Mississippi Hospitals Are On The Brink Of Closure Because Of Tate Reeves’ “Personal Political Interest”
MS Rural Health Association President: “We are in far more of a serious time now than we ever have been before.”
FOR IMMEDIATE RELEASE:
March 21, 2023
Nettleton, MS – A new report highlights the dire straits that Mississippi hospitals are in because of Tate Reeves’ “personal political interest” in refusing to extend Medicaid. Several hospital leaders detail how they will continue to advocate for Medicaid expansion to improve their hospital’s financial situation and keep their doors open.
Dozens of hospitals - many of them a lifeline in their communities - are currently on the brink of closing. Mississippi Today’s Devna Bose details how Greenwood Leflore is expecting to shut its doors this summer and the Delta’s largest hospital system is only going to make it through the end of the year.
Tate Reeves’ refusal to expand Medicaid has left 220,000 Mississippians uninsured, one-third of Mississippi hospitals at risk of closure, and $2 billion in federal funding on the table that could help hospitals stay open.
Read more below:
Mississippi Today: The death of rural hospitals could leave Mississippians ‘sick, sick, sick’
March 20, 2023
Greenwood Leflore is the community’s only hospital, and it’s months away from closing.
The COVID-19 pandemic drained the hospital, which was already financially vulnerable, dry. Costs went up, while profit did not. Doctors and nurses, burned out from the pandemic, left in droves. Now, the hospital is shutting down floor after floor, cutting costs to maintain operations.
Mississippians know this story.
Dozens of hospitals across the state, many the only in their communities, are struggling to stay open.
A report from the Center for Healthcare Quality and Payment Reform puts a third of Mississippi’s rural hospitals at risk of closure, and half of those at risk of closure within the next few years. There are only three other states with worse prognoses.
But it’s especially devastating in Mississippi, where life expectancy and health outcomes are consistently the worst in the country.
Hospital administrators are holding their breath, waiting on help from the state, but they could be getting less money this year than they need. And there’s little to no chance that state leaders will expand Medicaid this year as 40 other states have done. Expanding Medicaid under the Affordable Care Act would bring more than $1 billion in federal funding to Mississippi in a year.
Ryan Kelly, executive director of the Mississippi Rural Health Association, said the situation is dire, and there’s not a straightforward answer.
“I wish, for the sake of simplicity, I had one single thing I could point to and say this is the problem,” he said. “We have been saying this for a long time that this will get serious and it is now serious.
“We are in far more of a serious time now than we ever have been before.”
For the hospital CEOs, doctors and residents of rural Mississippi, this isn’t just a statistic. It’s a life-and-death reality.
‘Hospitals can close. Watch and see.’
Dr. John Lucas’s office is at the end of a quiet hallway, past empty rooms with empty beds.
“It wasn’t uncommon to have as close to 200 beds full when I first came here,” he said. “It’s really sad to walk these empty halls and to see that we only have one part of one floor occupied with patients.”
In the past decade, Lucas has watched the hospital close unit after unit, tapering services in an effort to stay open.
At a health affairs committee meeting in February, Nelson Weichold, chief financial officer at the University of Mississippi Medical Center, said the worst part about the looming hospital closures is the slow cessation of services.
“It’s not just when the hospital closes,” he said. “It’s the years building up to that when they’re taking financial measures to do everything they can to try and keep the doors open.”
Greenwood Leflore hasn’t been able to make the money back — it’s not clear why, but fewer people are seeking care, and payments have remained stagnant.
For several months, the University of Mississippi Medical Center was entertaining a plan to lease the hospital, saving it from closure. However, in November, the deal abruptly fell through without explanation from UMMC.
Marchand said the hospital has six months to figure out a plan or it’ll be forced to close.
“The struggle is to get the community and the legislators and others to understand a hospital is a business,” he said. “I think a lot of people think, ‘Oh, you need hospitals. They’re never going to go away.’
“Hospitals can close. Watch and see.”
A quick scroll on the hospital’s Facebook page shows that Greenwood residents know that closure is a real possibility.
Lucas said he hears the same refrain over and over again when he’s out in the community: “How’s the hospital doing?”
“Whenever I go to a social outing, it’s the first thing I get asked,” Lucas said. “Everybody’s concerned.”
Pie Fincher and her family are products of Greenwood Leflore Hospital.
Fincher, who is 89 years old, has only gone to another hospital for treatment one time in her life. Both of Fincher’s children were born at Greenwood Leflore, and the hospital has saved her life several times, she said, including once when she had a major brain bleed.
“It’s just been a lifeline for our family,” Fincher said.
But the neurology department doesn’t exist anymore. Neither does labor and delivery. Those doctors that delivered her kids and saved her life are long gone.
“If you really close this hospital down, we’re going to have to go to Jackson,” he said. “We’re going to have to go to Grenada. We’re going to have to go to Cleveland, and a lot of people don’t have transportation, like me.”
“If the hospital closes, there will be a lot of walking dead,” he said. “Folks will be sick, sick, sick.”
Marchand’s Plan A is getting Greenwood Leflore designated as a critical access hospital. That means the hospital would have to give up almost all of its 200 beds, but it would get more money for services that it provides. Critical access hospitals are typically reimbursed by Medicare at a rate of 101%, theoretically allowing a 1% profit.
Marchand is hoping for a waiver from the Centers for Medicaid and Medicare regarding the distance requirement. His argument is that because of transportation challenges for the hospital’s population, the hospital should be an exception.
If that doesn’t work, the hospital will go up for sale again.
The survival of Delta’s largest health care system will be ‘touch and go’ after this year
If you ask Iris Stacker, interim CEO of Delta Health System in Greenville, how long the hospital system has before it’s forced to close, perplexingly, she smiles.
“I intend to be here forever,” Stacker says.
But Chief Nursing Officer Amy Walker raises an eyebrow.
“We’ll be here through the end of the year,” Walker deadpans. “It’s really touch and go after that.”
The duo head up the largest health care system in the Mississippi Delta. And together, they’re trying to keep it from closing.
Walker’s cynicism is often balanced out by Stacker’s cheeriness, but they do agree on one thing: The hospital is losing money.
“Even Positive Polly over there can’t deny that,” Walker said.
Despite being licensed for over 300 beds, the hospital’s census hovers around 80 patients. And most of the patients are uninsured or on Medicaid or Medicare.
Last year, Delta Health spent about $26 million on uncompensated care. That amounts to about 15% of its total operating expenses.
But the decline in hospital patients isn’t because care isn’t needed in the Delta, which has some of the worst health disparities in Mississippi.
“It’s not because the patients aren’t here,” Walker said. “It’s because we don’t have the nurses to take care of them.”
Walker said the hospital has long struggled to recruit nurses to Mississippi, much less the Delta.
“We’ve always had that problem,” Walker said. “And if you look at our salaries, we usually have to pay more than Memphis and Jackson to get nurses here. We were already used to doing that.”
Since the pandemic, the hospital’s nurse workforce has nearly halved.
The exodus’ effects have rippled throughout the hospital: emergency wait time has quadrupled, the largest medical surgery unit is closed, and half of the hospital’s ICU beds are not in use.
“We’re pretty much living on grant money right now,” Stacker said.
Stacker knows that Medicaid expansion is unlikely to pass this legislative session, though it’s what she thinks would help the most.
Without systemic changes, Stacker admits that the hospital’s fate is uncertain.
And if the Delta loses the hospital system, it’s going to affect the entire region.
“We save people’s lives every day here,” Walker said. “Once hospitals start closing, those patients aren’t just going to go away.”
Staying afloat, for now
Winston Medical Center’s CEO Paul Black is a numbers guy.
Black’s hesitant to say it, but he admits that his background has helped keep the hospital afloat.
The hospital also lost staff during the pandemic — staff they can’t afford to hire back. McCall said he’s trying to do everything he can to prevent layoffs.
“To be honest, there’s just not anywhere to really lay off unless we just shut down a service line completely, which we’re trying to avoid at all costs,” he said.
McCall has kept a close eye on the Capitol the past few months. Like Stacker in Greenville, McCall knows Medicaid expansion isn’t going to happen this session, but he’ll keep advocating for it.
He doesn’t deny that hospitals need the grant money making its way through the Legislature, but said hospitals need a sustainable solution — not a temporary one.
“That’s one-time money,” McCall said. “That doesn’t fix the ongoing problem. So we’re going to be right back where we are now next year.”
Brandon Presley is a fighter who keeps his promises, stands up for the little guy, and isn't afraid to ruffle more than a few feathers to deliver results for hardworking Mississippi families. Brandon served as Mayor of Nettleton from 2001 to 2007, where he balanced the budget every year, cut taxes twice, and got the town moving again. As Public Service Commissioner, Brandon opened up meetings that had been closed to the public for decades, brought high-speed internet to some of the most remote and forgotten parts of Mississippi, put people back to work with the Hire Mississippi program, and saved taxpayers over 6 billion dollars.