Stories about the problems of rural hospitals led The Rural Blog's readership list in 2015

Stories about the problems of rural hospitals led the list of most-read topics on The Rural Blog in 2015. Of the 60 blog posts that were viewed at least 250 times by TRB readers, eight excerpted stories about rural hospitals, and some related items also had high readership.

The most-read item on the topic was one on Aug. 4 about the struggles of rural hospitals in Alabama, Oklahoma and Nebraska, perhaps appealing because it dealt with three states. Close behind was one published the day before, about a community's reopening of a southwest Virginia hospital that a chain had closed. Next in line was a Feb. 19 report on how the Syracuse Journal in Kansas had held the local hospital accountable in the face of claims by its fired administrator about "negative press."

We said in that item, "With many rural hospitals in financial trouble, rural news media need to cover their activities. Some handle hospitals with kid gloves, because they are such important local institutions, often run by well-regarded local people. But in many cases the accountability for these institutions is fuzzy, and rural news media are in a position to increase accountability."

Other well-read reports on rural hospitals included a March 18 item about hospitals facing federal reimbursement cuts for high readmission rates; one the day before reporting that 48 rural hospitals had closed since 2010 and 283 more were in trouble; an April 17 item noting that four of the 10 closures in Texas were due to a fraud case; and a July 24 item quoting an expert advising rural hospitals to strengthen their connections to their communities.

Some related reports also had high readership, such as a Jan. 16 item about the shortage of doctors in rural areas and one on June 9 about a national survey of rural stakeholders, which found that their top concern was access to health care, being limited partly by the closing of rural hospitals.

Renewable energy market shifts from biomass to solar, pinching Calif. farmers and biomass plants

Biomass waste is deposited at a waste-to-
energy plant. (Photo by Geoffrey Mohan)

As California almond growers bulldoze orchards due to drought, plants that make electricity from waste biomass "are folding in rapid succession, unable to compete with heavily subsidized solar farms, many of which have sprouted up amid the fields and orchards of the San Joaquin Valley," reports Geoffrey Mohan of the Los Angeles Times.

Almond processor and grower Paul Parreira "is running out of dirt roads where he can spread ground-up almond shells, even as he expands a one-megawatt solar array on six acres of his family's property in Los Banos," Mohan writes. "The waste-to-energy facilities where Parreira used to send about 50,000 tons of shells per year are vanishing. Six have closed in just two years, the latest in Delano, which shut down Thursday, after San Diego Gas & Electric ended its power-purchase agreement."

California had about 60 biomass plants in the 1980s, but hit the skids with deregulation of the state's energy grid, cheaper natural gas and expiration of long-term contracts and a state subsidy. The industry is now down to 25 plants, and seeking help from lawmakers in Sacramento.

The vanishing market for biomass waste may mean more open burning of it in the valley, which is allowed "if farmers do not have an economically feasible alternative," Executive Director Seyed Sadredin told the San Joaquin Valley Air Pollution Control District board last month. (Read more)

As S.D. publisher gives up his title, he tells the story of his family and their weekly newspaper

Tim Waltner

An outstanding weekly newspaper publisher is giving up the title, but not his connection with the newspaper, which his son and daughter-in-law will take over. Tim Waltner's column about the changes at the Freeman, S.D., Courier is a biography of himself, his family and the newspaper, and an exemplary piece of rural journalism, to be expected from a leader and award winner in the International Society of Weekly Newspaper Editors.

After recounting the twists and turns that took him to Freeman, then away, then back again, Waltner writes, "I could not be happier — for myself, for Jeremy and Stacey, for the Courier and the Freeman community. And I’m pleased I’ll be able to be part of that in these transitional years.

Sperlimg's Best Places map 

"I have no illusions about my time at the Courier; I know some people still bristle at my politics, reputation as a rebel and willingness to challenge authority. The role of a community journalist — if you’re doing your job — includes sometimes ruffling some feathers. I’m happy to play that role and am fully aware that some people, as there were 46 years ago, will be happy to see me start to step away.

"But I’ve been humbled and gratified by the support and respect shown me over my 40 years with the Freeman Courier. I’m thrilled to give Jeremy and Stacey the same opportunity Glenn Gering gave me four decades ago. My deepest hope is that community residents and leaders will give them — and the Courier — the support and respect they deserve." (Read more)

Cargill fires Muslim employees who walked out in dispute over prayers at Colorado packing plant

A Somali worker at the Cargill plant (Denver Post photo)

"About 190 workers, most of them immigrants from Somalia, have been fired from a meat packing and distribution plant on Colorado's Eastern Plains for walking off the job to protest a workplace prayer dispute," reports Kieran Nicholson of The Denver Post.

Cargill Inc. had allowed the workers at its Fort Morgan plant to use break time for Muslim prayers (observant Muslims pray five times daily), even providing a prayer room, but recently changed the practice, Nicholson reports.

Workers at the plant are represented by the Teamsters union but Cargill is negotiating the prayer issue with the Council on Islamic-American Relations. "They feel losing their prayer is worse than losing their job," CAIR Executive Director Jaylani Hussein told Nicholson. "It's like losing a blessing from God."

Coal seam that produced 'Sixteen Tons' still has potential, new investment, and fresh focus

Merle Travis, and then Tennessee Ernie Ford and many others, sang about a miner's daily production goal of "sixteen tons of Number 9 coal." That's the name of a coal seam in Travis's native Western Kentucky. It's still producing, and is the target of some new mines in a small county that has been known less for coal than for agriculture and the Green River.

Australia's Paringa Resources plans at least one new mine in McLean County (Wikipedia map), where Lexington-based Rhino Resources opened a mine recently as it shut down others in Appalachia, reports Austin Ramsey of the Owensboro Messenger-Inquirer: "The Western Kentucky No. 9 Coal Seam, where both county mines operate, could soon become the nation's second largest producer of coal, said Tomasz S. Wiltowski of Southern Illinois University's Advanced Coal and Energy Research Center."

Ramsey reports, "Wiltowski said he believes the Illinois Coal Basin (in blue on map) is preparing to play a center-stage role in an international showdown over energy production and environmental policy. The federal moratorium on construction of coal-fired power plants has hurt the industry nationwide, but the potential in western Kentucky makes for an attractive investor shift back toward nonrenewable energy, he said. Only time will tell what the final results will yield."

Many rural areas could benefit from drone boom

Drones are used to check health of strawberry fields in Florida.
(Photo by Jay Conner, Tampa Tribune, via New York Times)

Many rural areas could benefit economically from the boom in drones, not just North Dakota, the focus of a New York Times story and Rural Blog item earlier this week. "It is just one of several rural areas where there is concerted activity in commercial drones," or "unmanned aircraft systems," the name federal officials use, writes Times reporter Quentin Hardy, who did the North Dakota story.

"Far from Silicon Valley, entrepreneurs are working on drone applications for agriculture, energy, rail and other industries largely in less populated parts of the country," Hardy reports. "It makes sense: There is more need for drones in rural areas, and there are fewer costly things that a drone might crash into. The military operations involved with many of these endeavors are also in rural areas."

Anthony Albanese, president of Gryphon Sensors LLC, which makes drone sensing gear, told Hardy, “We envision building out in rural environments where you can build a safety case” for air-traffic control of unmanned vehicles. “Eventually it will be urban – you can envison delivery centers on top of buildings in cities.” But the proving ground will be rural.

"One thing all the rural experimentation sites share seems to be contacts from the likes of Amazon, Google and Facebook, all of which have big drone programs," Hardy reports. "Away from the government facilities, there is lots more experimentation in rural areas, from flying firefighting robots in Reno, Nev., to teams of drone pilots for work and play in Iowa, and a British company called BioCarbon Engineering that hopes to plant 1 billion trees a year in deforested areas by using drones."  (Read more)

Flooding disrupts Mississippi River system transportation; barge tows limited, bridges closed

U.S. Geological Survey map via DTN; click it for larger version

"Massive flooding, which usually occurs in spring, is plaguing the entire U.S. river system this winter," especially the Mississippi and its tributaries, Mary Kennedy reports for DTN/The Progressive Farmer. "That heavy precipitation has pushed the nation's main river system above flood stage, creating a mess for shippers. As of Dec. 30, the St. Louis harbor was closed."

Tom Russell of New Orleans-based Russell Marine Group told Kennedy, "Lower Mississippi River from Cairo to New Orleans is open but either at or will soon be at flood levels as water flushes through. Expect continued slow going logistics throughout the system. Fleets in St. Louis and Cairo are at max capacity. Tow sizes will be restricted to equivalent of 280 horsepower-per-barge-to-tow ratio. This is the first time I have seen such hp restriction."

Kennedy's report includes a rundown of most the major tributaries of the Mississippi and Ohio rivers. To read it, click here. The flooding has also prompted the closing of bridges, some major, such as US 51 over the Ohio between Cairo, Ill., and Wickliffe, Ky.

"Flooding on the middle and lower portion of the Mississippi River and some of its tributaries may reach levels not seen during the winter months since records began during the middle 1800s," says AccuWeather senior meterologist Alex Sosnowski.

In Iowa, which set an ethanol-making record in 2015, Cruz leads but opposes renewable-fuel law

Cruz speaks from hay bale at Iowa State Fair.
(Associated Press photo by Paul Sancya)

As Iowa reports record production of ethanol for 2015, Texas Sen. Ted Cruz, an opponent of federal support for the industry, is leading in polls for the state's first-in-the nation presidential vote in party caucuses on Feb. 1. But an attack by a leading Cruz supporter on the issue could backfire, writes Trip Gabriel of The New York Times.

Gabriel reports that former Virginia attorney general Ken Cuccinelli, "emailed subscribers to a personal list with an attack on Gov. Terry Branstad of Iowa, a popular Republican governor, and his son, Eric Branstad," who runs a super PAC that is airing TV and radio ads attacking Cruz for his stand against the Renewable Fuels Standard, which requires a certain amount of ethanol to be blended into gasoline.

"Every Republican caucus winner in the last quarter-century has been a strong ethanol supporter," Gabriel notes in the Times' "First Draft" blog. "But Mr. Cruz’s polling lead suggests the industry’s popular and political clout may be ebbing. Mr. Cruz has never tried to play down his call to end the fuel standard, unlike some rivals. Still, it may not be to his advantage to have supporters like Mr. Cuccinelli waving a red cape at an iconic Iowa industry."

"Iowa produced just over 4 billion gallons of ethanol in 2015, a record for the country’s largest producer of the renewable fuel," Chris Doering reports for The Des Moines Register. "The Iowa Renewable Fuel Association said the increase at the state’s 43 ethanol plants this year was the result of efficiency gains at existing facilities and production from cellulosic feedstocks such as corn stover. Iowa accounts for 27 percent of U.S. ethanol output."

We couldn't resist this one in a look back at 2015: A orphan kangaroo and his teddy bear

Photo by Gillian Abbott

The Huffington Post's collection of 12 feel-good stories during 2015 had a couple of rural-oriented items, including a story from Australia about an orphan kangaroo and his teddy bear.

Gillian Abbot, a licensed wildlife carer and member of the New South Wales rescue organization WIRES, has been caring for the kangaroo named Doodlebug, found abandoned a little over a year ago and too young to take care of himself. Now 15 months old, he is gradually being released to the wild, says Abbott's son, Timothy Beshara, who put on Twitter the photo his mother took of Doodlebug hugging his teddy. ""He lies next to it, practices his kicking against it and cuddles it," Beshara told Huffington Post.

The other item with rural resonance included a British weatherman's skillful pronunciation of the 54-letter name of a Welsh village, Llanfairpwllgwyngyllgogerychwyrndrobwllllantysiliogogogoch. 

Please consider a gift to The Rural Blog's publisher

Dear readers of The Rural Blog:

We're in our usual low gear for the holidays, but are still trying to take care of business, and asking for your help. As you write those year-end checks to worthy causes, we hope you will consider a donation to our publisher, the Institute for Rural Journalism and Community Issues, based at the University of Kentucky. The institute is a national program that helps rural journalists define the public agenda in their communities through strong reporting and commentary, especially on broader issues that have local impact but few good local sources.

The university pays the institute's director and some of his expenses. The institute has an endowment that covers other expenses, including a half-time staff assistant. We need full-time help, and that takes money. Donors can give to the endowment, which returns 3.5 percent per year and guarantees the sustainability of the institute, or to the institute's operating account, which is used for current activities. To learn more about the institute, go to www.RuralJournalism.org.

To donate to the institute, click here. To give to the endowment, go to the gift-designation box and select "Institute for Rural Journalism and Community Issues Endowed Fund for Excellence." To give to our operating account, choose "Other" and type in "IRJCI operating." Or, you can write a check to the University of Kentucky with "Rural Journalism endowment" or "IRJCI operating" on the memo line and send it to IRJCI, 122 Grehan Journalism Bldg., UK, Lexington KY 40506-0042. Any type of donation is tax-deductible and will be much appreciated!

Thanks,

Al Cross
Director, IRJCI, and associate extension professor, School of Journalism and Media, University of Kentucky

Goodbye to a barn cat: 'It was a strange but very fulfilling relationship'

Donald Gregg with Shadow (undated photo)

Barn cats have long been a staple of rural life, but are less a part of daily life than house cats, because they have their own territory and are usually wary of humans, even those whose property they share. But that doesn't keep them and their human neighbors from forming attachments, perhaps at arm's length but with a certain connection. Such a cat, named Shadow, was the frequent companion of Donald Gregg, the father of John Gregg, news editor of the Valley News in Lebanon, N.H., and White River Junction, Vt. When Shadow died recently, Donald Gregg emailed his family and friends a remembrance, and his son turned it into a Christmas Eve column for the newspaper. Here are exceprts:

Shadow, our feral cat, passed away earlier this month, very peacefully. She had been shutting down for a couple of weeks, eating less and less, and moving with a bit of stiffness. My wife, Meg, and I found her about noon, when we returned from yoga class, lying very gracefully, as though asleep.

The ground was soft, so I was able to dig her grave easily, near a favorite tree she used to scamper up, close to the old play house. . . . A few hours before Shadow died, for some strange reason I remember what we would say as children when on a swing, and we stopped pumping: “Let the old cat die.”

Well, die she did, and the first time I ever picked her up was to lay her in her shroud to be buried.

Shadow, true to her name, has slipped away. It was a strange but very fulfilling relationship. We shall miss her.

Donald Gregg, 88, lives in Westchester County, New York. He was a CIA official, national security adviser and ambassador to South Korea.

Small, rural hospitals doing more orthopedic work, perhaps putting patients at greater risk

Critical-access hospitals, a linchpin of health care in rural areas, are performing many more orthopedic surgeries. But the Medicare patients who get the five most common orthopedic procedures at such hospitals are one-third more likely to die within 30 days than those who get them at larger, general hospitals.

That's what The Wall Street Journal found by reviewing Medicare billing data from 2008 to 2013, which showed a 43 percent increase in surgeries at critical-access hospitals, "far outpacing the growth of those services at general hospitals" and raising "troubling implications for patient safety," says the Christmas Day story by Christopher Weaver, Anna Wilde Mathews and Tom McGinty. From 2010 to 2013, the death rate at such hospitals was 34 percent higher than at the larger facilities.

“Patients are getting bad outcomes, probably because they are getting procedures at hospitals without the experience to do it well,” Ashish Jha, a Harvard University public-health professor who has studied critical-access hospitals, told the Journal. He and his colleagues reviewed the Journal's data and concluded that "the 30-day mortality rate for inpatient joint replacements was about 9 per 1,000 at critical-access hospitals in 2013, compared with around 5 in 1,000 at general hospitals," the newspaper reports.

"Many studies suggest that patients generally get better results when their procedures are done at hospitals that perform them frequently," the Journal reports. "The average critical-access hospital performing inpatient joint replacements in 2013 did about 26 that year, compared to about 132 at general hospitals. Hospitals doing more than 100 procedures a year have the lowest risks, said Nelson SooHoo, an orthopedic surgeon at UCLA’s David Geffen School of Medicine who has studied the issue."

In general, critical-access hospitals must have no more than 25 beds and keep patients no more than 72 hours. In return, the federal government gives them a small bonus on their Medicare and Medicaid payments, part of a policy Congress enacted to maintain the viability of hospitals in rural areas.

"Financial incentives can make doing more surgeries appealing to critical-access hospitals, thanks to their special status with Medicare, especially as the rural hospitals merge with larger rivals," the newspaper notes. "The Journal’s analysis shows that the fastest-growing procedures at critical-access hospitals are often-elective orthopedic surgeries that could otherwise be scheduled at facilities with more experience. Experts say that as the hospitals’ experience grows, patients’ outcomes should improve. But so far, mortality rates have held fast, according to the analyses by the Journal and Harvard researchers."

Major banks become more skeptical of coal lending

First Energy's Mansfield plant in Shippingport, Pa.
(Photo by Andrew Rush, Pittsburgh Post-Gazette)

Demand for coal "has been dropping as competing fuels become less expensive. And in the past few weeks, coal companies have seen major banks turning their backs on the industry in public," Anya Litvak reports for the Pittsburgh Post-Gazette. "News that Morgan Stanley, Wells Fargo, Citigroup and Bank of America had all released coal-lending policies that pledge to decrease credit availability to the sector met with much fanfare a few week ago around the time of the Paris Climate Conference, where world leaders met to hammer out an agreement on keeping global temperature at manageable levels."

The banks have not completely abandoned the industry. Wells Fargo "was a leading underwriter of $700 million in bonds for Consol Energy Inc. and Cloud Peak Energy this year," Litvak notes. "The unifying theme in all these coal policies is added scrutiny in risk assessment and senior level approval of loans to the industry, although some banks have made specific pledges. Morgan Stanley and Goldman Sachs, for example, said they won’t fund mountaintop-removal mining and won’t give money to companies that do a lot of it. They also won’t finance new coal power plants in the U.S. and other developed nations, although those aren’t being built anyway because of tightening environmental regulations and competition from cheap natural gas."

Citigroup, "the leading bank providing financing for Alpha Natural Resources’ bankruptcy reorganization . . . said it would continue to decrease its coal financing activity, but didn’t rule anything out," Litvak reports. "Funding for projects would require senior approval, the bank said, and would be based on 'due diligence' and the coal company’s environmental, safety, and corporate governance performance, as well as human rights."

North Dakota wants to be Silicon Valley of drones

NYT photo by Michael Ciaglo

The drone boom could be a boon to North Dakota, "where there is plenty of open space and — unlike in other sparsely populated states — lots of expertise already in place" to improve the technology of unmanned aerial vehicles, Quentin Hardy reports for The New York Times.

"Private-sector drones are where personal computers were in the 1970s: a hobbyist technology waiting to become mainstream. The technology research firm Gartner says that, barring regulatory hurdles, the United States drone business could be worth $7 billion in a decade," Hardy writes. "North Dakota has spent about $34 million fostering the state’s unmanned aerial vehicle business, most notably with a civilian industrial park for drones near Grand Forks Air Force Base. The base, a former Cold War installation, now flies nothing but robot aircraft for the United States military and Customs and Border Protection . . .  to patrol from Seattle to the Great Lakes" and sometimes along the Rio Grande.

“The potential up here is tremendous,” Gov. Jack Dalrymple told Hardy. “It’s not about supporting a company or two; it’s creating the leading edge of an industry.”

Hardy reports, "Rural states with farming, oil and rail lines see many practical reasons to put robots in the sky. Infrared imaging can judge crop health. Cameras can spot leaks and cracks in pipelines. Smaller copters can inspect windmill blades. Livestock can be located easily. . . . If the occasional experimental craft crashes, it is unlikely to hit much beyond dirt. And with money, expertise and need here, people will keep trying."

For a "Field Guide to Civilian Drones," by Nick Wingfield of the Times, click here.