In what advocates say is a continued downward death spiral for their state, two more Texas rural hospitals closed for good earlier this week, bringing the total count of rural hospital closures in the Lonestar State to 18 in the last four and a half years alone, according to the Texas Organization of Rural and Community Hospitals or TORCH.
A hospital in Trinity, Texas closed on August 1, and another in Crockett, Texas on July 1. The closures leave those communities without immediate access to emergency and other hospital care services.
"This closure crisis, which has left many rural communities without emergency and other care, has clearly reached epidemic proportions and unless the Texas Legislature and Congress take immediate steps, it will only worsen," said Dave Pearson, CEO of TORCH.
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TORCH represents the 163 rural hospitals in the state of Texas. Of the 18 closures, they noted that four were temporary closures and three were replaced with free-standing ERs. Still, the organization said the care is those towns is now very limited, and 11 communities have no hospital or emergency care.
Many more are teetering on the edge of closure, Pearson said, with a third of the remaining rurals operating on "shoestring budgets" and struggling to keep their doors open. The worst part is these situations could be avoided he said, and are largely due to Medicare cuts in recent years totaling more than $50 million and Medicaid underpayments to rurals that total close to $60 million each year.
Torch Director of Government Relations Don McBeath said these closures and the resulting lack of access to emergency care has resulted in "documented deaths" because the local hospital was not there to service those patients.
Additionally, the closures have a devastating impact on both the local and state economies. Rural hospitals cover 85% of the state's geography and serve 15% of the population. That population, kept healthy by the presence of their rural hospitals, drives the state economy, from food production to fuel. David Byrom, CEO of Coryell Hospital in Gatesville, said each Texas rural hospital employs an average 173 people and has $23 million in yearly payroll. That equals more than 22,000 jobs and expenditures of $3.7 billion a year, for a combined economic impact of more than $18 billion a year.
"The citizens of our rural communities fortunate enough to still have a rural hospital need to know this is happening around them and call their elected state and federal representatives and tell them to take action now to stem the tide of Texas' rural hospital closures. The two closures in the last month, bringing the total to eighteen in the last four and a half years, could be the tip of the iceberg."
Pearson said the closures have the potential to crush their local community economically and send residents moving out of town looking for jobs. Local businesses and schools will suffer as well, and the chances of bringing future economic development are hurt.
The Texas state legislature has recently instructed the state Department of Health and Human Services to look into the ongoing situation but that could move too slowly to stem more closures. "With a two-year study window, followed by who knows how much time to react to the findings, we could see dozens more of Texas' rural hospitals vanish."