I have three things to say about this.
A few weeks ago, a woman gave birth at Hereford Regional Medical Center, a critical access hospital in the Texas Panhandle.
Or, rather, the woman gave birth in the parking lot at Hereford Regional Medical Center after driving over an hour to get there, according to Jeff Barnhart, the hospital’s chief executive.
Barnhart said he’s heard it all over the years: patients giving birth at rest stops and in ambulances and in the car on the side of the road. The hospital’s patients come from a 1,600-square-mile area in the Texas Panhandle, and some of them just don’t make it in time.
But now, even patients who do make it to the hospital have another variable to contend with: critical staffing shortages and exploding COVID-19 case counts. There are days when Hereford Regional doesn’t have enough nurses to operate the labor and delivery unit, forcing it to divert patients 50 miles northeast, to Amarillo.
“We give them a medical exam and see if there’s time to get them in an ambulance to another hospital that can take them,” he said. “But sometimes, that baby’s coming and there’s just not time.”
Those patients give birth in the emergency room, an increasingly common occurrence as rural hospitals limit or cease labor and delivery services due to insufficient staffing.
Nationally, the health care system is facing an unprecedented labor shortage as nurses retire, resign, burn out or leave staff positions for more lucrative travel nursing contracts. Rural hospitals, many of which already operate with a shoestring staff, are especially hard hit.
Declining populations and cuts to Medicaid and Medicare funding have made Texas the national leader in rural hospital closings, with some 26 closures — permanent or temporary — of rural facilities in the last decade. Two-thirds of the state’s 157 rural hospitals are public, which means less flexibility in salary negotiations. Administrators also say it’s often difficult to recruit medical personnel to smaller towns in remote counties.
Struggling to survive, the remaining hospitals in Texas’ rural communities have had to cut back services. And when that happens, labor and delivery is often the first to go.
Only 40% of Texas’ rural hospitals still have a labor and delivery unit, according to the Texas Organization of Rural and Community Hospitals, leaving whole swaths of the state without access to nearby obstetrics care.
“If we’ve got nurses to cover a day, of course, we’re going to try to take care of everything that we can here,” Barnhart said. “But it’s just a scheduling crisis, and whenever we can’t make it work, we just let the hospitals in Amarillo know so they can expect it.”
Before I get to my points I want to say this is a good story and you should read the rest. Now…
1. There have been a lot of stories in recent years about the serious problems that rural communities have in accessing emergency health care because so many rural hospitals have closed down. This is a corollary of that problem, and I have a lot of sympathy for everyone involved. But as is my wont, I can’t help but see these stories through a political lens. These areas are overwhelmingly Republican. Republican politicians like Greg Abbott have done everything in their power to continue that cycle, with the fanatical refusal to expand Medicaid at the top of the list. To be sure, there are problems beyond that, and the overall demographic trends are a big factor as well, but however you look at it their representatives and the state leaders that they keep voting for have done nothing to help them. Just once, in one of these stories, I’d like to see that question explored.
2. I should note that while Abbott and state leadership and Republicans in Congress and the Lege are the main actors in this drama, sometimes it’s these same rural communities that bring the damage on themselves. I say I have sympathy and I really do, but boy does it get tested sometimes.
3. I’m old enough to remember that one of the arguments made by the defense (i.e., the state of Texas) in the Whole Women’s Health v Hellerstedt case, in which a very different SCOTUS decided that the 2013 version of Texas’ radical anti-abortion law was unconstitutional, was that forcing women to travel up to 250 miles to get an abortion because all of the clinics closer to her had been closed down as a result of that law represented an “undue burden”. I wonder what those folks think about forcing women who are actively in labor to drive a hundred miles or more to give birth because your healthcare policies have resulted in the closure of hospitals and maternity wards closer to them. Haha, I’m kidding, I don’t wonder that at all. I know for a fact that they don’t care. But still. You, a normal person, might think that’s not such a great thing. Yet here we are.
Re the link about St Mark’s in La Grange http://www.offthekuff.com/wp/?p=91090
Googling shows it is still open and “in business”. What’s the backstory and where’s the money trail? What happened to the dire financial straits?