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Rural Hospitals Continue To Close

LEILA FADEL, HOST:

Nearly 20 rural hospitals closed this year alone, more than any year in the past decade. And that pace of closures is expected to continue as the cost of health care rises. With too few patients to cover expenses, the town of Fort Scott, Kan. lost its 132-year-old Catholic hospital at the end of 2018. NPR and Kaiser Health News have followed the city as it has tried to cope without it.

Sarah Jane Tribble with Kaiser Health News traveled to Fort Scott this month, where she found a town that was angry and scared but also coming to terms with what's left. And Sarah Jane joins me now in the studio. Good morning.

SARAH JANE TRIBBLE: Good morning.

FADEL: So when a hospital closes, what happens to a community? What do the people of Fort Scott say they miss and they still need?

TRIBBLE: Well, after the hospital closed a year ago, the cancer center also closed, and then a dialysis center closed. And a lot of residents that I talked to on this most recent trip were most concerned about the lack of a place to deliver a baby. Mercy Hospital in Fort Scott delivered more than 230 babies in the year before it closed.

Now those mothers need to travel to the nearest hospital, which is about 30 miles away. Sherise Beckham, for example, had complications that put her on bed rest. So when the time came to drive to the hospital, the drive really bothered her.

SHERISE BECKHAM: If you do live in a city, you do travel some to the hospital, but this is a different kind of traffic. You're on a two-lane highway, and a lot of times you could get behind, you know, a semi, you get behind a tractor, you know? It can be potentially unsafe driving conditions. Sometimes you're lucky if you have cell service.

FADEL: So what kind of health care is actually left in Fort Scott?

TRIBBLE: Well, it's not all bad news. That nearby hospital 30 miles away has kept the emergency department open, at least temporarily. And a large regional health center hired most of the local doctors, and they took over the buildings there in Fort Scott. It's providing many of the services that were in town, especially like regular checkups and things like mammograms.

Jason Wesco helps lead the Community Health Center of Southeast Kansas. Here's a bit of what he had to say about their commitment in keeping services in Fort Scott.

JASON WESCO: The best people in the world are from this place, and all we have to do is help them see their value because for a lot of years, the world has told Southeast Kansas it's the throwaway part of Kansas, the part we're not proud of. And that's true. And we believe that our place in the world is to be a health care organization but to also lift up this place. We can fix it; we just need time.

TRIBBLE: There is a lot of need in southeastern Kansas in the region. One out of every four children live in poverty in Fort Scott. Rates of diabetes, obesity, and tobacco smoking are higher than the state average. There are also high rates of premature deaths. But when you talk to Wesco and others, there's also hope.

FADEL: These numbers, the high rates of obesity, diabetes, poverty, why?

TRIBBLE: Right. So there is a whole series of things that happened in a region like southeastern Kansas that has generational poverty that has gone back beyond grandparents. And there are people who lived off the manufacturing. There was a coal industry in southeastern Kansas. And when that went away and new jobs came in, they weren't always qualified to do those jobs.

The amount of poverty in southeastern Kansas, which is common in a lot of rural areas, is often because they haven't been able to adjust to the changing world around them, but also because there hasn't been federal moneys going into those places as well. The hospitals themselves were dependent on, you know, the number of patients they could take care of in the hospital. Mercy Hospital closed - the year before it closed, it averaged nine patients a day. So for the residents themselves, they may work hard, but if there's not jobs to support them, they can't earn any incomes.

FADEL: You know, you've been visiting Fort Scott - I think you told me over a half a dozen times in the last year. How has it changed without that health care, without that hospital?

TRIBBLE: Well, the town leaders who were once very, very angry and concerned are now beginning to accept that maybe they can live without a hospital. Here's Reta Baker, the former president of the now-closed hospital.

RETA BAKER: I don't think there is any of us who haven't gone through the stages of grief and that aren't still maybe caught somewhere in one of those stages. It's been almost a year, or right on a year, and we don't like what happened, but it's time to accept it and create something new and move on.

FADEL: Sarah Jane Tribble has been reporting on the health care crisis in Fort Scott, Kan. She's a senior correspondent for Kaiser Health News. Thank you for talking with us.

TRIBBLE: Thank you. Transcript provided by NPR, Copyright NPR.