Rural hospital plans October closure; COVID was the last straw

The financial blow from COVID-19 has helped force the closure of a rural hospital in Georgia.

Southwest Georgia Regional Medical Center was facing financial challenges even before the pandemic struck, and Randolph County, where it is located, has among the highest per-capita infection rates in the state.

Randolph County

“It has become increasingly difficult for small, critical-access hospitals to survive in rural areas across the country and here in Georgia,’’ Southwest Georgia Regional’s CEO, Kim Gilman, said Friday in a news release announcing the hospital’s closure, planned for Oct. 22.

The facility in Cuthbert, the county seat, “had been operating on the brink for years and before the COVID-19 crisis,” Gilman said. “Once the crisis hit, it simply pushed our hospital past the point of no return.”

A Cuthbert nursing home belonging to the same health system has seen 55 residents and 33 staff members test positive for the disease.

Southwest Georgia Regional would be the eighth rural Georgia hospital to close since 2010, though some have reopened as downsized facilities with fewer services.

The administrator for the federal agency overseeing Medicare and Medicaid, who was in Atlanta to address health care leaders, said Monday that the Trump administration has taken action to help rural medical providers.

“We have always been concerned about rural hospitals,’’ Seema Verma, head of the Centers for Medicare & Medicaid Services, told GHN. “The pandemic has made things worse for rural communities.’’

She said the administration has improved the way that rural hospitals have been reimbursed, allowed them more regulatory flexibility, and dedicated funding to them from a provider relief fund.


Jimmy Lewis of HomeTown Health, an association of rural hospitals in Georgia, said the Cuthbert hospital closure was due to a combination of negative factors: financial pressures, a sparse local population, and the fact that many potential patients lack health insurance.

A public health calamity such as COVID-19 can send a rural facility “into financial distress and potential insolvency,’’ Lewis added.

Some improvement, but numbers still bad

At a Monday meeting with Verma and U.S. Sen. Kelly Loeffler (R-Ga.), leaders of metro Atlanta hospitals detailed their own financial challenges related to COVID-19, as did representatives of Georgia’s nursing home industry.


“The financial burden, especially in hot spots, has been really tremendous on health care systems and hospitals,’’ said Dr. Jonathan Lewin, CEO of Emory Healthcare. Getting personal protective equipment and even disinfectant wipes has been a big challenge, he added.

On Monday, state officials reported 3,181 COVID-19 hospitalizations. That’s a increase of 102 patients in 24 hours.

John Haupert, CEO of Grady Health System, said Monday that major hospital systems in metro Atlanta have seen a more than 300 percent increase in COVID-19 patients from a month ago. He said the hospital systems have been affected financially by this, experiencing  “significant losses.’’

A focus on nursing homes

Federal health officials are sending rapid point-of-care testing instruments and tests to nursing homes throughout the country to aid in identifying and curbing COVID-19 infections.

“Obviously, nursing homes have been hit hard by this,’’ Verma said at the Atlanta meeting. Amid the pandemic, nursing homes’ large numbers of medically vulnerable patients have made them centers of local outbreaks and deaths.

Verma speaking to reporters

Tony Marshall of the Georgia Health Care Association, which represents nursing homes, said Monday that new virus cases have gone from 1,400 in June to more than 2,000 so far in July.

Overall occupancy of nursing homes is down significantly, which is costing the industry $1 million per day in lost revenue, Marshall added.

Both Verma and hospital officials pointed to another crucial need: More outreach to minority communities to fight COVID-19 and promote overall health improvements.

Dr. Jayne Morgan, director of innovation for Atlanta-based Piedmont Healthcare, said stronger efforts are needed to recruit more minority patients into clinical trials. “It’s important for us to develop drugs and vaccines’’ for minority populations, she added.

With the disproportionate burden of COVID among African-American and Latino communities, Emory’s Lewin said messaging campaigns are critical to help connect with these residents.

At a Grady-run clinic on metro Atlanta’s Buford Highway, which serves mainly Latino patients, 58 percent of those tested have been found infected with COVID-19, Haupert said. That’s far higher than the state average. (Here’s a recent GHN article on the COVID impact on Latinos/Hispanics.)

Financial plight goes from bad to worse

Southwest Georgia Regional Medical Center said that even before the COVID-19 crisis,  it was in critical need of major upgrades and renovations.

The hospital said its top officials tried for months to secure more than $10 million in funding for facility improvements.

Phoebe Putney Health System, based in Albany, has managed all three of the Randolph County Hospital Authority’s facilities since 1996.

The Randolph County Hospital Authority, which oversees the hospital, unanimously voted in favor of the closure, WFXL-TV reported. “Within a few months, our financial situation would be such that we would not be able to make payroll,” said Steve Whatley, chairman of the hospital authority.

About 90 employees will be needed for the continued operation of the Joe-Anne Burgin Nursing Home and family medicine clinic. About 50 employees will be affected by the hospital closure, and Phoebe “has committed to placing as many of those people as possible within the Phoebe health system,” a press release stated.


Pandemic-related federal money has helped struggling rural hospitals stay afloat, according to a recent Stateline article.

“We’re due for reckoning in our rural hospital policy,” said Ge Bai, associate professor of health policy and management at the Johns Hopkins Bloomberg School of Public Health in Baltimore, Stateline reported.

Since 2010, 128 rural hospitals in the U.S. have closed, including a record 18 last year. Even more rural hospitals were on track to shut down this year until Congress in March approved $100 billion to health care providers in the CARES Act. The support included $10 billion in targeted funding that was allocated based on operating expenses before COVID-19.

Earlier this month, the U.S. Health and Human Services Department announced another $1 billion targeted to certain hospitals that serve rural populations.

Monty Veazey, CEO of the Georgia Alliance of Community Hospitals, said Monday that “in Randolph County, the next nearest hospital is 30 miles away, and many in the community will struggle with transportation if they become ill or simply need routine care.”

In some cases, he added, the lack of a local hospital may be a life-and-death matter. “In emergency situations, the ‘golden hour’ that can determine the outcome of a trauma can often be lost if transportation to a distant hospital is not available.”

National Guard at Southwest Georgia Regional