After its hospital closed, N.C. county works to be the first in the nation to reopen its hospital under ER-only designation

Martin General closed in 2023. (WITN TV photo)

After serving rural Martin County, N.C., for 73 years, Martin General hospital closed its doors, leaving the community's 22,000 residents without a medical care center. Like many rural hospitals across the United States, Martin General had faced shrinking profits and bankruptcy before it closed. But that's not the end of Martin General's story, reports Jaymie Baxley of NC HealthNews. "The county [is working] on a complex plan to resurrect Martin General — a plan that, if successful, could become a blueprint for other rural communities where hospitals have closed."

To make reopening possible, Martin County and hospital officials applied to change Martin General's designation from a full-service hospital to a 'rural emergency hospital,' which means the hospital would offer 24/7 emergency care but give up its inpatient services. Baxley explains, "In exchange, the hospital would receive millions in annual funding from the federal government. . . and be eligible for increased reimbursement rates for some outpatient services covered by Medicare."

But Martin General faced an unusual hurdle to becoming a rural emergency hospital -- it had already closed. Hospitals that had successfully made the switch did so while they were still open, Baxley reports. "Officials in Martin County, however, believe the hospital [could be] reopened using the rural emergency model — something that had not been attempted anywhere else in the nation. . . . Earlier this year, the Centers for Medicare and Medicaid Services confirmed that Martin General could reopen as a rural emergency hospital, clearing the first and arguably most important hurdle in the county’s path."

Martin General's status as a "closed hospital" also means state laws present reopening obstacles. Ben Eisner, interim Martin County manager, told Baxley, “As far as we can tell, this is really the first such situation in the country. Trying to navigate that has certainly been tricky. It’s taken us a number of months to work through some of the regulatory issues of opening a closed hospital as a rural emergency hospital.”

At present, Martin General's resurrection remains a work in progress. "In addition to being the first hospital in the nation to reopen as a rural emergency hospital, Martin General would be the first hospital in the state to receive the designation," Baxley writes. "Because the program is not open to facilities that closed before 2023, it cannot be used to bring back the state’s other shuttered hospitals. . . . But Martin County’s experience could provide a road map for other rural communities facing a similar situation in the future."