Texas rural hospitals out of money as coronavirus threat looms

[Mike 03]

The Texas Tribune

Rural Texas hospitals should be staffing up to face coronavirus. Many can't afford to.

Public health precautions undertaken to slow the spread of COVID-19, such as the cancellation of more lucrative elective surgeries, will hit rural hospitals especially hard, administrators say.

At a time when most hospitals are ramping up capacity to treat a massive number of patients who may become infected with COVID-19, rural hospital administrators say financial hardships could force them to do the opposite.

Before the contagious new coronavirus arrived in Texas, rural hospitals already faced a bleak financial forecast. Demographic shifts, high shares of uninsured patients and cuts to the facilities’ Medicare payments have for years led hospital administrators to abandon small-town markets where they could not turn a profit. In Texas, 26 rural hospitals have closed since 2010, according to a rural hospital trade association; roughly 160 remain.

Now hospital administrators say necessary public health precautions undertaken to slow the spread of COVID-19, such as the cancellation of elective surgeries — which are one of the hospitals' most lucrative income streams — threaten to hasten the rate of closures. A 2017 study found that roughly 41% of rural hospitals in the U.S. operate at a loss.

"If we're not able to address the short-term cash needs of rural hospitals, we're going to see hundreds of rural hospitals close before this crisis ends," Alan Morgan, the head of the National Rural Health Association, recently told Kaiser Health News. "This is not hyperbole."

John Henderson, chief executive of the Texas Organization of Rural and Community Hospitals, said help "can't come fast enough."

“Facing critical supply shortages, maxed-out lines of credit, growing payables and disappearing revenue streams, cash-strapped rural Texas hospitals are having to make layoffs to meet payroll,” he said. “And this is happening in a moment when we must build and sustain surge capacity.”

At Rolling Plains Memorial Hospital, a facility in Sweetwater that’s licensed for 86 beds but typically operates only about 35, there are six intensive care unit beds available in case of a surge in patients with COVID-19, the disease caused by the new coronavirus. The hospital, west of Abilene, has three ventilators and could add two that are in ambulances, said Donna Boatright, the hospital’s administrator. She and other administrators said they were getting creative to stretch a limited number of staff members, including cross-training nurses from other wards in preparation for ICU shifts.

Read more: https://www.texastribune.org/2020/03/24/texas-rural-hospitals-out-money-coronavirus-threat-looms/

This, unfortunately, is a horror story that will repeat itself in many rural locales where hospitals struggle.

[Hoyt]

1. Having worked in rural hospitals decades ago, they are not where I'd go in respiratory distress.

Some rural areas have closed their small hospitals and opened small emergency rooms that can stabilize a patient for ambulance or helicopter transport to better equipped hospitals.

[walkingman]

2. This crisis has highlighted the shortcomings of our healthcare system. Hopefully that will change

some things in the future with a Democratic POTUS!!

[Igel]

3. This won't be one of them.

Go with Medicare for All, universal healthcare, whatever you want, and you find that governments have most of the same constraints as businesses: There's a budget and things have to work in that budget.

Then add on the politics: Small-town politicians have less power than larger urban centers. Money follows power when it comes to government. Countries tend to like that, the press is urban and likes that, we travel and see urban areas and like that. Politicians certainly like that.

But it's the usual urban/rural divide, and urbanites rule in their own interests and mostly for themselves and very seldom have an inkling as to why the inferior people in rural areas don't see how what the urban areas do in terms of rule is really the best for everybody.

[walkingman]

5. I tend to agree with you. As someone that live in rural Texas and there are only 3 Democratic

couples in a 10 mile radius of us. Admittedly we do live in ranch country so not a lot of density and ironically when we moved here 33 years ago the county and everyone was Democrat. But in '94 with the Bush/Richards election the entire area turned Republican and has been that way ever since. I never noticed such divide back then but now it is unbelievable. Then with Rick Perry being elected it fit like a glove for these folks.

My neighbors just despise liberals (openly), worship Cruz and Cornyn, and think Trump is the second coming. All constantly talk about someone "taking their guns" and the usual GOP wacko stuff.

I'm not sure what it will take for Texas to turn BLUE in rural Texas again - I seriously doubt it will happen. I was hoping that things would change before I died but it's not looking that way but who knows?? Austin is rapidly moving out this way so we are becoming more suburban than rural these days and with that we even have a new hospital which I would have never though would happen.

As far as "inferior people"?? I haven't changed... but I do think they have through the years. Much more redneck that I remember in the past?? I think it's kind of sad.

[duforsure]

4. From trump and the GOP cuts to Medicaid and Medicare

Some were already getting into a position where they didn't have enough coming in to support the business.this will devastate many of them now.