23-04-2025
Texas legislature looks to help rural hospitals struggling to stay open
LA GRANGE, Texas (Nexstar) — Right on Highway 77, a few miles from downtown La Grange, sits a hospital that once provided emergency services and orthopedic surgery. Now, the St. Mark's Medical Center is an empty building with a sign on the front door that reads, 'Sorry, we're closed.'
The hospital closed in October 2023 because of 'ongoing inability to meet its financial obligations,' according to a news release that announced the closure.
St. Mark's was the only hospital in Fayette County.
About a mile from the empty hospital is the building that houses Fayette County's EMS fleet and personnel. Josh Vandever, the EMS Chief for the county, said he and his team cover 960 square miles and respond to about 4,000 calls a year. Before St. Mark's closed, Vandever said his team would transport between 50% and 60% of their calls to the local hospital.
Now, Vandever said he and his team are taking patients to emergency rooms in Smithsville and Columbus, both about 20 minutes away in either direction. But sometimes Vandever's team is making the hour-long trip to Austin for some patients.
Vandever said the patient outcome has not suffered, but what has suffered is the wear-and-tear on his vehicles and the distance for families in the community.
'You can't just go down the street to check on mom or dad at the hospital. Now they have to drive to Columbus, Smithville, or even in to Austin,' Vandever explained.
St. Mark's story is not unique. In the past 15 years, more than 20 rural Texas hospitals have closed because of financial issues. The most recent closure will happen this week after the Mid Coast Health System announced it is closing a hospital in Trinity.
John Henderson, the President of the Texas Organization of Rural and Community Hospitals (TORCH) advocates for hospitals in vulnerable communities that need financial assistance. He said problems can be contributed to a combination factors, including a low patient volume and a high percentage of Medicaid and Medicare customers.
'Which is such a tough recipe for survival,' Henderson explained.
Henderson said Medicaid does not pay the full cost of the services provided by the hospital, which leads to many hospitals operating with revenue shortfalls.. He said there are fewer commercially insured patients in rural areas.
'Rural hospitals are underwater when they treat Medicaid patients,' Henderson said.
A new push at the Texas Capitol will infuse almost $50 million over the next two years into rural hospitals and provide new training opportunities for hospital administrators. House Bill 18, authored by State Rep. Gary VanDeaver (R – New Boston) would create the State Office of Rural Hospital Finance to assist rural hospitals gain financial stability.
The bill would also require an assessment from rural hospitals that will help state officials determine which hospitals are most vulnerable and may need additional or immediate assistance.
The bill received unanimous support from the House Committee on Public Health and is expected to be voted on by the full House floor on Wednesday.
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