Over the last 10 years, more than 120 rural hospitals have ceased operations, and recent research from the Chartis Center for Rural Health found that more than 450 rural hospitals are vulnerable to closure. The COVID-19 crisis is putting even more small hospitals under financial pressure, and many regions are looking to reopen recently closed hospitals to meet the surge of expected patients.
‘Setting up for failure’
A roundup of reporting from local newspapers and media sources around the country provides a snapshot of some of the urgent issues. A story on the web site of WPFL in the Ohio Valley noted that local public health departments and hospitals say years of underfunding and hospital closures have diminished these services that now face the crisis. Nearly 20 percent of more than 100 rural hospital closures across the country since 2010 have been in Appalachia.
The story reports that Belmont Community Hospital in Bellaire, Ohio, closed last April, and five miles upriver, East Ohio Regional Hospital and Ohio Valley Medical Center near Wheeling, W.V., closed their doors. One hospital remains in Wheeling.
WPFL quotes Dan Brown, a former councilman for the riverside village of Bellaire, Ohio, as saying that the number of beds have gone down dramatically. “I can’t imagine if we had any kind of outbreak, with a two percent or five percent fatality rate, we’re in deep trouble,” Brown said. “The whole thing is setting up for failure.”
Even before the pandemic, Brown said, the hospital closures meant that those in communities near Bellaire would have to travel farther to receive services like kidney dialysis, and he’s concerned a similar situation could happen with the current outbreak. On March 13 Belmont County officials confirmed two cases of the novel coronavirus.
Healthcare workers affected in Yakima
An alarming March 24 story in the Yakima Herald in Eastern Washington noted that Yakima County has 44 cases of COVID-19, according to the state Department of Health. About 30 percent of the coronavirus cases in Yakima County are among healthcare workers. The high rate may be due to first responders, healthcare workers and those in critical condition being prioritized for testing.
Yakima Health district spokeswoman Lilian Bravo said that "various health centers" throughout Yakima County have staff cases of COVID-19, according to the article. She said this rate was a big concern since healthcare workers are key to treating and reducing the spread of infection. She added that the health district is working with the state Department of Health to handle cases among healthcare workers and in the two local nursing centers where cases have been confirmed.
The Yakima Health District ordered a stay-at-home order that is indefinite due to the vulnerability of the local healthcare system and recent closure of Astria Regional Hospital, leaving the city of Yakima with only one hospital. Asked if the former Astria hospital building would be used for COVID-19 care or quarantining, Bravo told the Herald that conversations remained at the state level and no updates were available.
Hospital slated to be closed converted for COVID-19
The issue doesn’t only apply to rural settings. Early in March, a group of state legislators called on Verity Health Systems to reverse its decision to close Seton Medical Center in Daly City south of San Francisco, arguing that the closure would make it harder for nearby residents to get to a hospital and affect the ability to treat coronavirus cases, according to local TV station KPIX.
“With COVID-19 posing a public health challenge and our homelessness crisis worsening — both of which are increasing trips to the ER — the closure of Seton Medical Center in Daly City is a huge problem for the community,” the four legislators wrote in their statement.
Then on March 20 Gov. Gavin Newsom announced the state would be leasing hospital beds for treatment in an effort to strengthen its response to COVID-19. One hospital secured in this action is Seton Medical Center in Daly City. The announcement is keeping the hospital open. According to San Mateo County leaders, 177 hospital beds will be designated to COVID-19 patients at Seton.
Threats of closure put pressure on states to act
A hospital in Eastern Pennsylvania is asking for help from the Commonwealth to stay open in the short run. Easton Hospital in Pennsylvania said it needed about $40 million by March 25 to keep it running or the facility would close by April 1, according to its corporate owner. Steward Health Care sent a joint letter with St. Luke’s University Health Network asking for a state bailout, according to a letter reviewed by The Allentown Morning Call.
“The hospital has been extremely distressed for months, and it lost $5 million from operations in February alone,” the two health systems wrote in the letter to Wolf.
Talks of a sale to St. Luke’s have stalled amid the coronavirus outbreak, the Morning Call reports. In a statement, a St. Luke’s spokesman said that in the face of the emergency the health system is focusing on its patients and their care, as well as the St. Luke’s clinical staff handling the outbreak, and is not deploying its resources to acquire other hospitals.
The Morning Call reports that the letter notes that since the coronavirus outbreak, Easton Hospital, like most hospitals, has stopped performing elective surgeries, dropping patient volumes significantly. “The resulting losses have made the continued operation of Easton Hospital impossible,” the letter states.
Lyndsay Kensinger, a spokeswoman for Wolf, told the Morning Call that the administration was aware of the letter but did not say if it would provide the money. “The administration understands the critical need for hospital accessibility routinely, which is exacerbated by the COVID-19 pandemic,” Kensinger said. “While working to secure access to health care for Pennsylvanians, we are also working tirelessly to ensure that our system secures necessary protective equipment, beds, ventilators and the other things our system needs to treat people with this disease.”
