Emergency-only status for rural hospitals can be a lifeline, but now residents have to drive further for other care

Entrance to St. Mark's Medical Center
in LaGrange, Texas (Photo via smmctx.org)

LaGrange, Texas, between Austin and Houston, is best known as the title of a ZZ Top song. Now the town of 4,400 and surrounding Fayette County, pop. 25,000, is an example of what may become a national trend: Rural hospitals going emergency-only in order to stay open, reports Liz Carey of The Daily Yonder.

"St. Mark's Medical Center announced last month that it would become a Rural Emergency Hospital," a newly created category.  The REH designation, which provides higher Medicare and Medicaid reimbursement rates, is designed to help rural hospitals stay open. "Studies indicate that of the nearly 2,200 rural hospitals across the country, as many as one in five is in danger of closing," Carey notes. "But the new designation comes at a cost. REHs must provide emergency services 24/7 and cannot provide in-patient services."

Fayette County, Texas (Wikipedia)

Roxanne Cotter, vice president of the La Grange Area Chamber of Commerce, told Carey, "It took all of us by surprise." Carey reports, "A type 2 diabetic, Cotter said she's been to the hospital four times in the past year for overnight stays to treat her diabetes. Now, she said, she'll have to travel to hospitals in other communities, some 20 or more miles away, for the same treatment. . . . Karen Killian, a former surgical nurse for the hospital, said her concern is the residents in the nursing homes throughout Fayette County." Killian told Carey, "We had some patients who came from the nursing homes here. Some of them have no family to help them," she said. "If their neighbors have to drive them all the way to another hospital, will that affect their care? How will they get home?"

REH will only solve some of the financial stresses rural hospitals face. Mark Kimball, St. Mark's president and CEO, told Carey, "Even with this new designation, St. Mark's will need additional financial support from the community to survive. REH is the only viable option at this time. . . . If our patient volumes increase and our financial status improves, one of the benefits of REH is that St. Mark's could reopen inpatient and surgical services." 

Rural communities can band together to reopen hospital services. Carey writes, "Cotter said the chamber and others in the community are working to determine what options are available to reverse the REH designation, and to keep the hospital open." She told Carey, "We'd like to be a part of the conversation. The (Chamber) board chair and I have started doing research on rural funding opportunities. . . . We think it will be a combination of philanthropic and government funding that will be necessary to keep the hospital operating."