Local 6 Extra: State of rural health care

Mother of five Tara Wilkinson spent more time in the emergency room in recent months than the grocery store.  

“I had a son run over by a lawn mower and cut his foot open,” she recalled.  

That isn’t the worst of it. Her daughter is deaf and has cochlear implants. Any slight mishap means emergency surgery.

“If she was to fall or bump that head really hard, we’ve got an emergency situation on our hands,” Wilkinson said.

Until April, Wilkinson’s hospital of choice was Parkway Regional in Fulton —a five minute drive away.  In December, the hospital announced an end to emergency services, citing “Fewer patients require acute care and reimbursement is less than the care provided,” according to a hospital news release.

The hospital, which earned national recognition for its surgical care, pulled the plug March 31.

A day before, Kentucky Auditor Adam Edelen released a 122 page report on the financial strength of the state’s rural hospitals. Reduced medicare and medicaid payments, imposed by the Affordable Care Act to help pay for expanded health care coverage, paint a bleak picture for the commonwealth.

Hospitals are trying to remain fiscally responsible. Unfortunately, some have had to issue layoffs or even pay cuts. Murray-Calloway County Hospital CEO Jerry Penner said his hospital hasn’t been immune to the financial struggles.

“The impact on hospitals is absolutely devastating,” Penner said.

Penner said those lower reimbursements hurt hospitals like his because that’s how most of his patients are insured: either through Medicare or Medicaid. “You can’t continue to squeeze these reimbursements down and expect us to continue to be able to be efficient as we can,” Penner told Local 6.

Starting in 2012, hospitals that had to readmit patients within 30 days of discharge faced even more cuts to Medicare —another part of the healthcare law.

“At some point you can’t be all things to all people when your revenue streams are drying up,” Penner said.

A year later Penner laid off 53 employees and closed the hospital’s Geriatric Behavioral Health Unit. He said the decision wasn’t easy.  

“I’ve got to meet them at Wal-Mart, and I got to see them at church, and I got to see them at Murray State game. I got to see them over at the park or the ball field where their kids are playing ball out there, and realize I laid them off. And that just makes my stomach turn,” Penner said.

Another financial report from the Kentucky Hospital Association estimates federal cuts to Kentucky hospitals will total $7 billion through 2024.  KHA President Michael Rust said most of the state’s hospitals receive 80 percent of their revenue through Medicaid and Medicare payments.  With $7 billion in cuts, it could put most hospitals on financial life support.

“When you have a program that, both programs that are reimbursing you below your costs, when you’ve got 70, 80 percent of your business is a significant challenge to your hospitals,” Rust said.
Paying qualified doctors is another challenge. Smaller, more rural communities typically don’t pay as much as larger, metropolitan cities.  Rust said KHA is working with universities, including Murray State, to attract more students.

“We worked with them to partner with some of our hospitals statewide to put in more training programs, more slots for these students,” Rust said.

Wilkinson said Fulton needs a shot in the arm because the nearest open Kentucky hospital is in Mayfield, which is almost 30 miles away, and many of her neighbors don’t have the resources to make it there.

“They don’t have transportation to get to jobs and stuff, and there is nothing for these kids to look forward to,” Wilkinson said.

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