Hospitals struggle to address terrifying and long-lasting \u2018ICU delirium\u2019<\/h3>\n
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Hospitals scramble to offer mental health care for depressed physicians<\/h3>\n
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Patient navigators can serve crucial roles in hospitals<\/h3>\n
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\u201cI keep seeing pain in my community, people calling me crying, and that\u2019s why I\u2019m hollerin\u2019 and fussin\u2019,\u201d O\u2019Neal said.<\/p>\n
He knows locals who had heart attacks that caused far more damage than they should have because with Pungo closed, it took more than an hour to get them to the nearest hospital with emergency services.<\/p>\n
\u201cThere are people with strokes, who could\u2019ve recovered, but can\u2019t now,\u201d O\u2019Neal said. \u201cThere are needless deaths.\u201d<\/p>\n
Since 2010, at least 75 rural hospitals, including Pungo, have been shuttered in the US. Almost half of those were in the South. These hospitals tend to be as small as the towns they serve \u2014 and often are found in areas that many health care providers have ignored.<\/p>\n
Even those that remain open are struggling: More than a third of rural hospitals operate at a loss, according to the National Rural Health Association. One in four is at risk of closing in the next decade.<\/p>\n
Read more:<\/em> Hospitals struggle to address terrifying and long-lasting \u2018ICU delirium\u2019<\/a><\/p>\n In communities like Belhaven, a majority-black town where nearly 1\u00a0in 3 residents lives below the poverty line, a hospital closure leaves locals in dire straits.<\/p>\n Many in the Belhaven area lack insurance \u2014 North Carolina did not expand Medicaid under Obamacare \u2014 and don\u2019t have transportation to get to the nearest safety-net hospital, located about 25 miles to the west.<\/p>\n Belhaven salon owner Eunice Williams, who lives outside of town \u2014 nearly 50 miles east of the nearest open hospital \u2014 said many people she knows rely on free rides from their neighbors to get care when they need it. \u201cA lot of people can\u2019t even afford gas to get to Belhaven,\u201d she said.<\/p>\n After shutting the hospital, Vidant Health, one of the largest health care systems in North Carolina, built an around-the-clock urgent care center in town. It opened this past summer, offering primary and preventive care, prenatal and cardiac consultations, and a helipad for emergency transport. Vidant spokesperson Christine Mackey said the company believes the urgent care model \u201cis the right direction for communities like Belhaven.\u201d<\/p>\n O\u2019Neal and his allies say it\u2019s not enough.<\/p>\n In his quest to save Pungo, O\u2019Neal has marched more than 700 miles, trekking to Washington, D.C., on foot multiple times, as well as to the statehouse in Raleigh, usually wearing a \u201cSave Our Hospital\u201d T-shirt. With the help of progressive black activists, including the NAACP, the conservative white mayor has raised hundreds of thousands of dollars in futile attempts to buy back the hospital property.<\/p>\n The diverse coalition was on full display earlier this month as the Rev. Curtis Everette Gatewood, field director of NAACP\u2019s state branch, led a couple dozen protesters in \u201cSave Our Hospital\u201d chants outside the governor\u2019s mansion in Raleigh. O\u2019Neal stood nearby, clad in his hospital T-shirt, lining up speakers for the parade of local TV reporters.<\/p>\n \u201cWhether you\u2019re from Belhaven or New York, whenever a local hospital closes, that is our<\/em> hospital,\u201d Gatewood told the protesters. \u201cThose are our people dying, because we are part of a larger family of humanity.\u201d<\/p>\n When Pungo District Hospital opened in 1949, it was one of the first in the nation to be designated a Hill-Burton hospital, which meant the federal government offered loans for construction in exchange for a pledge to treat those unable to afford medical care.<\/p>\n The area around Belhaven \u2014 a vast stretch of the Inner Banks that spans several counties and is home to soybean farmers\u00a0and seniors settling into retirement \u2014 long relied on Pungo for everything from childbirth to critical care.<\/p>\n But the 49-bed nonprofit hospital struggled financially. It cobbled together a mix of Medicaid and Medicare reimbursements, grant funding, and community contributions, yet still spent a few years in bankruptcy in the early 2000s.<\/p>\n By 2011, the Pungo District Hospital Corporation, which owned and operated the hospital, had sustained enough losses to consider selling. It reached out to Vidant, which today owns eight hospitals and serves over 1.4 million patients, and which specialized in nonprofit hospitals. By summer\u2019s end, a deal was reached.<\/p>\n Vidant started to invest in the Belhaven hospital, including a $2.4 million electronic records system. But in September 2013, Vidant\u2019s board shocked Belhaven residents when it announced the hospital would be closed.<\/p>\n Across its entire network, Vidant rang up\u00a0a surplus of $109.6 million in the year leading up to the closure \u2014 but the nonprofit health system lost $1.1 million on Pungo during that period. David Herman, the company\u2019s then-CEO, cited the state\u2019s failure to expand Medicaid as one reason for the shut down; it meant the hospital would continue to limp along without enough insured patients \u2014 or revenue \u2014 to repair its aging building.<\/p>\n It was around then that O\u2019Neal became, as he now quips, \u201cthat crazy mayor raising Cain.\u201d<\/p>\n Now 47, O\u2019Neal is stocky and starting to gray; he sells insurance whenever he isn\u2019t busy being mayor of Belhaven. More often than not, though, he\u2019s performing those mayoral duties, including the fight to save Pungo.<\/p>\n He\u2019s demanded, and received, meetings with top state and federal officials, including North Carolina Governor Pat McCrory and Health and Human Services Secretary Sylvia Mathews Burwell. He secured a federal loan commitment and a certificate of need, a legal document the state requires to operate a hospital.<\/p>\n Along the way, activists like the Rev. William Barber II, the state NAACP president, and Bob Zellner, a prominent civil rights activist, became unlikely allies.<\/p>\n With the NAACP\u2019s help, Belhaven sued Vidant over a breach of contract and unfair trade practices. O\u2019Neal argued that the community board never would have sold if they had known Vidant would shut down the hospital, throwing nearly 100 employees out of work in a county that at the time had a 7.7 percent unemployment rate \u2014 well above the national average of 6.2 percent. (A judge later dismissed the lawsuit.)<\/p>\n The mayor and his allies also filed federal civil rights complaints that accused Vidant of discrimination against \u201cvery poor minorities.\u201d One complaint prompted the federal Department of Justice to mediate a agreement in April 2014 that kept the hospital open for several more months. Vidant agreed to transfer ownership of Pungo to a community nonprofit called Pantego Creek LLC.<\/p>\n Read more:<\/em> Hospitals scramble to offer mental health care for depressed physicians<\/a><\/p>\n O\u2019Neal still believes Pungo, which brought in $10 million in revenue the year before it shut down, can operate in the black without Medicaid expansion. He cited multiple plans for doing so, including one that would downsize the facility to 10 beds and another that would turn over part of the hospital to serve veterans.<\/p>\n But before the hospital could get back online, the community nonprofit that owns it would have to sell it to a health care operator. It came close this past summer, but the deal fell through.<\/p>\n Pantego Creek also rejected two offers from an O\u2019Neal-backed group to buy the building and land because they came in at less than the property\u2019s appraised value of $1 million.<\/p>\n \u201cIf the property is ever sold at fair market value, the proceeds will be reinvested in the community in some manner,\u201d Pantego Creek attorney Arey Grady wrote in an email to STAT. \u201cFor instance, Pantego Creek has discussed the possibility of scholarships for local people interested in studying in the health care field and then returning to the area to work in health care \u2014 one of just several possibilities.\u201d<\/p>\n With no deal in sight, Pantego Creek voted to tear down the hospital, citing its decrepit state. As a demolition crew prepared to move in, several members of the nonprofit filed suit to stop the wrecking balls.<\/p>\n A judge issued a temporary restraining order in late November \u2014 and will decide at Wednesday\u2019s hearing whether the demolition can proceed.<\/p>\n The long fight to reopen Pungo has taken a toll on O\u2019Neal. By his own estimate, he\u2019s poured up to 40 hours a\u00a0week into saving his town\u2019s hospital.<\/p>\n It\u2019s a battle, he said, that has \u201cfinancially destroyed\u201d him, considering how much time he\u2019s spent away from his day job. It\u2019s also taken away from time he could have spent with his four sons. But he won\u2019t give up. He won his sixth term as mayor last year.<\/p>\n \u201cI don\u2019t have anything left to lose,\u201d O\u2019Neal said. \u201cIn life, sometimes, things are bigger than you are. I ran into something bigger than I am. I can\u2019t let people continue to die.\u201d<\/p>\n Read more:<\/em> Patient navigators can serve crucial roles in hospitals<\/a><\/p>\n He can\u2019t shake the memory of the first death after Pungo\u2019s closure.<\/p>\n The week after the hospital was closed, Portia Gibbs, a 48-year-old mother who lived east of Belhaven, died from a heart attack after a helicopter took more than\u00a0an hour to lift her to the next closest hospital. Her husband, Barry Gibbs, believed she would have survived had Pungo remained opened. He now worries about\u00a0what might happen to him.<\/p>\n \u201cIf you live in this area, you might as well have the mind-set that if anything happens to your [health], you\u2019re likely going to die,\u201d Barry Gibbs said.<\/p>\n O\u2019Neal is hoping the lawsuit buys a little time. Earlier this month, he scored a meeting with several top state lawmakers after the protest outside the governor\u2019s mansion. Those lawmakers suggested state funding may become available next year to help reopen the hospital.<\/p>\n O\u2019Neal is hopeful, but refuses to get too excited. There\u2019s no saving a hospital next year if the judge green lights the demolition this week. The heartbeat of his hometown hangs on this hearing.<\/p>\n \u201cIt\u2019s a matter of life or death,\u201d O\u2019Neal said.<\/p>\n <\/p>\n","protected":false},"excerpt":{"rendered":" Mayor Adam O\u2019Neal wants his hospital back. He was born in Pungo District Hospital in the sleepy town of Belhaven, N.C. Decades later, as mayor of Belhaven, he counted on the hospital to provide not just health care, but scores of jobs. In his rural stretch of coastal North Carolina \u2014 beautiful but isolated, with Read More<\/a><\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[],"tags":[],"class_list":["post-140632","post","type-post","status-publish","format-standard","hentry"],"_links":{"self":[{"href":"http:\/\/healthmedicinet.com\/i\/wp-json\/wp\/v2\/posts\/140632","targetHints":{"allow":["GET"]}}],"collection":[{"href":"http:\/\/healthmedicinet.com\/i\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"http:\/\/healthmedicinet.com\/i\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"http:\/\/healthmedicinet.com\/i\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"http:\/\/healthmedicinet.com\/i\/wp-json\/wp\/v2\/comments?post=140632"}],"version-history":[{"count":0,"href":"http:\/\/healthmedicinet.com\/i\/wp-json\/wp\/v2\/posts\/140632\/revisions"}],"wp:attachment":[{"href":"http:\/\/healthmedicinet.com\/i\/wp-json\/wp\/v2\/media?parent=140632"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"http:\/\/healthmedicinet.com\/i\/wp-json\/wp\/v2\/categories?post=140632"},{"taxonomy":"post_tag","embeddable":true,"href":"http:\/\/healthmedicinet.com\/i\/wp-json\/wp\/v2\/tags?post=140632"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}A bankruptcy and a surprise decision<\/h2>\n
A \u2018crazy mayor raising Cain\u2019<\/h2>\n
\u2018You\u2019re likely going to die\u2019<\/h2>\n