52 Counties Have None : Rural Texas Hospitals Becoming Rare

LUBBOCK, Tex. â€”  This fall, Hutchinson became the 52nd Texas county without a hospital when the town of Borger lost Golden Plains Community Hospital, a 33-bed facility brought down by financial problems and a steadily declining number of patients.

The decision to close was made by the hospital’s owners, Atlanta-based Gateway Medical Systems Inc. Doctors and county officials are trying to find a buyer.

In the meantime, residents of the rural Panhandle county must drive at least 28 miles if they need anything fancier than sutures for a cut or a cast for a broken bone.

“The doctors will meet patients in their offices to treat minor emergencies,� said Dr. Eduardo Coligardo, who was chief of staff at Golden Plains. “If it’s a major emergency, we refer them to a major hospital, usually in Amarillo� (an hour’s drive away).

Just 100 miles to the southeast is Memphis, a town about a fifth the size of Borger that nevertheless recently won a fight to keep Hall County Hospital open. In response to predictions that Hall would shut in 2 months, local people raised $366,000 in 6 weeks to buy new equipment and recruit a doctor.

Rapid Rate of Closings

Small community hospitals have become all but extinct in the western and southwestern parts of Texas, home to about 400,000 people. In 1986 and 1987, Texas led the nation in hospital closings, and 24 of the 32 hospitals that were shut were in rural areas.

So far this year, 19 Texas hospitals have closed, and 10 of them are small towns and rural areas, according to the Texas Hospital Assn.

Charles Bailey, vice president of legal affairs with the association, said the size of Texas is one simple reason for the high failure rate among hospitals. Tiny rural hospitals can’t afford to keep up with the technology and expertise offered by the big medical centers in the cities. Demand for rural hospital beds has fallen, Bailey said, as urban hospitals advertise to attract patients from outlying areas.

A more important factor is the ailing Texas economy.

“With businesses having trouble and some employees being laid off and losing their insurance, uncompensated care has increased in the state, which puts strain on hospitals financially,� he said.

Economic Hardships

The slumping Texas economy has added to the number of patients who cannot pay; hospitals provide more than $1.2 billion worth of uncompensated care each year.

Thousands of rural Texans are learning to live without a hospital nearby, but the people of Hall County decided to take a stand.

In mid-September, a team of analysts from an urban hospital predicted that the county hospital would be closed by Thanksgiving. It took just 6 weeks for the community to prove them wrong.

“We realized we had to do something for ourselves, or we wouldn’t have a hospital,� Bill Cosby, a retired accountant, said.

During the fund drive, children emptied piggy banks, ranchers raffled off pickup trucks and sides of beef, and the Memphis police chief used his radio to make an appeal to passing truckers for donations.

Almost two-thirds of the money raised was used to buy modern equipment that would attract patients. Other funds were used to recruit and pay the salary of a third physician to supplement the efforts of the two elderly doctors who serve the 5,000 residents of a county in which the average age is 57.

More Shutdowns Seen

The strong community support demonstrated by the fund-raising effort should be enough to ensure the hospital’s survival, but most communities aren’t so lucky, said Dave Clark, regional services coordinator for the Panhandle Health Care Coalition.

Hospitals will continue to close, he said, although some may be able to stay open as clinics or emergency centers.