Struggling rural Mo. hospital thrives by expanding; plan could be used by other rural hospitals

A rural Missouri hospital on the brink of closure found a way to stay open, not by cutting costs, jobs or services, but by expanding operations, Bram Sable-Smith reports for NPR. Faced with dwindling patients, operating losses, a shrinking budget and staff resignations, the Putnam County Memorial Hospital board considered closing down the Unionville (Best Places map) hospital, which caters to about 5,000 residents, many of them older, poorer, sicker and less insured than the rest of the state.

Before a decision was made about closing the hospital, the board received a call from "a doctor in the area called Jerry Cummings, who was then running a medical consulting business with his wife Cindy in central Missouri," Sable-Smith writes. "Instead of closing its doors, Putnam County Memorial should expand, the couple advised." They said "the hospital could convert an unused 10-bed unit into a psychiatric wing to bring in new revenue . . . and offer other medical services that Putnam County residents were driving hours away to get."

In 2012 the Cummings were hired to run the hospital and brought with them specialists in anesthesiology, gynecology and cardiology, Sable-Smith writes. "They also rallied the county to pass a roughly $7 million dollar bond initiative to buy out the hospital's old debt and renovate."

"And patients started coming back," Sable-Smith writes. Jerry Cummings told Sable-Smith, "Our revenues went from $4 million to $22 million—a huge increase. Our average daily [patient] census—it was less than 1 patient per day. Our average daily census now is around 11 to 12 patients."

A November 2014 report by the health panel of the Rural Policy Research Institute says more cash-strapped rural hospitals could thrive by taking the same tack, Sable-Smith. At least 55 rural hospitals have closed since 2010, and another 1 in 10 are at risk of going under.