What happens when the only hospital in a county closes? Fairfield is about to find out
In just the past two years, they have seen two major utilities walk away from a
Then in August,
But the slow death of the county's
"Those are always the worst," said
Fairfield Memorial will close later this year, leaving only a stand-alone satellite emergency room that will open in its place about a mile away.
The closing is part of a national trend of rural hospitals shutting their doors, leaving some of the country's poorest residents to find health care elsewhere -- the result of dwindling rural county populations and, in some cases, states rejecting federal Medicaid dollars.
Anticipating the hospital's impending death,
Leaders have beefed up the county's ambulance system and given paramedics higher wages, comparable to nearby
County officials also are working to better market their public transit system. That system now takes about 14,000
"If we couldn't save the hospital, we were going to do everything to save health care," said County Administrator
Part of a larger problem
Three other rural S.C. hospitals have closed since 2010 in
In Bamberg, the county's more than 14,300 residents lost their full-service hospital in 2012. They also lost 350 jobs, when Bamberg's hospital merged with
"Those were good-paying jobs," said
Today, the closest hospital for Bamberg's residents is the
That drive could be shortened in January, when an emergency department opens in
"The whole idea is if you get in a bad wreck, get bit by a copperhead or have a heart attack, now it will only take seven to 10 minutes to get all your emergency treatment," said state Rep.
In other areas of
In 2015,
That same year, the
"It's increasingly harder for smaller hospitals to make ends meet, so you see a lot of them partnering with larger hospitals," said
In 2014, state lawmakers created a
Health care economist
But Bailey notes that hospitals, like other businesses, need customers to stay open. Each of the four counties that have seen their hospitals close has less than 30,000 residents.
"That's not a paying customer base," Bailey said. "You've got to have between 30,000 and 50,000 people, and 25 percent of them need to have good commercial insurance. You can't survive on Medicare and Medicaid alone."
Hospital officials recognize the problem.
"It's really difficult to continue to run a hospital when you have rural flight and opportunities leaving rural areas," said Schipp Ames with the
Falling into disrepair
Three days a week,
As she and her husband grow older, the trek is not always easy, said Goins,
But that is reality for many of
"
One in four
Since the late 1980s,
"We've got people who couldn't get medical care if that service wasn't there," Smith said. "We're looking at ways to expand it. It's just been a huge thing for them."
Specialized medical services have dwindled as Fairfield Memorial has failed, even with the county giving it more than
"Even in a subsidized situation, they (Fairfield Memorial) were still losing money," said Taylor, the county administrator.
Increasingly,
Four to five years ago, at least 70 percent of
In December,
The hope is that some of the fewer than 100 employees now at Fairfield Memorial will be able to get jobs at the new emergency center.
But "the new facility will only employ around 45 to 50 (people)," Smith said. "There's going to be a net loss."
The county also is in the process of buying Fairfield Memorial's adjoining buildings -- a
But Adams with the state
"A free-standing ED (department) holds promise," he said. "But it's not going to meet all the needs of a local hospital either."
Bailey, the economist, also is skeptical.
"That's not where you go for diabetes treatment or to get your blood pressure checked," she said. "It's not a community health center."
Still, some say the loss of a local hospital doesn't have to be life-altering.
"I grew up in
"I would tell communities that, with the updates in telemedicine, they don't have to be concerned."
'It's been an institution'
The issuing of failing rural hospitals is not limited to
Nationwide, 87 rural hospitals have closed since 2010, according to the
Independent emergency rooms are being used to fill some of the gaps. But gaps remain.
Bamberg, the state legislator, knows firsthand how important having fast access to life-saving services can be.
When the lawmaker's cousin was in a car wreck in
"If the weather's bad and the helicopter can't get you out, you have to hold on for 45 minutes in the back of the ambulance," he said. "The paramedic might have to do CPR for 45 minutes to an hour before they get to an emergency facility."
The lack of emergency facilities also can hurt an area's ability to attract new business.
"What employer wants to come when they know if they have an accident, their employee dies?" Bamberg asked.
The closing of a local hospital also often marks the end of an era in a rural county.
While
"It's been an institution around the county that we're now losing."
Rural S.C. hospitals closing
Over the past six years, four S.C. hospitals in small, rural counties have closed their doors:
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