Closed Hospitals Leave Rural Patients 'Stranded' as Coronavirus Spreads

[Eugene]

Source: New York Times

Closed Hospitals Leave Rural Patients ‘Stranded’ as Coronavirus Spreads

A for-profit company bought three struggling hospitals in West Virginia and Ohio. Doctors were fired, supplies ran low and many in need of care had to journey elsewhere. Then the doors shut for good.

By Sarah Kliff, Jessica Silver-Greenberg and Nicholas Kulish
April 26, 2020, 5:00 a.m. ET

Michael Nuzum had spent weeks fighting coronavirus-like symptoms — a wracking cough, terrible chills, an exhausting fever — before collapsing at his home in rural West Virginia.

Mr. Nuzum, a 54-year-old animal control worker, was already in cardiac arrest when the emergency workers arrived on April 3. That left them with a difficult decision: Should they transport their patient to the nearest hospital, 30 minutes away?

“There’s only so much one paramedic can do in the back of an ambulance,” said Michael Angelucci, who leads the Marion County rescue squad that cared for Mr. Nuzum. The two-person team that responded decided it couldn’t risk the long ride and instead tried to revive the patient at the scene. But the workers couldn’t save him.

Two weeks earlier, the options would have been different. Fairmont Regional Medical Center, just five minutes from Mr. Nuzum’s home, would still have been open. Mr. Angelucci, who is also a state representative, can’t help wondering if the hospital and its emergency room could have given the man a fighting chance.

-snip-

Fairmont was one of three hospitals that have shut down in this corner of rural West Virginia and Ohio since September. They delivered hundreds of babies each year, treated car crash and gunshot victims, repaired hearts and knees and offered addiction treatment and psychiatric care.

They had been acquired by a for-profit company, Alecto Healthcare Services, beginning in 2014. Employees expected the new ownership to put the institutions on solid footing after years of financial struggle. Instead, decisions made by Alecto wound up undercutting patient care and undermining the hospitals’ finances, according to more than two dozen interviews with doctors, nurses, other staff members, government officials and patients, as well as a review of court records.

-snip-

Read more: https://www.nytimes.com/2020/04/26/us/hospital-closures-west-virginia-ohio.html

[CurtEastPoint]

1. Wow. Never heard of Alecto Healthcare Services but Googling them reveals not much good.

[Srkdqltr]

2. The main problem with health care in the US is for profit.

Hospitals should not have to make a profit on suffering. They should make enough for expenses and payroll.

[Igel]

4. But expenses means not just supplies,

but renovations, new and replacement equipment, upgrading software when it's either a good idea or just required by law.

They have to not just meet minimum standards, they have to be able to attract patients by having a range of services or some service/presentation that others don't. Why a range of services? You check in with a suspected problem and it's mis-suspected so you need fMRIs and other expensive stuff done but the hospital doesn't have the equipment? Doctors won't send others there in the future.

Lots of hospitals without a lot of profitable elective surgeries, lots of hospitals with patients who don't pay for whatever reason, have trouble maintaining those standards, keeping up to date.

Non-profits are especially bad. They have to serve the community not just in ways that meet professional standards, they have community-based boards that also tend to impose political, social, cultural standards. In good times there's money, and it gets shunted from professional/medical uses to things that the board wants to make itself happy and serve "the community"; then in bad times they don't like the give-backs, they don't like that they've slighted upgrades and expansions for personal pet projects.

These hospitals were struggling financially. The original owners gave up and put them up for sale. If they hadn't sold them, you think that 2, 3, 5 years later they'd still be open?

"But they wanted a profit." More than a couple hospitals are run as not-for-profits but held by for-profit companies.

[appalachiablue]

3. The profit motive should never be involved in health care or education