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A Look at Rural Hospital Closures and Implications for Access to Care: Three Case Studies

Description of Selected Hospitals

Marlboro Park Hospital – Bennettsville, South Carolina

Marlboro Park Hospital stopped admitting patients on April 25, 2015 and transferred all its remaining patients to nearby Chesterfield General Hospital in Cheraw, South Carolina, approximately 15 miles away.1 Both hospitals were owned by a real estate trust and had been operated by Community Health Systems (CHS), which announced in 2014 that it would not renew the leases for either hospital when they expired on April 30, 2015. McLeod Health Systems, a South Carolina system, assumed operation of Chesterfield General Hospital and renamed it McLeod Health Cheraw, but it declined to operate Marlboro Park. According to the South Carolina Department of Health and Human Services, Marlboro Park Hospital lost nearly $35 million between 2009 and 2013 – more than any other hospital in South Carolina, while Chesterfield generated an $8.5 million profit during those same years. Currently, some residents of Bennettsville receive care at McLeod Health Cheraw, while others travel to one of the two hospitals in Florence, South Carolina (approximately 40 miles away by car) and Scotland Memorial Hospital in Laurinberg, North Carolina (approximately 17 miles away by car).

Mercy Hospital – Independence, Kansas

Mercy Hospital, part of the Mercy Health System, began a phased closure on October 10, 2015. In 2014, the hospital formed a task force to consider an affiliation with the Coffeyville Regional Medical Center, but those discussions ended after the hospitals were unable to reach an agreement.  The nearest hospitals are now 16 minutes away in Neodesha and 20 miles away in Coffeyville (the Coffeyville hospital is now the only hospital in Montgomery County).

Parkway Regional Hospital – Fulton, Kentucky

After serving one of the poorest counties in western Kentucky for over two decades, Parkway Regional Hospital closed its emergency department and 70-bed inpatient hospital in Fulton, Kentucky in March, 2015.  Two nearby hospitals in Union City and Martin, Tennessee competed with Parkway Regional for many of the same patients.2 Fulton residents who had private insurance or could afford the cost typically left Fulton to seek care, primarily at Tennova Healthcare – Volunteer Martin, a 100-bed hospital only 12 miles away in Martin, Tennessee. Community Health Systems (CHS), the owner of Parkway Regional, also operates the hospital in Martin and promoted use of that Tennessee facility, including for specialty care, both before and after the closure of Parkway Regional. The closest Kentucky hospital is Jackson Purchase Medical Center (operated by LifePoint Health) in Mayfield, Kentucky – 22 miles from the town of Fulton. Some Fulton County residents received care at Jackson Purchase before the closure, including women who went there for labor and delivery services.

Appendix Table 1: Characteristics of Study Communities Compared to State and U.S. Overall, 2014

Table 1: Characteristics of Select Communities Compared to State and U.S. Overall, 2014
U.S Overall Kentucky Fulton County, KY
Population 318,857,056 4,413,457 6,265
Percent Change in  Population (2010-2014) 3.3% 1.7% -8.4%
Age
Under 18 23.1% 22.9% 21.0%
Over 65 14.5% 14.8% 19.4%
Race/ethnicity
White, single race 77.4% 88.3% 72.4%
Black, single race 13.2% 8.2% 24.3%
Hispanic or Latino 17.4% 3.4% 1.5%
Poverty Rate 14.8% 19.1% 31.2%
Median Household Income (2010-2014) $53,482 $43,342 $32,948
National South Carolina Marlboro County, SC
Population 318,857,056 4,832,482 27,924
Percent Change in Population (2010-2014) 3.3% 4.5% -3.5%
Age
Under 18 23.1% 22.4% 20.7%
Over 65 14.5% 15.8% 15.2%
Race/ethnicity
White, single race, 77.4% 68.3% 42.1%
Black, single race 13.2% 27.8% 51.0%
Hispanic or Latino 17.4% 5.4% 3.2%
Poverty Rate 14.8% 18.0% 31.4%
Median Household Income (2010-2014) $53,482 $45,033 $28,765
  National Kansas Montgomery County, KS
Population 318,857,056 2,904,021 34,065
Percent Change in  Population (2010-2014) 3.3% 1.8% -4.0%
Age
Under 18 23.1% 24.9% 23.9%
Over 65 14.5% 14.3% 18.1%
Race/ethnicity
White, single race 77.4% 86.8% 85.2%
Black, single race 13.2% 6.3% 5.8%
Hispanic or Latino 17.4% 11.4% 6.3%
Poverty Rate 14.8% 13.6% 18.0%
Median Household Income (2010-2014) $53,482 $51,872 $40,716
SOURCE: All estimates are from the Census Bureau’s 2014 QuickFacts. QuickFacts provides statistics for all states and counties and for cities and towns with a population of 5,000 or more. http://www.census.gov/quickfacts/table/PST045215/00
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