Hospital Closures Rattle Small Towns

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By Sarah Varney, Kaiser Health News

 

For years, Sybil Ammons was the director of nursing at Stewart County’s only hospital. Now, she’s the county coroner.

 

Since the hospital here closed three years ago, Ammons says more than a dozen local residents were unable to get medical care quickly enough and were either harmed or died because of the delays. “We’ve had a stroke, several heart attacks,” she said, standing along Richland’s main street in this small town about 150 miles south of Atlanta. “We’ve had traumas out on the four-lane

 

Across the country, more than 50 rural hospitals have closed over the last six years, and another 283 are in fragile financial condition, according to the National Rural Health Association. With rural populations long in decline in the United States, small-town hospitals have lost customers and struggled to keep pace with the striking advancements in medical technology.

 

But the pace of closures has escalated in recent years, hastened by a series of budget control measures passed by Congress that reduced Medicare payments and by the Affordable Care Act, which is slowly restructuring the health care industry. The law rewards scale and connectivity — difficult goals for rural hospitals that are, by their geographic nature, low-volume and remote.

 

Compounding their financial troubles, 19 states have not taken advantage of a key provision in the health law to expand their Medicaid programs. That’s left many rural hospitals with uninsured patients just as federal subsidies for taking care of the uninsured are being reduced.

 

As hospitals have closed in Georgia, hundreds of people have lost their jobs, and many small towns have been left reeling.

 

When the Lower Oconee Community Hospital in Glenwood, two and a half hours southeast of Atlanta, abruptly laid off its workers, transferred its remaining patients and locked the front door nearly two years ago, it was yet another blow to a rural town accustomed to hardship.

 

The hospital was the town’s largest employer and without the daily traffic from its 100 employees and families and friends of its patients, the town’s only restaurant closed, followed soon by its only bank.

 

“After the hospital closed, we dropped about 30 percent sales,” said D.K. Patel, owner of the local grocery store that sits on the edge of Glenwood’s town square. “All I can say is it’s been hurting a lot.”

 

The town’s mayor, G.M. Joiner, who has held his elected post for three decades, and whose father was mayor before him, laments the hospital’s decision to close. “It was our lifeblood,” he said. “It’s not overemphasizing or trying to be a doomsday prophet, but it’s devastating.”

 

Joiner has been courting suitors for the shuttered hospital, but with little success. The building sits eerily abandoned. At a nurses’ station, antiquated security cameras flicker between images of empty hallways and patient rooms with the beds still crisply made; dead cockroaches litter the floors; vials of patient blood sit in refrigerators, long ago unplugged, in the hospital laboratory.

 

For many residents, the disruption in medical care caused by the hospital closures has been deeply unsettling and, for some, life threatening.

 

It only takes one tragedy to realize how detrimental losing this facility is.

 

For more information, go to www.khn.org

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