North Carolina’s latest budget includes millions of dollars toward a plan that, in a first for the nation, could reopen a shuttered hospital under the federal Rural Emergency Hospital designation.
Martin General Hospital was a 73-year-old, 42-bed facility whose 2023 closure left county residents without a medical center. Locals have had to travel 22 miles south to ECU Health’s Beaufort Hospital to reach the next-closest emergency department. State officials have said (PDF) the closure diverted more than 10,000 emergency visits and brought a downstream effect of 180 lost jobs and over $33 million in annual economic impact losses.
To remedy the detrimental effects of increased travel for care, officials from Martin County, the state and ECU Health have been exploring whether the hospital could be revived under the $3B nonprofit system using a 2023 federal designation intended to sustainably maintain around-the-clock emergency care.
These Rural Emergency Hospitals receive greater federal support but are may not exceed 50 beds and are limited to ED services, observation care and some other outpatient services that don’t exceed a 24-hour stay on average. Just over 50 such hospitals currently hold the designation, none of which are in North Carolina despite about a third of its population living in rural areas.
Additionally, each of those Rural Emergency Hospitals was a Critical Access Hospital that was still operating when it initiated its transition. Martin General Hospital’s potential reopening would be a first for the designation.
The plan is a work in progress, but has earned concrete funding support from the state government. A budget bill (PDF) signed into law on July 7—among numerous other healthcare-related provisions intended to address federal funding cuts from the One Big Beautiful Bill Act—allocates $25 million “to Martin County for a care center which shall include a rural emergency hospital.”
The other part of the plan would see ECU Health beef up the inpatient capacity at its Beaufort Hospital to handle additional admissions generated by the ED-only Martin General Hospital.
The system, in a statement celebrating the budget’s passage, said the state has now approved $15 million of “initial support” toward the construction of a new $150 million inpatient tower. The budget’s new funds, plus $35 million of funds previously allocated by the state’s NC CARE rural health fund, “allows ECU Health and Martin County to move forward with efforts to reach a formal agreement,” the system said.
“We are grateful for the support of our state elected leaders for infrastructure funding as we pursue rural health initiatives designed to improve the health and well-being of the most vulnerable communities in North Carolina,” Michael Waldrum, M.D., CEO of ECU Health, said in the statement.
“We appreciate the partnership with ECU Health and the support from state leaders as we continue working toward a long-term solution that restores access to care and serves our residents well into the future,” Drew Batts, county manager for Martin County, said in the same release.
ECU and the county said they are now working on a formal agreement covering the structural responsibilities and commitments necessary for the plan to succeed, and warned that “this process will take time as there are contingencies noted in the letter of intent that must be resolved to make this vision a reality.” Of particular note for ECU Health is the remaining money necessary to open its $150 million capacity expansion at the Beaufort Hospital.
“As the only healthcare partner with a viable plan, as well as a willingness to re-establish care in Martin County, we remain committed to working with county leaders and state partners to make high-quality local health care a reality on behalf of the patients, families and communities we are honored to serve,” Waldrum said.