ECU Health Seeks to Create North Carolina’s First Rural Emergency Hospital

Greenville, N.C.-based ECU Health is proposing to create the state’s first Rural Emergency Hospital (REH) in Martin County, initially located in the existing medical facility. 

The proposal outlines the nine-hospital ECU’s commitment to advocating for a $70 million investment from the State of North Carolina to build a new Rural Care Center in Martin County that would serve as the future home of the REH with the potential to expand outpatient services including preventative care.

The REH designation became effective on January 1, 2023. The designation is a relatively new attempt by CMS to try to meet some of the challenges that rural hospitals are facing with respect to providing acute inpatient care. The program allows rural hospitals to close down their inpatient operations and maintain a freestanding emergency department and outpatient care services. In exchange for doing that, Medicare provides them with a facility fee and a Medicare outpatient payment add-on for providing those outpatient services.

Forty hospitals have converted to Rural Emergency Hospitals since January 2023, according to data compiled by the North Carolina Rural Health Research Program. 

At a public hearing in front of a standing-room only crowd at the Martin County Board of Commissioners meeting on June 4, ECU Health CEO and Brody School of Medicine at East Carolina University Dean Michael Waldrum, M.D., M.B.A., outlined the vision to re-establish essential healthcare services for Martin County and the surrounding communities.

Because REHs cannot provide inpatient services except in very limited situations, ECU Health is also advocating for $150 million to expand inpatient capacity at ECU Health Beaufort Hospital, a campus of ECU Health Medical Center. ECU Health Beaufort Hospital is a Hill-Burton Act hospital built in 1958, highlighting the importance of investing in modernizing the facility to support the regional system of care.

“Solving the rural health challenge means pursuing transformative solutions that create sustainable heath care access,” said Waldrum, in a statement. “ECU Health’s expertise is rural healthcare, and our proposal reflects our unwavering commitment to our mission to improve the health and well-being of eastern North Carolina. In my conversations with state leaders, it is clear there is a shared desire to support rural communities like Martin County. The state investments we’re seeking are critical to support the development of a regional system of care which is central to creating sustainability in and around Martin County.”

Like many rural regions, eastern North Carolina faces high rates of chronic illnesses and socioeconomic disparities. Martin County is one of North Carolina’s least healthy counties, according to a study by the University of Wisconsin Population Health Institute. With high rates of obesity, smoking and premature deaths, the county’s health challenges underscore the need for local access to high-quality care.

The Martin County Board of Commissioners will consider ECU Health’s proposal and public input before determining next steps.