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McKenzie Regional Hospital Closure and Its Consequences 2019-08-20T10:50:13-05:00

MCKENZIE REGIONAL HOSPITAL CLOSURE AND TENNESSEE’S SILENT EPIDEMIC

Tennessee leads the nation in rural hospital closures per capita – an increasing phenomenon in states that have not expanded Medicaid. How many more hospitals will close before legislators take action?

 Mayor Jill Holland stands in the parking lot of the shuttered McKenzie Regional Hospital

December 6th, 2018 / Authors: Alex Kent and Anna Walton

December 6th, 2018 / Authors: Alex Kent and Anna Walton

THE SILENT EPIDEMIC: TENNESSEE’S RURAL HOSPITAL CRISIS:

Tennessee leads the nation in rural hospital closures per capita – an increasing phenomenon in states that have not expanded Medicaid. How many more hospitals will close until legislators take action?

Reverend Garrett Burns could have lost his first child that night. “My wife called me into the bathroom. There was blood everywhere.” Just half an hour after Garrett’s trembling hands dialed 911, the couple was in McKenzie Regional Hospital’s emergency room where his wife gave birth to a healthy baby boy.

Garrett, the Associate Chaplain at Bethel University, can tell you how important having a hospital in McKenzie was for the emergency delivery of his child. Garrett said, “It did matter for us, the fact that we had a hospital here in McKenzie. Had it been something more serious and we had to go to Jackson, I don’t know what would have happened.”

Since McKenzie Regional Hospital closed its doors in September of 2018, families are now facing the uncertainty of an hour-long commute to the hospital in Jackson. The closure of McKenzie’s hospital is the latest casualty in an epidemic plaguing states that did not expand Medicaid. Eleven hospitals have closed in Tennessee since 2010 – more hospitals per capita than any other state in the nation.

The loss of a major employer has both short and long-term consequences. Many residents lost their jobs and access to care immediately but the entire region served by the hospital will see ongoing economic aftershocks.

Carroll County, which includes McKenzie, has the 13th highest unemployment rate of Tennessee’s 95 counties and the health care sector provided the town’s most common jobs and highest paying salaries. The hospital’s approximately 200 employees are now unemployed, many having to seek employment outside city limits. Jill Holland, the Mayor of McKenzie, was told by local business owners that they are already feeling that trickle-down effect. Holland said, “The lack of this hospital in McKenzie, it creates a mushroom effect. Families are being relocated to other areas because of their jobs.”

The city was already struggling financially but when McKenzie Regional Hospital closed, the city lost its third largest industry overnight. “We are like every small town in America, we need more industry and we constantly need more jobs,” said Gary Simmons, a local business owner and chairman of McKenzie’s Industrial Board. Gary is always working to recruit new employers to McKenzie and told us, “When you tell them your hospital is closed, that’s a black eye to begin with.” If you want young people to build and start their life in your town, you have to have access to health care and employment opportunities. A closed hospital is disquieting to current and prospective residents alike.

The hospitals in Carroll County added roughly $16 million to the county’s economy last year. The loss of this economic activity is particularly detrimental to the city of McKenzie where nearly one in five residents live in poverty. 

Many small businesses are unable to provide health insurance for their employees. The majority of residents in McKenzie that have access to private health insurance work for a handful of employers. At least twelve percent of employed residents in the county are uninsured and many more remain underinsured. Residents of rural areas are less likely to have health insurance than those living in urban areas. Nearly a quarter of people living in rural areas lack health insurance which creates a greater financial burden on rural hospitals faced with providing more uncompensated care than urban hospitals. It’s financially difficult – and in some places like McKenzie, impossible – for hospitals to stay open if care is not paid for by insurance.

Eleven hospitals have closed in Tennessee since 2010 – more hospitals per capita than any other state in the nation, and more hospitals than every state except Texas. 

Medicaid and Medicare payments are vital to rural hospitals. The uninsured rate has fallen by more than half for low-income, rural adults in states that expanded Medicaid, reducing the impact of uncompensated care provided by local hospitals. In a recent report to Congress, the GAO found rural hospitals in Medicaid expansion states were far less likely to close than those in states that had not expanded Medicaid.

Sixty-one hospitals in rural Tennessee absorbed $292 million in uncompensated care in 2015. Carroll County alone had just under $2 million in uncompensated care in 2017. “This is not a problem unique to McKenzie, it’s experienced in about thirteen other communities across Tennessee, six of those in West Tennessee,” said Keith Priestley who served on the Chairman of McKenzie Regional Hospital and currently serves as the Treasurer of McKenzie’s Industrial Board. “A few years ago Governor Haslam proposed his Insure Tennessee program, dealing with Medicaid expansion… [If Insure Tennessee] had passed, it could have been the difference between our staying open or closing.”

The lack of access to medical care isn’t a new phenomenon to rural Tennesseans like Phil Williams, who has been the Mayor of McLemoresville for over 44 years, making him the longest-serving mayor in Tennessee history. “That’s just how life is in rural America,” Phil said, “The value of life is the same in our community as it is in Nashville.” Despite the odds, Phil remains hopeful that things will change.

In the meantime, he has become accustomed to less because “that’s just how life is in rural America.”

But it begs the question: is that how it has to be?

Closed McKenzie Regional Hospital

Our lawmakers have spoken of the need for health reform but no serious efforts have been made since Governor Haslam’s 2015 Medicaid expansion plan, Insure Tennessee. Some reform ideas, like telemedicine, are constructive but inadequate for the life-and-death situations that people face in rural areas where the hospital have closed.

What the people of Carroll County – and Haywood and Gibson and McNairy – need are open hospitals and access to affordable health insurance to pay for their care. Medicaid expansion is not a silver bullet, but it is a pragmatic and tangible step towards stabilizing hospitals and addressing health care costs.

Reverend Garrett Burns could have lost his first child that night. “My wife called me into the bathroom. There was blood everywhere.” Just half an hour after Garrett’s trembling hands dialed 911, the couple was in McKenzie Regional Hospital’s emergency room where his wife gave birth to a healthy baby boy.

Garrett, the Associate Chaplain at Bethel University, can tell you how important having a hospital in McKenzie was for the emergency delivery of his child. Garrett said, “It did matter for us, the fact that we had a hospital here in McKenzie. Had it been something more serious and we had to go to Jackson, I don’t know what would have happened.”

Since McKenzie Regional Hospital closed its doors in September of 2018, families are now facing the uncertainty of an hour-long commute to the hospital in Jackson. The closure of McKenzie’s hospital is the latest casualty in an epidemic plaguing states that did not expand Medicaid. Eleven hospitals have closed in Tennessee since 2010 – more hospitals per capita than any other state in the nation.

The loss of a major employer has both short and long-term consequences. Many residents lost their jobs and access to care immediately but the entire region served by the hospital will see ongoing economic aftershocks.

Carroll County, which includes McKenzie, has the 13th highest unemployment rate of Tennessee’s 95 counties and the health care sector provided the town’s most common jobs and highest paying salaries. The hospital’s approximately 200 employees are now unemployed, many having to seek employment outside city limits. Jill Holland, the Mayor of McKenzie, was told by local business owners that they are already feeling that trickle-down effect. Holland said, “The lack of this hospital in McKenzie, it creates a mushroom effect. Families are being relocated to other areas because of their jobs.”

The city was already struggling financially but when McKenzie Regional Hospital closed, the city lost its third largest industry overnight. “We are like every small town in America, we need more industry and we constantly need more jobs,” said Gary Simmons, a local business owner and chairman of McKenzie’s Industrial Board. Gary is always working to recruit new employers to McKenzie and told us, “When you tell them your hospital is closed, that’s a black eye to begin with.” If you want young people to build and start their life in your town, you have to have access to health care and employment opportunities. A closed hospital is disquieting to current and prospective residents alike.

The hospitals in Carroll County added roughly $16 million to the county’s economy last year. The loss of this economic activity is particularly detrimental to the city of McKenzie where nearly one in five residents live in poverty. 

Many small businesses are unable to provide health insurance for their employees. The majority of residents in McKenzie that have access to private health insurance work for a handful of employers. At least twelve percent of employed residents in the county are uninsured and many more remain underinsured. Residents of rural areas are less likely to have health insurance than those living in urban areas. Nearly a quarter of people living in rural areas lack health insurance which creates a greater financial burden on rural hospitals faced with providing more uncompensated care than urban hospitals. It’s financially difficult – and in some places like McKenzie, impossible – for hospitals to stay open if care is not paid for by insurance.

Eleven hospitals have closed in Tennessee since 2010 – more hospitals per capita than any other state in the nation, and more hospitals than every state except Texas. 

Medicaid and Medicare payments are vital to rural hospitals. The uninsured rate has fallen by more than half for low-income, rural adults in states that expanded Medicaid, reducing the impact of uncompensated care provided by local hospitals. In a recent report to Congress, the GAO found rural hospitals in Medicaid expansion states were far less likely to close than those in states that had not expanded Medicaid.

Sixty-one hospitals in rural Tennessee absorbed $292 million in uncompensated care in 2015. Carroll County alone had just under $2 million in uncompensated care in 2017. “This is not a problem unique to McKenzie, it’s experienced in about thirteen other communities across Tennessee, six of those in West Tennessee,” said Keith Priestley who served on the Chairman of McKenzie Regional Hospital and currently serves as the Treasurer of McKenzie’s Industrial Board. “A few years ago Governor Haslam proposed his Insure Tennessee program, dealing with Medicaid expansion… [If Insure Tennessee] had passed, it could have been the difference between our staying open or closing.”

The lack of access to medical care isn’t a new phenomenon to rural Tennesseans like Phil Williams, who has been the Mayor of McLemoresville for over 44 years, making him the longest-serving mayor in Tennessee history. “That’s just how life is in rural America,” Phil said. Despite the odds, Phil remains hopeful that things will change.

In the meantime, he has become accustomed to less because “that’s just how life is in rural America.”

But it begs the question: is that how it has to be?

Closed McKenzie Regional Hospital

Our lawmakers have spoken of the need for health reform but no serious efforts have been made since Governor Haslam’s 2015 Medicaid expansion plan, Insure Tennessee. Some reform ideas, like telemedicine, are constructive but inadequate for the life-and-death situations that people face in rural areas where the hospital have closed.

What the people of Carroll County – and Haywood and Gibson and McNairy – need are open hospitals and access to affordable health insurance to pay for their care. Medicaid expansion is not a silver bullet, but it is a pragmatic and tangible step towards stabilizing hospitals and addressing health care costs.