OKLAHOMA CITY – Several rural hospitals in Oklahoma have been on life support in recent years. Some have been shuttered but others are thriving or at least surviving as clinics, albeit at a reduced level of service.
Oklahoma Hospital Association records indicate six hospitals have closed since 2016 and eight others have declared bankruptcy in the past four years. However, several of those facilities are still in operation.
ALTUS HOSPITAL ACQUIRED HOLLIS FACILITY
Jackson County Memorial Hospital (JCMH) at Altus assumed ownership of Harmon Memorial Hospital (HMH) at Hollis in March of this year. JCMH, constructed in 1949, is licensed by the state for 49 beds. Services it provides include clinical care, women’s services such as obstetrics/ gynecology, labor and delivery, plus a women’s imaging center in radiology.
JCMH also has a counseling center for mental and behavioral health, a diabetes center, a sleep lab, Home Care, hospice, clinics for family practice, pediatrics, and orthopedics, and rehabilitative services, including physical, speech, and occupational therapy. Patients with more severe ailments, such as a brain injury, would be stabilized and transported to a medical facility elsewhere, Ms. Reimer said. Two air ambulances services – Survival Flight and Air EVAC – operate in the area.
HMH is a 25-bed “critical access” facility that is a designation given to eligible rural hospitals by the Centers for Medicare and Medicaid Services. The designation is designed to “reduce the financial vulnerability of rural hospitals and improve access to health care by keeping essential services in rural communities,” said Amanda Reimer, public relations/ marketing director at Jackson County Memorial Hospital.
To obtain the Critical Access Hospital designation, a hospital must meet the following conditions, Ms. Reimer related:
• have 25 or fewer acute care in-patient beds;
• be located more than 35 miles from another hospital (exceptions apply);
• maintain an annual average length of stay of 96 or fewer hours for acute care patients;
• provide around-the-clock emergency care.
JCMH and HMH both have 24-hour emergency services, Ms. Reimer said.
FREDERICK HOSPITAL NOW A CLINIC
Memorial Hospital at Frederick stopped offering inpatient treatment and closed its emergency room at the end of March 2016 as a consequence of declining traffic and reduced Medicaid reimbursement rates for physicians.
A Comanche County Memorial Hospital spokesperson said there weren’t enough patients seeking treatment at the Frederick hospital to justify the cost to keep the ER open. The hospital’s emergency room treated fewer than two patients per day, on average, and services for patients admitted to the hospital lost the most money, she said. Instead of a “full-service” hospital, Frederick now has a medical clinic that is a primary care facility offering laboratory services, physical therapy and radiology services (X-ray only), said Nicole Jolly, Comanche County Memorial Hospital’s marketing director. The Frederick health-care facility is affiliated with the Lawton hospital.
DUNCAN REGIONAL RUNS WAURIKA HOSPITAL
Duncan Regional Hospital leased and took over operation of Jefferson County Hospital at Waurika in early 2017. In addition, Duncan Regional operates family care clinics in Comanche, Marlow, Ringling, Ryan, Velma, Walters, Waurika, and three in Duncan; a medical supply company, an imaging center, a cancer center, and a behavioral health center; specialty clinics in hospice, wound care, bone and joint, obstetrics/gynecology (in Duncan and Chickasha), eye care, intervention radiology, a children’s clinic, orthopedics, urology, pulmonology, a sleep institute, and an allergy, ear, nose and throat clinic.
SAYRE HOSPITAL SHUT DOWN
Sayre Memorial Hospital in Beckham County, a 31-bed non-profit community facility, closed its doors on 1 February 2016, citing “continual financial strain.” In the wake of the 2008- 2009 recessions, the federal budget-cutting sequestration act trimmed Medicare payments by 2%, hospital officials said. Then in 2012, reimbursements to Sayre for Medicare patients who couldn’t cover their out-of-pocket expenses were slashed 30% - 35% by the Centers for Medicare & Medicaid Services.
The financial stress was aggravated by the adamant refusal of Republican Oklahoma state government leaders to expand Medicaid; by the temporary closure of a major employer, the North Fork Correctional Facility at Sayre, in November 2015; and by a downturn in the oil patch that accelerated the hospital’s financial deterioration.
PV CENTER TO REOPEN AS URGENT CARE CLINIC
Pauls Valley Regional Medical Center, a 62-bed hospital that opened in January 1970, was closed in mid-October 2018 after struggling financially for several years. The shutdown cost more than 100 hospital employees their jobs. Southern Plains Medical Group, which was established and has been serving central and southwest Oklahoma since 1915, has announced plans to open an urgent care facility in the former Pauls Valley hospital building, perhaps sometime this month. Mike Schuster of SPMG indicated X-ray, lab and nursing will be some of the services offered at the clinic.
Other hospitals that have closed in recent years included Epic Medical Center in Eufaula and Latimer County General Hospital in Wilburton. Mercy Hospital at El Reno shut its doors but has reopened as an outpatient-only facility managed by SSM St. Anthony, according to Susie Wallace of the Oklahoma Hospital Association.
Affiliates of EmpowerHMS, which owned Drumright Regional Hospital, Fairfax Community Hospital, Haskell County Community Hospital at Stigler, and Prague Community Hospital, filed for Chapter 11 bankruptcy in March of this year. Nevertheless, all four hospitals are still in operation.
Craig General Hospital at Vinita announced in 2015 that it was broke but remains open as Saint Francis Hospital Vinita. Pushmataha Hospital, which filed for bankruptcy, remains open and provides emergency care, laboratory and radiology services, general surgery and “swing bed,” according to its internet website.
Atoka County Medical Center also remains open despite bankruptcy and provides several services, including emergency services, imaging, laboratory, surgery, therapy, and swing bed. (The swing bed program is a skilled- care program designed to help patients who are no longer in need of acute care in a hospital, but still require more rehabilitation before they can return home. Stays are typically short-term and are utilized for a variety of conditions, such as extended antibiotic therapy, heart disease, joint replacement and other surgeries, respiratory diseases, strokes and other debilitating conditions.)
RURAL HOSPITALS FACE CHALLENGES
Brock Slabach, senior vice president for member services at the National Rural Health Association, told the Oklahoma Watch news organization that the most serious challenges rural hospitals have faced are:
• the effects of mandatory across-the-board federal spending cuts (known as sequestration) on Medicare payments to providers;
• the drop in Medicare’s reimbursement rates for hospitals to cover bad debts;
• the fact that rural hospitals treat higher percentages of patients who are elderly, sick and poor;
• a decline in the number of patients caused by various factors, including insurers limiting covered hospital stays, and higher deductibles causing patients to delay or forego medical treatment.
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