Health

Rural Georgia community revolts after hospital closes


CUTHBERT, Ga. – Lacandie Gipson has trouble breathing.

A 33-year-old woman with multiple health conditions, respiratory failure and waiting for an ambulance. About 20 minutes after the emergency call, it arrived.

The Cuthbert house where Gipson lives is less than a mile from Southwest Georgia Regional Medical Center, but an ambulance could not take her to the single-story brick hospital because it had closed three months earlier, in October. 2020.

Instead, the EMTs put Gipson in an ambulance and drove her more than 25 kilometers to a hospital in Eufaula, Alabama, where she was pronounced dead.

“They said it was a heart attack,” said Keila Davis, who, with her husband, lives with Gipson. “If the hospital had stayed open, it could have saved her.”

Cuthbert Hospital is one of 19 rural hospitals in the United States that closed in 2020. That is the largest amount of such facilities will be shut down for a year from 2005, when the Cecil G. Sheps Health Services Research Center at the University of North Carolina began tracking the data.

In the past 10 years, eight rural hospitals have closed in Georgia; only Texas and Tennessee were closed more. The center’s data shows that 86 of the 129 hospitals that closed at the time were in Texas and the Southeast.

Healthcare professionals and recent research says Medicaid expansion helps keep hospitals open because it increases the number of low-income adults with health insurance. None of the eight states with the most rural hospital closures since 2014, when the Medicaid expansion was first implemented through the Affordable Care Act, chose to expand insurance programs as early as 2021. In some of those states, including Georgia, Republican-led governments have said such a move would be too costly.

Georgia’s inaction on expanding Medicaid “probably hurts us more than anyone else,” said Cuthbert Mayor Steve Whatley, a Republican who lost his re-election bid in a city of approx. 3,400 inhabitants in November.

Some communities may feel more hospital closures than others. Whatley said, one of the people at Cuthbert, “had an unbelievable impact.” Not having an emergency room nearby means that each ambulance response takes two to three hours offline, said Whatley, who is also president of the Randolph County Hospital Authority.

Clifford Hanks, 78, of Cuthbert recently had to drive to Eufaula’s clinic when he had severe back pain. “Ambulances are too slow and unavailable,” Hanks said, sitting in a shop on Cuthbert Square. The drive, he said, was tough.

According to the Sheps Center, a number of factors have contributed to hospital closures across the country. George Pink, a senior researcher at the center, said rural hospitals are struggling to treat large numbers of uninsured patients and those with chronic illnesses. “They have a high level of uncompensated care, and not enough patients have private insurance, which will reimburse hospitals for a higher rate than Medicaid and Medicare,” says Pink.

Populations in rural areas also tend to be older, which will lead to increased costs of care.

Pink also says that recruiting doctors in rural areas, many of which have shrinking populations, is difficult. And many of the hospitals that have closed are experiencing infrastructure problems as funds to maintain buildings and equipment are dwindling.

“These hospitals have been at a loss for years,” says Pink.

University of Washington researchers found that rural hospital closures resulted in increased mortality for inpatients in that area, while urban closures had no effect. measurable use. Among the reasons they cited were an increase in the time people had to travel for hospital care and some medical providers leaving the community when hospitals were closed.

Federal covid relief funding has reduced hospital closure rates this year, according to Brock Slabach, operations director of the National Rural Health Association. However, the team estimates that 453 rural hospitals, or about a quarter of the total, are at risk of closing.

Jimmy Lewis, CEO of HomeTown Health, a rural hospital association in Georgia. “They’re running out of cash.”

Nationally, rural hospitals serving communities with large Black populations are more likely to be financially disadvantaged than rural hospitals, according to Sheps Center’s North Carolina Rural Health Research Program. And among rural hospitals struggling financially, the program’s research found, those serving areas with large Black and/or Hispanic populations were more likely to close. than. (The Spaniards can be of any race or a combination of races.)

The closure of the Cuthbert hospital severely affected the Black population in the area.

More than 60% of the residents of Randolph County are Black, and the surrounding counties, where residents used to go to Cuthbert for hospital care, have a Black population of 47% or more.

In the region, black Americans, especially older adults with diabetes and high blood pressure, are very concerned about hospital closures, said Charisse Jackson, an employee at CareConnect medical center. the institute said.

The community hopes for a return to medical care, if not a full resurgence of the hospital. The hospital regulator, locally based Andrews University and a Mississippi management company are working together to bid for US Department of Agriculture grants worth $1 million and $10 million. millions of dollars. The vision is to have an independent emergency room with a small number of beds. The hospital regulator, Whatley said, still has “a few million dollars” to support funding if it is approved. Whatley said: “Fifteen million dollars will do it.

US Senator Jon Ossoff (D-Ga.) has been concerned about the health care environment in Randolph County and is helping to identify private and public sector opportunities to restore more services healthcare in the area. “The challenges that people in Randolph County face are similar to those in rural health care,” Ossoff said.

In downtown Cuthbert, the history of Southwest Georgia Regional Medical Center is reflected in a mural on the walls of the former Randolph County courthouse, which is now the seat of the Randolph County Chamber of Commerce.

The family of local pharmacist Carl Patterson founded the hospital in 1916 as Patterson Hospital. After the facility’s closure, Patterson said, Randolph County did not have a full-time physician.

Supporting the hospital financially has always been difficult. It needed $10 million to upgrade, and surgery, a lucrative service at some facilities, wasn’t performed there.

“Our hospital isn’t the biggest, but it’s a vehicle to help you settle in. It has helped a lot of people,” said Brenda Clark, who was born in the hospital and now works at a Cuthbert wellness center across from the closed facility. Elderly people in need of care “can’t get into their car and drive to Eufaula or Albany,” she said.

Rebecca White, executive director of the county chamber of commerce, said the hospital closures have “devastated” businesses. About 25% of Randolph County residents lived below the poverty line.

“Without a doubt in my mind, that hospital was a lifesaver,” said Dr. AS Ghiathi, a family physician who has worked at Southwest Georgia Regional Medical Center for over 20 years. Ghiathi, 64, still lives in Randolph County but primarily works at a Mercer Medicine clinic in Fort Gaines in nearby Clay County. That county also doesn’t have a hospital.

Closing the Randolph County hospital, he said, was “like a death.” “Everyone is grieving this loss. We want to pass this hospital on to the next generation.”

Some Randolph County residents say the loss of the hospital was a factor in medical tragedies, such as the death of Lacandie Gipson, and possibly others.

Jeanette Love, 67, of the Randolph County town of Shellman, died while waiting for an ambulance, her sister Susie Jackson said. It’s called because Love is finding it hard to breathe.

The Randolph County ambulance was tied up, Jackson said, so someone from another county had to be dispatched to pick up Love, who has chronic obstructive pulmonary disease and diabetes. The delay was longer when that ambulance went to the wrong address.

“It took an hour and a half or so,” Jackson said.

“It’s about 15 to 20 minutes to Cuthbert,” said Jackson, who drove from her home in Shellman to Love’s house that day to help her. “I had a car. I was able to get her to the hospital. She could have been saved.”

Instead, while the sisters waited, Jackson said, Love “sitting beside me, resting his head on my shoulder, and died.”

Regarding the medical situation in Randolph County, Jackson said, “We’re better than this.”

KHN (Kaiser Health News) is a national newsroom specializing in the production of in-depth coverage of health issues. Along with Policy Analysis and Exploration, KHN is one of the three main activities in KFF (Kaiser Family Foundation). The KFF is a nonprofit organization privileged to provide information on health issues to the nation.

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