Rural hospitals are typically the lifeblood of their communities and their closure can bring dire consequences. Not only do these rural communities lose a major employer, they also lose the ability to attract new employers and residents to the area. And, the closure of rural hospitals frequently leads to the closure of other local businesses. NPR reported on this phenomenon in an April 7, 2019 story on the closure of Columbia River Hospital in Celina, Tennessee: Economic Ripples: Hospital Closure Hurts a Town’s Ability to Attract Retirees, linked here.

According to the National Rural Health Association, nearly 90 rural hospitals have closed in the country since 2010, most of them in the south and mid-west. Columbia River Hospital was added to this list when it closed on March 1, 2019, becoming the eleventh rural hospital to close in Tennessee in recent years. Tennessee has had the second-highest number of rural hospitals to close, exceeded only by Texas.

Twenty-five bed Columbia River Hospital was the only hospital in Celina, a town with a population of 1500, and had been serving patients there since 1965. Its services included an 8-bed inpatient psychiatric facility focused on the mental health and behavioral health needs of elder adults, a skilled nursing facility, an emergency room, and outpatient services, such as diagnostic imaging, diagnostic laboratory, and physical therapy. With its closure, no hospital services will be available in the community, including emergency room, inpatient, and outpatient hospital services.

The hospital was Celina’s second largest employer (after the local school system), employing 147 nurses, aides, administrative staff and other individuals who must now find other employment, many of whom will find it elsewhere. In addition, the town has lost one of the main attributes that has allowed it to attract retirees in recent years. As reported by NPR, the individual leading the Chamber of Commerce’s effort to attract retirees to Celina, and herself a recent retiree from Washington State, said she’d now say to retirees: “Look elsewhere.”

With the closure of Columbia River Hospital, the nearest hospital to Celina is 30 minutes away over winding roads. That 30 minute drive could mean the difference between life and death, particularly when one of the town’s two currently operational ambulances is not available. In addition, residents fear that the three physicians in town will either choose to leave or not be replaced when they retire and that other businesses could close. Their fears are not misplaced. For example, when Lower Oconee Community Hospital in Glenwood, Georgia closed in 2014, the closures of the town’s bank and pharmacy and the only grocery store in the county soon followed.

A Navigant study, published February 20, 2019, found that one in five rural hospitals in the country are at risk of closure, 64% of which are essential to the health and economic well-being of their communities.

The causes for this increase in rural hospital closures include significant decreases in reimbursement to hospitals by third party payers and the failure of many of these states to expand Medicaid. As quoted in a statement issued by Cookeville Regional Hospital, which had operated Columbia River Hospital, CEO Paul Korth stated: “Unfortunately, many rural hospitals across the country are having a difficult time and facing the same challenges, like declining reimbursements and lower patient volumes that Columbia River Hospital has experienced.”

The lawyers at Whatley Kallas, LLP will continue to follow the closure of rural hospitals across the country and the consequences of these closures.