Big hospital tries to keep small town from building one

Wikipedia map, labeled by The Rural Blog

A small farming town in southwest Florida wanted to build a small hospital but found an unlikely enemy: a larger hospital nearby.

About 50,000 people live in the Collier County community of Immokalee, but when Dr. Beau Braden moved there to open a medical clinic he discovered that the town, about 40 miles inland from Naples, had fewer hospital beds per person than Afghanistan, Jack Healy reports for The New York Times.

Braden proposed a 25-bed hospital to serve Immokalee and nearby Ave Maria, but this summer NCH Health Systems, which operates a hospital in Naples and another nearby, "derailed those plans by asking the state to deny the proposal, saying that the small, rural hospital would siphon away patients and revenue, Healy reports. "The move has upended people’s hopes around Immokalee and delayed any plans to start building the hospital for months. Maybe for good." The NCH said its hospitals provide coverage for Immokalee's residents and questioned whether Braden was experienced enough to run a hospital.

Braden and other local health officials said the NCH hospitals don't adequately serve Immokalee and that it and other rural areas all over the country are suffering from the lack of hospital and emergency care: "Babies are regularly born in ambulances before they can reach a hospital, and adults drive themselves bleeding to the hospital when the three available ambulances get swamped with calls, emergency responders say. Children younger than 1 die at triple the rate of the rest of Collier County, and the number of people dying in places like fields or parking lots grew by 143 percent from 2014 to 2017, according to state health statistics that Dr. Braden submitted to regulators," Healy reports.

NCH's action is one example, albeit a rarer one, of the challenges rural communities face in trying to secure local hospital care. It's all the rarer since far more rural areas are losing hospitals than gaining them: 87 rural hospitals have closed in the U.S. since 2010. "But as Dr. Braden learned, even when a town wants to open a new hospital to make up for the loss in care, the challenges can be enormous," Healy reports. "Just to open the doors, rural hospital projects need to raise millions of dollars for construction, equipment and salaries for doctors and nurses. They need to woo highly trained staff to out-of-the way towns. They must thread a maze of regulations without an army of experts and high-priced consultants, which are available to larger hospitals.