The devastating impact on a poor community when a rural hospital closes its doors

A sunset over a barn structure
Brownsville, Tennessee now relies on ambulances to provide emergency care since Haywood Park Community Hospital closed three years ago. (Getty/ehrlif)

Hospital closures have become an epidemic in rural communities across the country. More than 75 rural hospitals have closed since 2010 and the most recent projections from the National Rural Health Association indicate that 673 additional facilities are vulnerable to closure. But when one hospital closes its doors, the ripple effects are felt throughout the entire community.

Nowhere is it more apparent what happens to a poor community when it loses its hospital than in the town of Brownsville, Tennessee, which now relies on ambulances to provide emergency care since Haywood Park Community Hospital closed three years ago, the Washington Post reported. The community lost its access to care, its best jobs and many of its residents struggle with health issues like obesity and diabetes.

Local leaders are trying to get an emergency room open in town. In the meantime, three ambulances serve as make-shift ERs but the community will likely lose one of the vehicles this summer due to costs. But even with the three ambulances on call, residents have a long journey to a hospital. When Haywood was open, the typical call took 30 minutes. Now, The Post reports, it is closer to 2 1/2 hours. That’s because other hospitals have also closed.

The community has also lost Methodist Fayette Hospital, which was 26 miles from town and McNairy Regional Hospital in Selmer, which was 60 miles southeast of town. Humboldt General Hospital and Gibson General Hospital, which were about an hour away to the north, also shut their doors.

Ambulance crews now must cover 565 square miles and have had to increase their services. Emergency personnel now insert chest tubes, start intravenous antibiotics and intubate patient, according to the article. And many of the residents often refuse to be taken to the nearest hospital because once they get there, they have to find their own way home, said David Smith, director of the Brownsville-Haywood Country Ambulance Authority.

The problem, Smith told the publication, is Medicaid and Medicare won’t pay for the ambulance transport unless the patient is transported to the hospital. Although the ambulance authority sends out bills, Smith said the residents are so poor, “there is no way to turn them over to collections.”