A North Country Hospital is Ailing

It is a fact of life: Times are tough for small rural hospitals all over America.

Maggie Elehwany is the vice president for policy at the National Rural Health Association.

“Small rural hospitals have long been struggling they just often don’t have the significant number of individuals to serve, patients in the area, to make ends meet.”

In New Hampshire the perfect example is the Upper Connecticut Valley Hospital in Colebrook.

It struggles with two conflicting goals.

One is providing quality healthcare – even to people who can’t pay for it.

The other is balancing the budget, which is getting harder with a faltering economy.

“It is incredibly challenging right now.”

That’s Louise McCleery.

She’s the chief executive officer at the hospital.

About 60 people come in every day for out-patient treatment.

And says McCleery, on an average day six people stay over for treatment.

It is the smallest hospital in the North Country.

The next closest is about 36 miles away in Lancaster.

Right now the budget is McCleery’s over-riding problem.

In fiscal 2008 the hospital lost money.

So, it had to take about $800,000 out of its investments to balance things out.

Those investments had totaled several million dollars.

Unfortunately they were down due to the stock market.

“It is not like we are on life support here but what we recognize is that you can burn through several million dollars really quickly when you lose half a million or $800,000 from operations and that is our concern.”

McCleery says borrowing from savings is a dangerous way to run a business

Recently, the country’s economic problems reached out to give the tiny, 16-bed hospital another whack.

The Ethan Allen furniture factory across the river in VT laid off 69 workers, 50 of whom live in and around Colebrook

McCleery says the hospital has depended heavily on those workers because they have health insurance.

“Commercial insurance is the bread and butter of all hospitals and all health-care units. It is good reimbursement.”

And, McCleery adds, as the number of people with health insurance has been declining, the number of people using Medicaid has been increasing.

But Medicaid does not come close to covering what it costs a hospital to provide care.

So, less insurance and more Medicaid is a bad formula.

But Maggie Elehwany of the National Rural Health Association says it is a national problem.

“If you look at the unemployment rate it is actually increasing at a higher level in rural America and what that means in healthcare is that you get more people being uninsured or under-insured and that creates a tremendous burden on your critical access hospitals, on your rural health clinics, on your community health centers.”

McCleery acknowledges Upper Connecticut Valley is being hit the hardest among hospitals in the north country.

“…. We’re small and even the smallest shifts in our financial situation in reimbursement has an incredible impact on us.”

She says there isn’t any room for cuts.

“We already run at core staffing. We have never been able to have fluff expenses.”

Several years ago the hospital stopped delivering babies.

It has only one surgeon.

That limits the times when surgery can be performed.

McCleery says she is working with other North-Country hospitals.

They are exploring ways to save money and increase profits.

If Upper Connecticut Valley had to close more would be lost than access to health care.

Jobs.

With 126 employees, the hospital is a large, North-Country employer.

For NHPR News this is Chris Jensen.