At the emergency room in Irwin County Hospital in Ocilla, Georgia, nurses treat a man for a possible stroke. The man is propped on a bed and hooked up to a machine that monitors his heart rate. He’s the only patient in the emergency room.
“Our ER is not very large. It’s only four exam rooms, a cardiac room and trauma room,” said Jason Baxley, a nurse at the hospital.
While it isn’t very large, Baxley said the ER stays busy treating patients from the community.
“We see on average, some days that are slow, seven to eight patients, to 12 or 13 patients per shift,” he said. “We treat anything from common colds to cardiac arrests.”
Irwin County, which the hospital serves, has a population of about 9,000 people. The 34-bed hospital has been struggling financially, said Clay Jones, regional director of operations for E.R. Hospitals, which manages the hospital.
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“If we’re not here, people die, and that’s something that we live with every day,” Jones said.
Irwin County Hospital is one of many rural hospitals in the country that have been struggling to keep their doors open. Since 2010, nearly 80 hospitals have closed across the country, according to the North Carolina Rural Health Research Program.
Irwin County Hospital, which has been in debt, recently had to lay off about 20 staff members. Jones said one reason for the shortfall is that a lot of patients that the hospital and emergency room serve do not have insurance or are underinsured.
“Our emergency room doesn’t make money,” he said.
The Affordable Care Act was supposed to help by insuring more people, but Georgia was one of 19 states that did not expand Medicaid coverage. In the meantime, reimbursement payments to hospitals from the federal government have been declining, and rural patients are also often older or sicker, said Maggie Elehwany, vice president of government affairs and policy at the National Rural Health Association.
She said she hopes Congress will specifically address the rural hospital closure crisis.
“If the hospital closes, the physicians leave, soon the nurses leave, the nurse practitioners, the physicians’ assistants leave," Elehwany said. "We’re actually seeing these health care deserts forming across the country.”
As Congress looks to replace the ACA, Elehwany said she wants health care to work for rural America, including making sure people still have access to a nearby hospital.