COVID-19 funding halted rural hospital closures throughout Texas, till now

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LA GRANGE — A final ditch effort to save lots of St. Mark’s Medical Middle failed this week, forcing the one hospital in Fayette County to shut amid ongoing monetary struggles.

The 18-year-old hospital introduced final week that it might shut on Thursday, eliminating greater than 50 full and part-time jobs in La Grange, a rural city of about 4,400 folks.

On Monday, as sufferers trickled out and in of the hospital to say goodbye to their favourite receptionists and to select up medical data, a non-public firm known as Progressive Well being Group emerged to attempt to assist maintain the hospital afloat.

An emergency assembly was known as on Wednesday afternoon, however the hospital board determined to proceed with the closure as deliberate. Board president Dudley Piland mentioned there have been too many unanswered questions and inadequate time to investigate the funds of Progressive Well being Group.

“It was an important hail mary,” Piland mentioned. “Had it occurred weeks earlier, we most likely might have taken a special path. We had been simply to date down this path that reversing it with out strong data was not possible.”

St. Mark’s closure marks Texas’ first rural hospital closure because the COVID-19 pandemic began in early 2020. Federal reduction funding helped stave off hospitals’ closures over the previous two years, however now that the funding has dried up, Texas hospitals, particularly these in rural areas, are once more liable to shuttering. A 2022 report discovered that the % of Texas hospitals liable to closure almost doubled since 2020.

Throughout the decade previous the pandemic, Texas already led the nation in rural hospital closures, with 26 closures throughout 22 communities, together with one neighborhood hospital in Colorado County about 21 miles south of La Grange, which closed its doorways in 2016. Different hospitals close to Fayette County, together with hospitals in Rockdale, Cameron and Bellville additionally shuttered inside the previous 20 years, leaving a well being care desert within the area. With out St. Mark’s, sufferers now must journey about 20 miles to Smithville or 26 miles to Columbus for the closest emergency care.

First: Registered Nurse Stacie Schramek recordsdata paperwork on the final day of service at St. Mark’s Medical Middle. Final: Medical gear is saved contained in the pre-operative holding space. Credit score: Eli Hartman/The Texas Tribune

Nationally, greater than 120 hospitals have closed throughout the identical time-frame. Rural hospitals are particularly in danger as a result of affected person volumes are low, the uninsured inhabitants is comparatively excessive and reimbursement charges are insufficient. Texas has the very best uninsured inhabitants within the nation and is considered one of 10 states which have elected to not develop entry to Medicaid.

St. Mark’s Medical Middle had been some extent of delight in La Grange, which sits between Houston and Austin. Residents now concern La Grange could endure stagnation and financial decline as a result of job losses and lack of quick access to well being care.

“It’s going to be dangerous,” mentioned Twila Thurman, a former affected person at St. Mark’s. “I would really like for it to remain, however they’ve been struggling for years.”

Efforts to save lots of St. Mark’s

Earlier than this week, neighborhood members and the board had tried to save lots of the power. However in 2019, Fayette County voters rejected a proposition to create a taxing district for St. Mark’s, which might have helped maintain the hospital open.

In February, the 65-bed hospital suspended inpatient providers and utilized for the Rural Emergency Hospital designation, a federal program that gives financially struggling rural hospitals the flexibility to take care of emergency and important outpatient providers if they will’t maintain a full neighborhood hospital. Hospitals that obtain the designation get elevated reimbursement charges and a month-to-month facility cost from Medicare.

St. Mark’s is considered one of 4 Texas hospitals which have obtained the designation because the program launched in January.

This system helped the hospital keep afloat for a couple of months, however was not sufficient to maintain them out of the pink. The rising prices of well being care coupled with inflation and a $13 million mortgage had been finally an excessive amount of, mentioned CEO Mark Kimball. The hospital laid off 64 staff in February and now could be dropping 49 full time positions, 7 part-time positions and 37 contract roles, Kimball mentioned.

“It’s unhappy for the neighborhood and unhappy for the staff,” Kimball mentioned. “It is a nationwide drawback that must be addressed on the federal stage, otherwise you’re going to proceed to see an increasing number of small rural hospitals like St. Mark’s shut.”

Within the spring, a neighborhood group of involved residents got here collectively in La Grange to attempt to save the hospital. They fashioned a nonprofit known as Hospital Middle of Excellence and raised about $5.3 million, the quantity they decided was wanted after spending 1,300 hours with the hospital’s administration. The group wanted a guarantor for a $1.5 million mortgage, although, and turned to the town.

Throughout a closed session at a special-called council assembly final week, council members tabled additional dialogue on the problem. Interim Metropolis Supervisor Frank Menefee mentioned that earlier than the council might attain a choice, they wanted to conduct analysis to find out whether or not it was authorized and advisable to ensure the mortgage. However the Hospital Middle for Excellence mentioned they may not stall the choice for longer.

“It’s actually a disgrace that the county and metropolis has not been extra supportive of what it might take to save lots of this hospital,” mentioned Sam Wilson, who organized the Hospital Middle of Excellence.

First: The Fayette County Courthouse at La Grange. Final: Hunter Callis, left, and Shelby Dixon peer within the window of an vintage retailer in downtown La Grange. Credit score: Eli Hartman/The Texas Tribune

John Henderson, government director of the Texas Group for Rural and Neighborhood Hospitals, mentioned St. Mark’s seemingly would have closed earlier had it not been for the COVID-19 reduction funding.

Now, the city’s future is in jeopardy. If different hospitals are any indication, the closure doesn’t bode properly for La Grange, Henderson mentioned.

“What we’ve seen in different communities is that they lose their hospital after which they lose their pharmacy and their grocery retailer and their financial institution,” Henderson mentioned. “I fear that you just’ll return in a few years and in some methods, the neighborhood will fall down as a result of it was that hospital that was holding them up.”