Troubled rural hospitals just got a new advocate—and he's on the move.
The mayor of a small North Carolina town began a 14-day, 273-mile walk Monday to Washington—an action he hopes will reopen his local hospital and draw attention to other struggling nonurban facilities across the nation.
“You can't let rural hospitals close across the country. People die,” Adam O'Neal, the Republican mayor of Belhaven, N.C., told Modern Healthcare as he walked Tuesday morning.
Fifteen rural hospitals closed their doors in 2013, and another seven have already done so this year, according to the National Rural Health Association.
At issue is one of those newly shuttered facilities: Vidant Pungo Hospital. The critical-access hospital sits in Belhaven, a town of about 1,700 residents that has a median household income of only $18,179, according to the U.S. Census Bureau. Pungo's service area encompasses about 20,000 people.
Vidant Health, the not-for-profit, Greenville, N.C.-based parent of Pungo, officially de-designated (PDF) and closed the hospital July 1. In September, Vidant originally announced it would shut down Pungo in April because of financial problems and replace it with a new 24-hour, multispecialty care clinic. After a series of negotiations, Vidant and Belhaven reached a mediation agreement in which Vidant would operate Pungo until July 1, with the town finding a new owner and operator by then.
That deadline has come and gone, resulting in the closure of Pungo. Roger Robertson, president of Vidant's community hospital division, said in a release that Vidant will still build the new multispecialty clinic in Belhaven. But Belhaven no longer has an emergency room, meaning area residents will have to travel as much as 80 miles to receive hospital care.
O'Neal said Pungo represented a sliver of Vidant's operations and shouldn't have been on the chopping block in the first place. Pungo lost $1.1 million in fiscal 2013 and posted $10.9 million in operating revenue—a drop in the bucket to Vidant's overall surplus of $109.6 million and $1.6 billion in revenue (PDF).
“You have laws to stop people who are immoral or have motives that are not for the public good,” O'Neal said. “We have an immoral, greedy nonprofit that is taking our hospital away.”
Vidant officials did not respond after multiple attempts for comment.
When O'Neal arrives in Washington, he hopes to meet with President Barack Obama and members of Congress to create legislation and put safeguards in place before health systems can shut down critical-access hospitals.
Along the way, he said he would also rally support for Medicaid expansion, a provision of the healthcare reform law that North Carolina and other conservative states have not embraced. O'Neal, who agrees with Republicans “on 95% of issues,” differs when it comes to expanding insurance for the poor, which he said is fundamental to securing hospitals' finances.
Rural health advocates believe closures such as Pungo are likely to continue as the year drags on. “It's tragic obviously for the patients and the community,” said Maggie Elehwany, vice president of government affairs and policy for NRHA. “And it's not the only story we're going to hear like this. That's the sad part.”
By the end of Tuesday, O'Neal plans to be in Ahoskie, N.C., a town with another Vidant facility: Vidant Roanoke-Chowan Hospital. He is optimistic his town's hospital will eventually reopen, but he wants a quick turnaround.
“When people start dying, I'm going to feel somewhat responsible in some way,” O'Neal said. “And I can't let that happen.”
O'Neal's walk schedule can be found at saveourhospital.org.
Follow Bob Herman on Twitter: @MHbherman
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