- Rural Hospital Closures, Conversions, and Re-openings
- Staff Spotlight: Hannah Friedman
- Rural Emergency Hospitals
- Rural Population Health Chartbook
- Service Outside Our Center
- In the News
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Rural hospital closures & reopenings |
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Since our Fall 2022 newsletter, six rural hospitals have closed or converted, and one has reopened. We are also reporting the first conversion to a Rural Emergency Hospital (REH). We believe there may be others, but we are refining our confirmation process to report consistently moving forward. This is a rapidly developing story. Stay tuned for updates soon.
Below are summaries of each closure and conversion situation. Since 2005, 190 rural hospitals have closed (1 conversion to REH/88 conversions to other services/101 complete closures-providing no health care services). Sixteen additional hospitals closed but have since reopened. Visit our website for a complete list of Currently Closed Rural Hospitals.
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St. Mark's Medical Center – La Grange, TX, ceased inpatient services on February 18, 2023. The hospital board announced the closure in a press release less than a week before closing, saying that they are pursuing a Rural Emergency Hospital (REH) conversion, which requires them to have 24/7 emergency care, select outpatient services, and no inpatient care. In addition to cutting services, they are laying off 64 of their 144 employees.
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Falls Community Hospital and Clinic – Marlin, TX, a Sole Community Hospital, ended inpatient services in February 2023 and is pursuing conversion to a Rural Emergency Hospital (REH). A phone call to the hospital confirmed that they no longer provide inpatient care, but do provide emergency care services. However, due to difficulties confirming official REH status with the Centers for Medicare & Medicaid Services (CMS) and the hospital, we are not reporting it as an REH conversion yet.
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Crosbyton Clinic Hospital – Crosbyton, TX, previously a CAH, ceased inpatient services and officially converted to an REH on January 30, 2023. It is the first hospital to convert to an REH status since the designation was created in January. A phone call with hospital administration confirmed they received a letter from CMS terminating CAH status and providing a new REH certification number. Crosbyton currently offers ED, Lab, Rehabilitation, and Radiology services.
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St. Margaret's Health – Peru, IL. On January 28, 2023, St. Margaret's Health-Peru, a Medicare Dependent Hospital, temporarily suspended all hospital services. The system cites lack of funding, a recent cyber-attack, the high cost of traveling nurse wages, staff shortages, and the hospital’s emergency room provider terminating their contract for the sudden closure. They hope to reopen eventually as a Rural Emergency Hospital (REH), but will need state permission and plan reviews that may take a long time. St. Margaret’s Health has another hospital four miles away in Spring Valley, IL, but the Peru hospital was the only one with an obstetrics unit.
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AllianceHealth Clinton – Clinton, OK. AllianceHealth Clinton, a 45-bed Sole Community Hospital, closed on December 31, 2022 when AllianceHealth’s lease agreement ended. According to the hospital authority, AllianceHealth canceled state and federal licenses instead of transferring them to the new operator before closing, so they must apply for a new license and Medicare provider agreement before they can restart operations. This includes obtaining all new permits as well, which may take up to a year to complete. 192 employees lost their jobs.
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Ascension St. Vincent Dunn – Bedford, IN. On December 16, 2022, Ascension St. Vincent Dunn hospital ceased providing all health care services. After failing to find a buyer for the hospital, Ascension announced in September that it would close the hospital along with all 11 of their walk-in clinics in the county. The hospital was one of two Critical Access Hospitals in the town of Bedford, located within two miles of each other, but it was the only one that offered labor and delivery services.
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Haywood Park Community Hospital – Brownsville, TN. On December 31, 2022, Haywood Park Community Hospital reopened fully as an acute care hospital. The hospital originally closed in 2014, and during the first phase of the reopening, the facility opened as a rural health clinic and changed its name to Haywood County Community Hospital. A recent call to the hospital confirmed that, as of December, they are fully functional with an emergency department and inpatient services.
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One of the perks* to life at NCRHRP is working with up-and-coming health services research leaders like
Hannah Friedman. Hannah is a PhD Candidate in Health Policy and Management at UNC-Chapel Hill, an AHRQ NRSA Pre-doctoral Fellow, and a NC Rural Health Research Program Graduate Research Assistant. As her titles show, she wears many hats. We are lucky to have someone with her skills and diverse interests. She has contributed to projects on rural hospital closure patterns, rural hospital access, rural-urban Medicaid utilization, rural cancer caregivers and barriers to care, and to a study evaluating the needs of primary care practices during the COVID-19 pandemic. Prior to her graduate work at UNC, she worked as an analyst at RTI International where her primary role was assisting with the development of health care quality measures for CMS in post-acute care and hospice settings. Most recently, Hannah co-authored a New America Policy Report: Health, Work, and Care in Rural America. The report examines access to paid leave and hospital-based health services in rural America, finding that rural communities are three to four times further from important types of hospital-based health care than those in urban communities and have less access to paid family and medical leave and paid sick time.
We are also excited to share that Hannah has accepted a postdoctoral fellowship at the Boston Veterans Affairs' Center of Innovation, the Center for Healthcare Organization and Implementation Research (CHOIR), where two of her projects will have rural aims. Outside of work, Hannah enjoys baking, playing tennis, swing dancing, and trivia. In fact, she once had the chance to audition for Jeopardy! I’ll take "Rural" for a thousand, please! Thank you, Hannah, for contributing so much to our team! Boston got lucky to snag a gem like you!
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Rural Emergency Hospitals |
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Publishing more recent financial data for REH-eligible hospitals provides comparative information for hospitals considering conversion to REH. The data for the three rural hospitals interested in conversion provide some real-life examples of hospitals that might convert to REH. Visit our website to see our REH portfolio.
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Service Outside Our Center |
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Dr. George Pink, NCRHRP Deputy Director and lead investigator for our REH research, is also serving as an advisor to the Rural Emergency Hospital Technical Assistance Center, funded by the Federal Office of Rural Health Policy to assist hospitals considering REH conversion. January was the first month hospitals could apply for REH status. Now that hospitals can apply for conversion, we are looking forward to transitioning from predictions of what might happen to helping new REHs succeed.
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Dr. Mark Holmes, NCRHRP Director, and Dr. Pink presented at the February 2023 National Rural Health Association Policy Institute in Washington, DC. Mark (pictured right) presented some recent findings of the National Advisory Committee on Rural Health and Human Services, and George presented Risk and the Rural Emergency Hospital.
Dr. Pink also presented Rural Hospital Closures and Financial Trends (and why the REH has arrived) at the February 2023 American Hospital Association National Conference in San Antonio, TX.
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Population Health Chartbook |
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On February 7, 2023, we released the Rural Population Health Chartbook. While there are numerous data sources and chartbooks available, these sources are not usually designed to highlight rural-urban disparities in population health, nor do they provide an in-depth look at the data.
Our chartbook presents a full range of U.S. rural population health data areas across multiple geographic areas (county, state, Census division, Census region). When looking at data like these, it is important to consider the data range or distribution, not just the average, because the data points may cluster in one direction or another, and interpretation may become difficult or misleading. Similarly, focusing exclusively on averages may cause us to overlook sub-problems. A national average can conceal rural, regional, and/or state issues; and likewise, a state average may conceal a problem in many of its counties. This is particularly important when making rural-urban comparisons due to the wide range of geographic variation across the U.S.
We include 33 indicators to describe population health in rural America and document health disparities between rural and urban areas. The indicators are organized into five domains: Access to Care, Health Outcomes and Risks, Mortality, Social Determinants of Health, and Socioeconomics.
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Our 2022 list of U.S. hospitals is ready! Each year, we compile a list of operating U.S. Hospitals as a downloadable resource for the public. The spreadsheet includes acute care hospitals (Critical Access, Cancer, Indian Health Service, Medicare-Dependent, Rural Referral Center, Sole Community, and Prospective Payment System Hospitals), and specialty hospitals (long-term acute care, children’s rehabilitation, psychiatric, and religious hospitals), their addresses, bed counts, rural/urban definitions, CMS rural payment designations, and more. The current U.S. Hospital List (2022) includes hospitals that were open as of January 1, 2022.
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Acknowledgement: The Federal Office of Rural Health Policy (FORHP), Health Resources and Services Administration (HRSA), U.S. Department of Health and Human Services (HHS) funds three of the programs that support our work. The information, conclusions and opinions expressed in this document and those linked to it are those of the authors and no endorsement by FORHP, HRSA, HHS, or The University of North Carolina is intended or should be inferred. |
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*"perk": This word choice led to some internal debate as we were drafting this newsletter. “Perk” is short for “perquisite”, meaning a benefit. One person thought that we should use the abbreviation “perq” which, while perhaps more true to its linguistic origins, is not the preferred spelling by most dictionaries and style guides and is not even considered acceptable in many sources. So now you know. Thanks for joining us on this journey. 😉
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NC RURAL HEALTH RESEARCH PROGRAM
CECIL G. SHEPS CENTER FOR HEALTH SERVICES RESEARCH
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Have feedback on this newsletter or suggested content for future newsletters? Contact Kristie Thompson.
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