Rural U.S. Hospitals Are on Life Support as a Third Wave of COVID-19 Strikes

Time Magazine

When COVID-19 hit the Southwest Georgia Regional Medical Center in Cuthbert, a small rural town in Randolph County, in late March, the facility—which includes a 25-bed hospital, an adjacent nursing home and a family-medicine clinic, was quickly overwhelmed. In just a matter of days, 45 of the 62 nursing home residents tested positive. Negative residents were isolated in the hospital while the severely ill patients from both the nursing home and the local community were transferred to other better-equipped facilities.

“We were trying to get the patients out as fast as possible,” says Steve Whatley, Southwest Georgia Regional’s board chairman. “It was a daily nightmare.”

The scramble was exacerbated by a dire lack of medical necessities. Employees had to diligently conserve personal protective equipment. The hospital had no ventilators. And the nursing home’s air systems had to be retrofitted to create negative-pressure rooms to contain the airborne virus particles. Making matters even worse, one of the county’s only two physicians became ill with a severe respiratory disease unrelated to the coronavirus, while the other had an unexpected surgery requiring eight weeks of recovery time. Nurse practitioners stepped up as Southwest Georgia Regional waited for backup from neighboring health care organizations. More than 30 of 200 employees stopped working out of fear or because they got sick; the state of Georgia provided six nurses and two respiratory therapists as emergency relief. Despite the heroic efforts of the center’s staff, more than a dozen nursing home residents died within eight weeks of the virus’ arrival, though it’s unclear how many were directly due to COVID-19.

The ordeal left Southwest Georgia Regional—which was already struggling to survive—in financial shambles, as costs related to the coronavirus greatly exceeded revenues. It will permanently close on Oct. 22, making it the seventh Georgia hospital to do so since 2010. After Southwest Georgia Regional closes, Randolph County will become the 55th in the state to have no hospital at all. Residents will need to drive 30 minutes west and across the state line to Eufaula, Ala. or 50 minutes east to Albany, Ga. for care.

The middle of a pandemic is a bad time for a hospital to close. Yet Southwest Georgia Regional isn’t unique. Hospitals in St. Paul, Minn., Chicago, Houston and Philadelphia have recently closed or are set to do so soon. And in rural areas of the country, where hospitals often have enough beds for just a few dozen patients, 15 facilities have shuttered this year as of Oct. 20, including 11 since March, according to the Cecil G. Sheps Center for Health Services Research at the University of North Carolina at Chapel Hill. There may be as many as 18 such closures in 2020, topping last year’s record high. The hospitals in the worst financial shape generally have one thing in common: they serve the country’s most vulnerable people, who rely on Medicare and Medicaid or who are poor and uninsured.

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