Becker's Hospital Review

21 CFO / FINANCE The rural hospital closure crisis: 10 things to know By Ayla Ellison M any rural hospitals across the nation are faced with financial challenges, causing some to scale back services and others to close. Ten things to know about rural hospital closures: 1. Across the U.S., more than 120 rural hospitals have closed since 2010, according to the Cecil G. Sheps Center for Health Services Research. 2. irty-one states have seen at least one rural hospi- tal shut down since 2010, and the closures are heavily clustered in states that have not expanded Medicaid under the ACA. 3. Twenty rural hospitals in Texas have closed since 2010, the most of any state. Tennessee has seen the second-most closures, with 13 rural hospitals shutting down in the past decade. 4. e Sheps Center began tracking rural hospital clo- sures in 2005. Since then, 163 hospitals in rural com- munities have shut down. 5. e number of closures has steadily increased over the past three years. Rural hospital closures hit a re- cord high in 2019, with 19 shutting down. 6. A variety of issues have put rural hospitals in a fragile position, including low patient volume, heavy reliance on government payers, increased regulatory burden, rising pharmaceutical drug costs and the shi from inpatient to outpatient care, according to a re- port by the American Hospital Association. 7. Although for-profit hospitals accounted for just 11 percent of rural hospitals in 2013, nearly 40 percent of the hospitals that closed between 2013 and 2017 were for-profit, according to a report by the U.S. Govern- ment Accountability Office. 8. Across the U.S., more than 600 rural hospitals are vulnerable to closure, according to an estimate from iVantage Health Analytics, a firm that compiles a hos- pital strength index based on data about financial sta- bility, patients and quality indicators. 9. Sixty-eight percent of the hospitals vulnerable to closure are critical access hospitals — a designation that requires certain conditions be met, including be- ing located at least 35 miles from another hospital. 10. Patient access to care suffers when a rural hospi- tal shuts down, and consequently, patient outcomes can worsen. A working paper published by the Na- tional Bureau of Economic Research found rural hospital closures increased inpatient mortality by 5.9 percent. n AdventHealth to sell Texas hospital to Christus By Alia Paavola A ltamonte Springs, Fla.- based AdventHealth plans to sell its hospital in San Mar- cos, Texas, to San Antonio-based Christus Santa Rosa Health System. Christus Santa Rosa has entered into an asset purchase agreement to acquire the 170-bed Central Tex- as Medical Center and its assets. The systems expect the deal to be finalized in the spring, pending necessary regulatory approval. "CTMC has been a very import- ant part of AdventHealth for many years," said Terry Shaw, president and CEO of Advent- Health. "Over time we've realized that the interests of CTMC and the community it serves would benefit from the hospital joining a strong health system with a ro- bust regional network." Christus said it will release more details of the transaction when it is finalized. n Intermountain unveils more details about 2nd children's hospital By Alia Paavola S alt Lake City-based Intermoun- tain Healthcare disclosed more details about its second Prima- ry Children's Hospital campus. The pediatric hospital campus, which is part of a $500 million investment to bolster pediatric care in the region, will be built on a 38-acre campus in Lehi, Utah. The campus will feature a new hos- pital with five floors and 66 beds. It will also contain a three-story medical office building. The hospital will offer trauma and emergency services, pediatric intensive care, surgical services, behavioral health services, infu- sion services and more. The facility is expected to open in 2023. n Novant to build $154M hospital in Charlotte By Alia Paavola W inston-Salem, N.C.-based Novant Health will build a $154 million hospital in Charlotte, N.C., after securing approval from the city council, according to The Charlotte Observer. The 161,000-square-foot hospital will house 36 acute care beds, two operating rooms and a C-section room. The hospital will be on a 40-acre site in the upscale Ballantyne neigh- borhood. It is expected to open in 2023. The Charlotte City Council approved the project, which included re- zoning the site for development, on Jan. 21. State regulators had al- ready approved the plan. n

• Cover