Rural Virginia County waits, after years, to reopen the hospital
Rural Virginia County waits, after years, to reopen the hospital
It was lunchtime on Election Day and Gary McElyea, a councilman in a small town in the sprawling westernmost county of Virginia, was campaigning under a tent when the heart attack occurred.
"We were at the polls, and he just hit the ground," said Pennington Gap council member Jill Carson, who described an agonizing wait for a helicopter to arrive and take McElyea to a Tennessee hospital about 40 miles away.
There was nowhere to look for care because the only hospital in Lee County, one mile from the road where McElyea got sick, abruptly closed its doors in 2013.
In the five years since then, the leaders of the local community have been struggling to reopen the facilities, and after a series of attacks and starts, it seemed that much of this year could happen thanks to an agreement with a new company. However, according to officials, the financial challenges to which the company recognizes that it has been operating have questioned the plan at the last minute. It is a story that illustrates the arduous task of trying to revive a closed rural hospital and the harsh realities of disparate access to health care in many parts of America.
"Our county desperately needs a hospital," said Dr. J. Scott Litton Jr., a family medicine physician and native of Lee's mountainous county, which is home to some 24,000 people. One of the poorest counties in Virginia, hit by the opioid crisis and the decline of the coal industry, Lee County stretches for 70 miles (113 kilometers) to the corner where the state is located. meet with Kentucky and Tennessee.
Litton and other local officials and community leaders say the closure has been devastating, which has not only generated much longer travel times for patients like McElyea, but also puts pressure on emergency services and the local economy. Some are convinced that people have died due to lack of access to care.
Litton said it is not uncommon for patients to wait in their parking lot before the office opens, often with problems that would be better handled in an emergency department.
"We have patients who walk with fractures and patients who walk with their hands wrapped in a towel with an active and bleeding laceration," Litton said.
The long, triangular shape of Lee County has made the loss of the hospital a "nightmare for emergency personnel," said County Administrator Dane Poe.
In some areas, it's now at least an hour to get to a hospital of any kind, and the closest trauma center is in Kingsport, Tennessee, Poe said. That can mean a response time of three to four hours in a single call for the mosaic of volunteer rescue squads in the county.
The closure also cost county jobs and has made it harder to recruit new industries or even workers for the area, Poe said.
Many residents were surprised when the previous owner of the hospital announced closure plans in 2013 shortly after renovating the emergency room. But the closure was adjusted to the national trend of rural hospitals in distress that close their doors.
According to the North Carolina Rural Health Research Program at the University of North Carolina at Chapel Hill, 89 rural hospitals have closed since January 2010. Eight have reopened.
According to the National Association of Rural Health, another 673 rural facilities, or about a third throughout the country, are vulnerable and could be closed.
In addition to the challenge of hospital closures, rural areas in the United States generally have fewer doctors to care for residents who are more likely than their urban counterparts to be elderly, uninsured and living in poverty.
After the hospital closure, Lee County recovered. They held organizational meetings, looked for new potential operators and formed a hospital authority, a measure that obtained special approval from the state legislature.
The members of the authority then obtained a certificate from the state to operate a hospital. They sought advice and help from the delegation of the state Congress.
According to a report from the hospital authority, they bought the building and kept it paying for the basic maintenance of the land and the boiler system.
Approximately three years after that effort, Americore Health, a new management and procurement company for rural hospitals, approached the group to reopen it.
The company has already invested around $ 5 million in the opening of the facility and will probably spend around another $ 2 million, said Americore CEO Grant White. The plans require a 25-bed intensive care hospital and two general-purpose operating rooms that open by December 31, a deadline according to the state's existing public need certificate.
By all accounts, Americore had been working diligently on reopening until mid-August, when work on the project seemed to stop, said Jeff Mitchell, a lawyer for the Blacksburg-based authority. Members of the authority also began to see news reports about problems at the company's other hospitals, including unpaid tax bills, payroll problems, layoffs and disputes with lenders.
The authority recently gave the company two weeks to provide evidence of the "feasibility and sustainability of the project," Mitchell said. He said he expects the board to determine at its next meeting on Thursday whether he believes the company can reopen the hospital and consider the next steps.
White said he believes Americore can satisfy the authority and is committed to carrying out the project.
"We are pushing full steam to reopen the site by the end of the year," he said on Friday.
Meanwhile, the community waits and prays for the best, said McElyea and others.
"I can not think of anything more important for Lee County at this time, or at any time, than in a hospital," said veteran Gary Parsons.
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