Rural hospitals are closing across the country. Naysayers may say it’s the end of rural healthcare as we know it. However, many hospitals are flipping this trend on its head.
America’s best rural hospitals are thriving in uncertain times by expanding care, taking advantage of telemedicine, and specializing in in-demand areas.
By taking this approach, rural hospitals have grown revenue even when dealing with aging populations, higher-than-average Medicare patient totals, and other challenges that have sunk competing providers.
Today, we’re exploring four more rural hospital success stories from small towns across the United States.

Gold Beach, Oregon Hospital Increases Services, Becomes Economic Driver for Region

Gold Beach, Oregon is a small, relatively isolated community along a picturesque section of Oregon’s southern coast.
For decades, the community was served by a small, outdated facility built in the 1950s. The facility exclusively provided acute care, meaning patients had to travel long distances to access specialized medical treatment.
Things became progressively worse for Gold Beach’s Curry General Hospital over the years. The facility could no longer meet local needs, and the building itself was not compliant with building doctors. The facility struggled to attract and retain doctors.
Things changed when the hospital received new funding. Residents of the Curry Health District approved a $10 million fund to fund construction on the facility. The hospital received an additional $20.9 million through the USDA Rural Development’s Community Facilities Program. By taking advantage of favorable interest rates and 40-year terms, the rural district was able to afford considerable healthcare spending it would normally be unable to afford.

Kalispell, Montana Emphasizes Outdoor Lifestyle to Attract Talent

Some rural hospitals have turned a disadvantage into an opportunity. Rural hospitals can be isolated – but that doesn’t mean they can’t attract talent.
Kalispell, Montana is a relatively isolated city in a picturesque corner of the state. Although isolated, the city is surrounded by world-class ski hills, Glacier National Park, multiple lakes, and considerable outdoor adventure opportunities.
By emphasizing these opportunities, Kalispell has attracted high-quality medical care to the region regardless of the remoteness.
On July 1, 2020, Kalispell Regional Healthcare opened the first floor of Montana Children’s. The $60 million facility was funded by debt, operating reserves, and philanthropy.
The opening is a big deal for the city of Kalispell. Previously, Kalispell residents needed to visit Spokane, Washington – four hours away across multiple wintry mountain passes – to get similar patient care for children. Parents of children with chronic diseases were forced to move to Spokane, Denver, and other larger cities – or face multiple harrowing drives each winter.
Now, thanks to the new opening, Kalispell residents can access quality patient care even in a relatively remote area.

North Dakota Hospital Thrives Thanks to Booming Oil and Gas Operations

In neighboring North Dakota, hospitals have faced a surge in revenue thanks to the booming oil and gas industry.
North Dakota’s McKenzie County saw its population double between 2010 and 2020, due mostly to oil and gas operations in the region. As the population grew from 6,000 to over 12,000, local legislators recognized the urgent need to expand healthcare.
Using federal and state loans, funding from the oil industry and private citizens, and a sales tax increase, the region opened the new McKenzie County Hospital in Watford City in June 2018.
Before the opening the hospital, residents had to drive 50 minutes to access surgeries and preventative healthcare services. Today, residents of the 12,000-person county enjoy high-quality healthcare even in a relatively remote, rural setting.
And, like Kalispell, McKenzie County has attracted talent by emphasizing the rural setting:
“Not everybody wants to live in a city, and not everybody should, and there are great places in America that should not have to suffer with second-class health care,” explains Patsy Levang, board chair of McKenzie County Healthcare Systems, in a statement to US News.

Mississippi Town, Population 1,600, Revitalizes Local Economy with Federal Grant

Mississippi’s Field Memorial Community Hospital (FMCH) is located in a town of 1,600 residents. While other hospitals serving similarly-sized towns close down, FMCH is taking the opposite approach.
Thanks to a federal grant, FMCH is building a new $21 million facility that will introduce big changes to local residents.
Centreville is located about 130 miles northwest of New Orleans, and approximately one-third of residents live below the poverty line.
The goal is to use FMCH as an economic driver for the region.
“A lot of times in the rural communities your health care systems are your economic drivers, and that’s true here,” explains Chad Netterville, chief executive of the Field Memorial Community Hospital, in a statement to NY Times, which covered the expansion in April 2015.
Today, Centreville has a 16-bed hospital thanks to the federal economic development program designed specifically to increase investment in low income communities. By targeting rural hospitals and expanding patient care, federal grants can revitalize local economies while contributing to higher-quality patient care.

Final Word

Since 2010, more than 100 rural hospitals across the country have closed down, according to a study from the University of North Carolina – Chapel Hill.
While times are tough for some rural hospitals, others have succeeded despite these challenges. They’ve turned challenges into opportunities, taking risks where other hospitals are not willing.
Contact HMI, LLC today for expert revenue cycle management consulting, chargemaster service consulting, coding services, and more. Founded in 1989, HMI, LLC has revitalized small and large healthcare organizations across the county.

Rural hospitals face considerable challenges throughout the country. While some rural hospitals thrive in challenging situations, others falter.
Today, we’re highlighting some of the best success stories of rural hospitals across America, including situations where ingenuity, creativity, and flexibility saved small hospitals in rural settings.

Rural Hospital in Beatrice, Nebraska Specializes in Healthcare for Older Adults

Rural areas of America tend to have older populations than urban areas. This increases challenges for rural hospitals.
It’s hard enough running a small, rural hospital. These challenges increase with older populations who have larger, more complicated healthcare needs – and who also tend to be Medicare patients.
Despite these challenges, a small hospital in Beatrice, Nebraska is thriving by implementing a seemingly obvious solution: they’ve invested in aging healthcare, allowing them to specialize in the specific areas where older adults need them most.
The average age in Beatrice, Nebraska is 6 years older than the average age in Nebraska. It’s an older, rural town with a population of 12,200 people.
To address these challenges, the Beatrice Community Hospital and Health Center (BCHHC) has implemented a range of solutions. BCHHC has continued to grow, opening a new building while doubling patient numbers since 2009.
What did BCCHC do differently? The hospital made significant investments in treating and serving the area’s aging residents. As the town’s population gets increasingly older, several nursing homes have opened in town, with BCCHC being the primary medical hub for these residents.
Today, BCHHC is the second largest employer in Beatrice. It has a 25-bed hospital employing 512 people with a payroll of $28 million. The hospital earned $100 million in revenue last year – even as other businesses are leaving Beatrice en masse.
Because of their foresight, the Beatrice Community Hospital and Health Center continues to thrive amid uncertain times for small, rural hospitals.

Millions of Americans depend on small, rural hospitals for healthcare. Unfortunately, due to several challenges, many of these small hospitals are struggling to survive.
Between 2010 and 2014, 47 rural hospitals across America stopped providing inpatient services, according to a report by the Rural Health Research Gateway. An additional 673 rural hospitals are at-risk for closure.
Today’s climate may seem daunting for small, rural hospitals – but it doesn’t have to be. Today, we’re highlighting some of the best strategies today’s small, rural hospitals are using to survive.

Visit https://hmi-corp.com/the-best-strategies-small-rural-hospitals-are-using-to-survive/

I write this review as a member of Rosie’s Book Review Team (authors, if you are looking for reviews, check here), and I freely chose to review an ARC copy of this novel.

This is another great find by Rosie and although I wasn’t familiar with the author (who also publishes under her real name, Denise Deegan), I’m convinced this won’t be the last time I read one of her books.

The description of the book does a good job of highlighting the main aspects of the plot: we have Grace, a woman escaping a difficult and dangerous marriage, with her teenage children, Jack and Holly, hopeful that returning back to the village where she grew up will offer them all a second chance. There awaits her father, Des, who is going through a major change in his life (he’s a recently retired family doctor suffering from early stages of Parkinson’s disease) and doesn’t know the ins and outs of Grace’s decision. Moving from Dublin to a small and sleepy village comes as a shock to Grace’s children, and she finds it difficult to confront the gossip and the expectations of having to step into her father’s shoes. But, this novel about second chances builds up slowly and we see that although not everything is ideal and there are misunderstandings and difficulties to be ironed out, Killrowan, the place and its community, is a place worth sticking with.

The novel touches on a variety of themes: abusive marriages and family relationships (and how difficult it is to walk out); starting over in a different place, picking up friendships and relationships, and rebuilding one’s life; the struggles of dealing with a chronic and debilitating illness; how much one’s self-identity can be enmeshed with our profession and our job; the differences between a big city and a small village; being a family doctor in a rural/village location; how teenagers feel when they have to move and be uprooted from school, friends…; the role animals play in helping us fit in a place and feel rooted; small community life, with hits highs and lows; and even a hint of possible romance(s). There are funny moments, plenty of heart-warming episodes, some scary and nasty shocks as well, some sad and touching stories, and even medical emergencies and action scenes thrown in. In her acknowledgements, the author highlights the process of her creation and her research and having read the novel, I can confirm that it has paid off. She manages to weave all the topics into a novel that brings the characters and the village to life, and I was delighted to read that she is thinking about a sequel. I’d love to go back to Killrowan and revisit the places and the characters that have also become my friends.

Alexander creates multi-dimensional characters easy to relate with. Grace doubts herself and is forever questioning her actions and doubting other people’s motive. Her self-confidence has suffered after years of being undermined and abused by her husband, and she feels guilty for uprooting her family, while at the same time experiencing the thrill of freedom. The novel is written in deep third person and allows us to see the action from different points of view. Grace’s point of view dominates the book, although we also see what her father, Des —another fantastic character who treads carefully and whose life suddenly regains a meaning when his daughter and grandchildren come to live with him— thinks and does, how both of Grace’s children, Jack and Holly, feel, faced with a completely different environment (Jack was the popular sporty type, while Holly had a hard time fitting in and had no friends other than her dog). We meet some fantastic characters in the community, like the scary (at least at first) receptionist at the doctor’s surgery; the butcher’s wife (a gossip with a big heart); Grace’s old pals, Alan (with some secrets of his own) and Ivonne; Benji, a wonderful dog that adopts the family; a handsome American writer; the wife of a local magnate (who reminds Grace of herself); Des’s old love; the local policeman; Grace’s partner at the doctor’s surgery and some of her patients, although not everybody is nice, don’t worry. We also get brief snippets of the events from some of the other character’s perspectives, not only the Sullivans, and that gives us access to privileged information at times. Although the different characters’ points of view aren’t separated by chapters, they are clearly differentiated, and I experienced no confusion while reading, quite the opposite. I enjoyed the opportunity to share in the bigger picture.  

The writing style is fluid and flows well, without rushing us through the events, allowing us time to reflect upon events, enjoy the wonderful settings (the sea, the beach, the island, the pub…) and become acquainted with the location, the emotions, and the characters. The author knows well the area, and although Killrowan doesn’t exist (or, at least I couldn’t find it), it feels real (and some of the comments and attitudes Grace and her family experience reminded me of similar events I had witnessed in a small village I used to visit when I was younger) and it leaps from the pages. I confess to enjoying the style of the writing and feeling emotionally engaged with the story (I’d recommend having tissues handy). I’ve selected a couple of quotes to share, but as usual, readers might want to check a sample of the book to see if it suits their taste before purchasing it.

Here Grace is thinking about the family dog and how his death gave her the strength to finally leave her husband.

Benji was more than a dog. He was family. And her defender. Tiny little ball of fur rushing to the rescue. Or trying. Tiny little ball of fur that brought so much comfort to all three of them, Holly especially. Benji knew when they needed love and he gave it in spades.

Here Des is thinking about retirement.

What fool started the tradition of watches as retirement presents? Any thinking person would know that the last thing a man would want is to count all the time he now has on his hands.

Holly had just told her brother that their mother wanted to start over, and Grace realises her daughter is right.

Minutes ago, it had been to escape Simon, shake him off. But escaping Simon is still all about Simon. Grace sees that now. What she must do is start over. Because that is about Grace.

The ending is more than satisfying as well. Yes, not everything is settled and sorted in the end, but this is a book about new beginnings, and we leave the Sullivans and Killrowan to carry on merrily, getting to know each other and discovering what new changes and challenges life will bring. As I mentioned above, the author hints at a possible sequel, and I hope it comes to be.

This is a novel full of heart, friendship, a strong sense of community, and also heartache and personal growth. It is inspiring and comforting in these times when we have been obliged to live pretty enclosed lives. I agree with the TV series mentioned in the description (Call the Midwife one of my favourites), and I’m sure fans of any of those will enjoy this novel, which fits perfectly in the feel-good category, although that does not mean it hides from the most unsavoury aspects of life. There are menacing and dark moments, none too explicit, and I’d recommend it to anybody who enjoys stories with a heart, fond of Ireland and stories with an Irish background, and those who want a gentle read full of wonderful characters and a memorable community we’d all be happy to join.

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