JELLICO, Tenn.—Rebecca Jarboe, expecting her third child, began what turned out to be a difficult labor on Valentine's Day. A snowstorm blanketed the 14 miles of mountain roads that separated her home from the nearest hospital.
Her husband wanted to drive her to the University of Tennessee Medical Center in Knoxville. But that would have been a 70-mile journey over Jellico Mountain, which they rejected given the weather and her condition.
Instead, the couple called their family physicians, Drs. Geogy Thomas and Daniel Yoder, who drove from their homes down icy roads to meet them at 54-bed Jellico Community Hospital. After the surgical nurses arrived, the team performed a C-section on Rebecca, delivering the Jarboes' first son.
“The care here is excellent,” a tired-looking Jarboe said while lying in her hospital bed cradling 2-day-old Silas and surrounded by her family. “Whatever you need, they are right at the door, and everyone is really friendly.”
The Jarboes, who live just across the state line in Kentucky, were fortunate to have a hospital nearby that does deliveries. A year ago, it looked as if the not-for-profit facility would close because of the deteriorating economics of running hospitals in small towns. With a population of 2,300, it's located in the heart of the economically depressed Appalachian region of eastern Tennessee.
The hospital's financial woes can be only partially blamed on the state's refusal to expand Medicaid to low-income adults. Like hundreds of rural facilities across the nation, the hospital suffers from a payer mix skewed toward low-paying government programs. Good-paying jobs with health benefits have dwindled in the region.