When dialysis treatment centers close, rural patients have no choice but to drive further for care

After the Chadron dialysis center closed, Pieper's 
treatment travel time tripled. (KFF Health News photo)

Rural residents who require dialysis treatment to stay alive are having to drive longer distances for care as smaller hospitals and clinics shed unprofitable services to stay afloat, reports Ariella Zionts of KFF Health News.

When Chadron Hospital shuttered its dialysis center, which served Nebraska residents in the state's far western panhandle, Mark Pieper became one of the many displaced patients who would have to find another dialysis center for treatment.

Because the human body cannot survive without kidney-like functions that filter toxins, remove excess fluid and balance electrolytes, dialysis cannot be rescheduled or skipped. When faced with the closure of their dialysis center, renal patients like Pieper have two choices: Travel for treatment or die.

"Pieper eventually found treatment in Scottsbluff, which, with about 14,000 residents, is the biggest city in the rural Panhandle region," Zionts writes. "The hour-and-a-half drive will triple his time on the road to more than nine hours each week."

Chadron Hospital discontinued its dialysis service despite the $219 million in federal money Nebraska will receive this year from the Rural Health Transformation Program. But RHTP awards aren't meant to "help existing services stay afloat," Zionts explains. Instead, they are earmarked to help rural medical centers "explore new, creative ways to improve rural health." Only 15% of RHTP funds can be used to pay for patient care.

Chadron Hospital was "losing $1 million a year on its dialysis service due to low reimbursement rates that didn’t cover operational costs," Zionts reports. Nephrologist Mark Unruh said the "dialysis closure in Chadron reflects a wider trend of staffing and funding challenges."

Preventing kidney failure is one of the best ways rural areas can change what rural dialysis patients like Pieper are facing now, Unruh told KFF Health News. "He pointed to a tele-education program that helps primary care doctors in rural and other underserved areas prevent end-stage renal failure."