first test.

As The Denver Post reports, officials from rural schools, hospitals and business groups testified about the dire financial situation facing much of rural Colorado – a situation that they fear will only get worse in coming years.

AgWeek

In an opinion piece this week, the editorial board of the weekly agricultural newspaper AgWeek insisted that rural health care has reached a dire state, and must be addressed now.

When it comes to heath care, writes AgWeek, “the worry is greater today than it's ever been.” Hospitals have been closing across rural America at a troubling pace. Many agriculturalists have taken jobs away from the farm, just so they can have health care.

Helen H. Richardson / The Denver Post

The Colorado Legislature is proposing a major overhaul to the state’s budget, in a move that would redirect money toward rural schools and roads.

Creative Commons

The Colorado Legislature has proposed a series of deep budget cuts that could cause rural hospitals across the state to close.

StatNews.com

In recent years, rural hospitals have struggled to survive in the United States, and many have closed. But in the small West Texas town of Childress, the hospital is thriving against all odds.

Trump's travel ban could worsen rural medical crisis

Feb 6, 2017
Creative Commons

In the past, HPPR has reported on the fact that rural America has been struggling to find enough doctors to serve its populace.

healthline

Rural living has long been thought to be healthy for the body and the soul. But a new article in Healthline disputes this notion, with an essay provocatively entitled, “If You Want to Die Young, Move to Rural America.”

The truth is, when it comes to the five leading causes of death, rural dwellers lag behind inhabitants of America’s cities.

Dodge City Medical Center (DCMC ) will join clinics in Garden City and Ulysses as a partner of Colorado-based Centura Health.

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