Small rural hospital closes doors; more may follow

The Friday closing of Calhoun Memorial Hospital in the southwest Georgia town of Arlington reflects the financial squeeze that many rural facilities face.

A handful of other rural hospitals in the state also may be teetering on the brink, with rising levels of uninsured patients and with Medicaid continuing to pay low rates for services.

HomeTown Health, an organization of rural hospitals in Georgia, says a half-dozen facilities could follow Calhoun Memorial’s move and shut down in the coming months.

Ironically, news of the nonprofit hospital’s closing came just hours after the state House passed a bill to facilitate renewal of the hospital provider fee. Jimmy Lewis of HomeTown Health said that if the bill had failed and the fee had vanished, more than 20 rural hospitals might have had to close.

Many hospitals in rural counties, though they have managed to stay afloat, have already given up obstetrical services because of financial losses and difficulty in recruiting OB/GYNs to deliver babies. (Here’s a recent GHN article on the problem.)

The 25-bed “critical access’’ Calhoun Memorial is the first rural facility to close since Telfair Regional Hospital in McRae, in south-central Georgia, closed in 2008, Lewis said Monday.

Earl Whiteley, CEO of Calhoun Memorial, cited the increase in charity care that the Calhoun County hospital incurred as a major reason for the hospital’s demise.

He told GHN on Monday that indigent charity care rose from $834,000 in 2008 to $1.8 million last year.

“You just can’t continue to give away free care,’’ Whiteley said.

He also noted that the federal Affordable Care Act (ACA) is removing indigent care funds that go to hospitals. As originally envisioned under the ACA, the uninsured patients affected by that cutoff were to get coverage through Medicaid instead. But the U.S. Supreme Court ruled last year that states don’t have to expand Medicaid to cover such people, and Gov. Nathan Deal says Georgia won’t do it because it’s too costly.

Calhoun County has an 18 percent unemployment rate, and Whiteley added that even patients with insurance had high deductibles, ranging from $1,500 to $5,000 a year. Those amounts can make it difficult for many people to pay medical bills until the deductible is reached.

The impact of the closing on Calhoun County’s 6,600 residents may be profound. According to county health rankings produced by the University of Wisconsin, the county’s health outcomes already are ranked 154th in Georgia, ahead of only Terrell and Talbot counties. (Three of Georgia’s 159 counties did not receive a ranking.)

Factors that drove Calhoun’s ranking downward included its high rates of uninsured, obesity, premature deaths, and low-birthweight babies, the data show.

Whiteley said with the closing, it may take residents 45 minutes to drive to the nearest hospital. The effect will be dramatic, especially for those needing emergency care, he said. “The golden hour is lost to many patients.’’

(The “golden hour’’ is the time in which the lives of many critically injured patients can still be saved if full-scale hospital treatment, such as surgery, is provided.)

Prior to Friday’s action, the Calhoun hospital authority had sold an assisted living facility and its nursing home. The hospital had stopped admitting patients, so there were none left to transfer to other hospitals. A medical clinic will remain open in Arlington, Whiteley said.

The economic impact on Arlington and Calhoun County will be profound, with up to 100 employees losing jobs.

Then there’s the emotional toll as the hospital ends 62 years of service.

“It’s a sad day,’’ Whiteley said.

“Heartbreaking,’’ hospital pharmacist Sally Ray told WALB-TV in Albany. “It’s truly like a death.’’