If Pioneer Community Hospital of Scott follows through on its closure notice, it will be the sixth rural hospital in the Volunteer State to close in the past sixteen months.
In what is becoming a disturbingly common event, another rural hospital in Tennessee has filed notice with the state that it will close.
If Pioneer Community Hospital of Scott follows through on its 30-day notice with the state, it will be the sixth rural hospital to close in Tennessee in the past 16 months. The list of shuttered hospitals includes Gibson General Hospital in Trenton; Humboldt General Hospital; Haywood Park Community Hospital in Brownsville; Methodist Fayette in Somerville; and McNairy Regional Hospital in Selmer.
(Since 2010, Tennessee has also lost Parkridge West Hospital in Jasper, Starr Regional Medical Center-Etawah, and United Regional Medical Center in Manchester.)
The specific details of the closings vary somewhat for each hospital.
In most cases the hospitals were old and in need of significant capital upgrades. Their patient mixes were largely uninsured or Medicare-/Medicaid-dependent.
When Gibson and Humboldt closed, parent company West Tennessee Healthcare kept outpatient clinics open to assure continued access to care. In most cases, the communities were left to fend for themselves.
The closure of Pioneer Community Hospital of Scott, which is owned by Magee, MS-based Pioneer Health Services, provides a dire example of all the bad things that happen when a hospital shuts down in rural America.
Pioneer is a critical access hospital serving a poor and isolated region. When it closes, residents of Scott County, which borders Kentucky, will have to travel 40 miles on twisting roads to access care at the nearest hospital: Jamestown Regional Medical Center.
'You Can't Get There from Here'
On the economic side, Scott County is one of the poorest counties in Tennessee. The mean annual household income is $30,206, and 26% of families live below the federal poverty line.
The loss of about 100 relatively well-paying hospital-related jobs is sure to have a negative effect on the local economy, and the lack of a hospital will make it that much harder to recruit new businesses to an already struggling area.
"Scott County is one of those places where you can't get there from here," says Tennessee Hospital Association President Craig Becker.
"It is up in the mountains and it's a long haul down to Knoxville for sick patients. That was one of those hospitals that is very much isolated and one where it's going to be a devastating economic impact on that community as well."
The common thread for this spate of closings is that Tennessee remains one of 19 states that continue to reject Medicaid expansion under the Affordable Care Act.
That means that hospitals across Tennessee have to provide charity care for about 350,000 people who otherwise would have been eligible for Medicaid. Becker says 24 rural hospitals in the state have been identified as "vulnerable" to closing and he says the refusal to expand Medicaid is taking its toll.
"All you have to do is look at what is going on in other states (that have expanded Medicaid) to realize that it does make a positive difference for rural hospitals," he says. "We have seen what it can do in other states and we think the same thing would happen here."
Feeling the growing public pressure, the Republican-controlled Tennessee General Assembly has called for a task force to consider a gradual approach to Medicaid expansion.
"We're hopeful on that, but right now there are not a whole lot of details," says Becker.
"Because hospitals are going to be expected to pay for it, until we see the details we are holding back."
John Commins is a content specialist and online news editor for HealthLeaders, a Simplify Compliance brand.