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Hospital closures create more than medical issues for rural America

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For more than a decade, health care advocates have warned about rural hospitals struggling to survive.  Since then, dozens have closed, including one this year, not even a month into 2022. 

Extreme pressures on medical systems have forced hospitals to close in rural and urban areas. But those closures have different effects. 

A study of California communities that lost hospitals found rural patients experienced a 76% increase in ambulance transportation time, and in-patient mortality rose nearly 9%. Urban communities saw little change. 

In Ducktown, Tennessee, besieged by debt and a drying population, Copper Basin Hospital became one of 138 rural hospitals in the last 12 years to close.

Lisa Cook worked as a nurse at Copper Basin. She is concerned about residents and transportation.

“A lot of them don’t have vehicles. They don’t drive. They don’t learn to drive. It made a difference to them if they had Tennessee insurance that wouldn’t allow them to go across state lines; it would make it very hard on them. If they don’t have gas money to go two miles down the road, then they don’t have gas money to go 36 miles down the road,” Cook said.

Losing the hospital meant losing the area’s largest employer. It meant the largest letdown since the mines dried up, and it’ll be a mountain-sized climb to get local medical care back. 

Brock Slabach runs the National Rural Health Association. He says once a hospital closes, the chances of it coming back are small.

“Once the physicians, the nurse practitioners, the physicians’ assistants leave, all of your staff leaves, recruiting that back could be next to near impossible,” Slabach said.

In a November survey of rural hospitals, 96% of respondents said they have difficulty finding nurses. Nearly 99% said they were short on staff. 

Cook wanted to stay in her hometown. Now, she works at a hospital in another state. 

“I’m going to be honest with you: these people here depend on neighbors, friends, and family. You didn’t just lose the business. You lost that connection with the family,” Cook said.