Once struggling rural hospital in small Idaho town now thrives; could be model for other hospitals

Arco, Idaho (Best Places map)

While 78 rural hospitals have closed since 2010, and many more are in danger of shuttering, one in a tiny Idaho town has found a formula for success that could prove as a model for other struggling rural hospitals, Anna Gorman reports for Kaiser Health News. In 2013, 14-bed Lost Rivers Medical Center in Arco, Idaho, was on the verge of closing, due in large part to declining population in Butte County, which has 2,501 residents. The next closest hospital is an hour away and requires travel across high-altitude prairie.

When Brad Huerta was hired as CEO four years ago he "found the nearly 60-year-old hospital in disarray—dilapidated facilities, fearful employees, reluctant patients and a financial mess left behind by the former CEO," Gorman writes. "The hospital’s bank account held just $7,000 and morale was at an all-time low." He told Gorman, "We were the poster child for everything that was wrong with rural health care. It had been a slow, steady decline from neglect."

After borrowing money to pay his employees, "Huerta campaigned to pass a $5.5 million bond for Lost Rivers," Gorman writes. "He asked locals if it was worth $5 a month—one six-pack of beer or two movie rentals—to keep the hospital running. They answered 'yes' at the polls, and the hospital emerged from bankruptcy. Next, Huerta set his sights on overhauling the badly outmoded facilities. One of his top priorities was the laboratory, which he said looked like a high school science classroom from the 1950s."

"He instituted a new philosophy: If it doesn’t happen at a 'real' hospital, it doesn’t happen at Lost Rivers," Gorman writes. "That meant ending some local practices, nixing little things like letting staff members wear scrubs of any color they fancied, and big things, like allowing people to bring their horses in for X-rays."

"To bring in more revenue, he applied for grants and got the hospital a trauma center designation (the first level-IV trauma center in Idaho) so it could get paid more for the care it was already providing," Gorman writes. "He saved money by inviting the town’s residents to help renovate clinic exam rooms and by moving the medical records to a cloud-based system that didn’t require more information technology employees. He also brought in more rotating specialists, started using telemedicine to connect the hospital to experts elsewhere and is now planning to open a surgery center and a long-term care rehabilitation wing."

Tom Ricketts, senior policy fellow at the Sheps Center for Health Services Research at the University of North Carolina, Chapel Hill, told Gorman, "Being in a rural place does not preclude high-quality medicine. They are under a lot of pressure, but there are rural places you can point to as places you would say, 'This is how things ought to be done'."