Hospital in county of 6,000 finds niches to first survive, then thrive; employs 500

Rural hospitals are struggling nationwide, but one Georgia hospital is thriving after a bold gamble on a new program, Elly Yu reports for WABE-FM, Atlanta's NPR affiliate.

When Robin Rau took over as the CEO of Miller County Hospital a decade ago, the hospital was $6 million in debt and its attached Miller County Nursing Home had almost 30 empty beds. When the recession hit, things got worse. The facility needed patients, so Rau decided to develop a program for ventilator care in the nursing home to lure patients away from crowded hospitals in Atlanta. The hospital invested millions in specialized equipment and staff, and many of the tracheotomy tube patients were uninsured, even homeless, so it was a big financial risk.

But the hospital forged ahead, enlisting social workers to help uninsured patients get Medicaid or private insurance so the nursing home could get paid for services. "It was a tremendous gamble that we took, but it was either that, or we were going to close,” Rau told Yu. Today the hospital employs about 500 people in a county of under 6,000 residents. The ventilator unit at the nursing home houses 60 patients, and the hospital has begun construction on space for 50 more nursing-home beds.

Rau implemented other cost-cutting measures at the hospital, like opening a pharmacy to save money by filling prescriptions in-house. To attract more insured patients, the hospital gave free doctor visits to employees of local companies To cut down on emergency-room visits for non-emergency care, it beefed up services at a rural clinic and creating programs to proactively manage people's health.

"I’m trying to keep people healthy so they’re not in our emergency room," Rau told Yu. "It costs me maybe $100, $110 to see somebody in our rural health clinic – that’s my cost. But if they come into my emergency room, it’s going to cost me a lot more than that."