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Rural Hospitals Struggling Financially Because Of COVID-19


The coronavirus pandemic has put immense strain on U.S. hospitals. Not only have nearly 1,300 health care workers died, but dozens of hospitals have filed for bankruptcy. And rural America is bearing the brunt of this trend, which started before the pandemic. More than 130 rural hospitals have closed in the past decade, 15 in 2020 alone.

We're joined now by Sarah Jane Tribble of Kaiser Health News, who's been covering these closures and the communities which they affect. Sarah Jane, thanks so much for being with us.

SARAH JANE TRIBBLE, BYLINE: Thanks for having me.

SIMON: You have a podcast called Where It Hurts, and it's about Fort Scott, Kan., and what happened to the people there after the town hospital closed. Why did you spend more than a year reporting on this one small town?

TRIBBLE: Well, Scott, I'm from rural Kansas. I grew up on a gravel road in the southeastern part of the state just an hour from this town, Fort Scott. My parents still live there. It was my mom who called me one day and told me Mercy Hospital was closing. And it closed at the same time my older sister, who was living just outside of Kansas City, was sick with pancreatic cancer. So I was thinking a lot about how people use the health system at the time.

SIMON: Yeah. You've reported on some of the many reasons why rural hospitals are losing money, including they're in areas that are losing population and the aging population. But now that this hospital, Mercy in Fort Scott, has closed, where do people who need medical help go for treatment?

TRIBBLE: Well, people have to drive further. They have to drive further to have a baby, to get dialysis. They even have to drive further for their chemotherapy treatment. And that's really hard. Rural Americans as a whole tend to be an older and sicker population, and they have lower incomes. I spoke to people who couldn't afford that drive.

One of the saddest things is when a small-town hospital closes, it affects those people's sense of place, their pride in their community, and the people feel less secure and more vulnerable, like Linda Findley. Her husband died just after the hospital closed, and now she lives alone.

LINDA FINDLEY: You know, I don't think losing the hospital is the end of the world for Fort Scott, but I sure think it put an ugly notch in our belt, and not just Fort Scott - all these other hospitals that have closed down. I mean, my gosh, you need to feel like you're safe and can be taken care of where you're at.

TRIBBLE: Those are real fears. We know that people who live in rural places where a hospital has closed are more likely to die than those who live in cities where a hospital has closed.

SIMON: And now, of course, we're in the eighth month of a pandemic. And, in fact, in rural America, coronavirus cases seem to be at record levels. What does this mean for people who live in communities like Fort Scott where hospitals have closed?

TRIBBLE: Yeah, it's really troubling. We know COVID-19 is more dangerous for certain people, like older Americans, but also people who are obese and people who have chronic diseases like diabetes. Plus, we know the virus is especially difficult for people of color. When you consider that rural hospital closures have happened more frequently in the South, it's a recipe for more deaths.

SIMON: And, Sarah Jane, what are you hearing out of Fort Scott during this pandemic with the hospital gone?

TRIBBLE: Just this week, I heard there's a surge of cases in southeast Kansas. So after Mercy Hospital closed in Fort Scott two years ago, the next-closest hospital became Via Christi in a town called Pittsburg. That hospital said this week that they have 20 COVID-19 patients in their beds. That's a significant number for them. So they're temporarily stopping elective surgeries and procedures to deal with this surge of patients, and that's going to hurt their bottom line.

SIMON: I'm wondering what you've learned from people in Fort Scott that other communities might learn from right now.

TRIBBLE: I talked with a lot of people in Fort Scott who have really significant health care needs, and they were scared when the hospital closed. But even if the hospital had not closed, not all of their health problems could've been taken care of at the hospital. Hospitals are not always the best place for people who need help managing their chronic illnesses, like emphysema and diabetes, not to mention addiction and mental health issues.

I saw people in Fort Scott gradually come to terms with this idea that a traditional hospital may not be what they really need. Often, just a good community health clinic can fill some of the gaps. And some rural places have tried a kind of hybrid hospital - just an emergency room with maybe a few overnight beds.

SIMON: Sarah Jane Tribble, a health reporter at Kaiser Health News, talking about the closing of rural hospitals and the stories she found in one small Kansas town where that's happened. You can hear more in her narrative podcast Where It Hurts. Sarah Jane, thanks so much for being with us.

TRIBBLE: You're welcome, Scott. Transcript provided by NPR, Copyright NPR.

Sarah Jane Tribble
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