Mendocino Coast's plight is that of many rural hospitals

The plight of a hospital in a remote Northern California town seems to be symbolic of what many rural facilities are suffering throughout the country.

Mendocino Coast District Hospital in Fort Bragg, California, filed for bankruptcy three years ago and is still barely hanging on, NPR has reported. It recently posted a surplus during the first time in memory--for a single month last summer. By the next month, it was back in deficit.

The hospital, which serves a community of 7,000 about 150 miles north of San Francisco had hit hard times in 2002, when the lumber mill that was the center of the town's economy closed, taking with it many jobs that included health coverage.

Yet as it was being battered by the rough economy of California's Mendocino Coast region, the hospital itself wound up as the region's economic and clinical nexus, providing many of the few well-paying jobs remaining--as well as a medical lifeline.

"Nobody can live here without that hospital. I mean, the nearest hospital is an hour and a half away on treacherous mountain roads," Fort Bragg resident Sue Gordon told NPR.

However, more than 80 percent of the patients being treated at the hospital are covered by government payers such as Medicare or Medi-Cal, the state's Medicaid program, which has among the lowest reimbursement rates in the country. Mendocino Coast Chief Executive Officer Bob Edwards calls it a "starvation model."

However, Mendocino Coast is far from alone. According to a recent survey by  iVantage Health Analytics, about 13 percent of all rural hospitals nationwide are in danger of closing due to financial duress. Some hospitals that are less isolated than Mendocino Coast have begun collaborating to provide services and beef up services that are onerous to obtain, such as outpatient care.

To learn more:
- read the NPR story