Rural hospitals in Tennessee, near the Kentucky border, remain closed as the voluntary state continues to reject Medicaid expansion.

By Taylor Sisk
KFF Health News

JELLICO, Tenn. — In March 2021, this town of about 2,000 on the Kentucky border in the shadow of Pine Mountain lost its hospital. Campbell County ranks 90th of Tennessee's 95 counties in health outcomes and has a poverty rate almost twice the national average. The loss of its cornerstone of health care therefore had repercussions throughout the region.

“This hospital was not only the pillar of health care for this community,” said Tawnya Brock, health care quality manager and Jellico resident. “Economically and socially, it was the center of the community.”

Since 2010, 149 rural hospitals in the United States have closed or stopped providing inpatient care, according to the Cecil G. Sheps Center for Health Services Research. University of North Carolina. Tennessee had the second most closures of any state, with 15, and the most closures per person. Texas has the most, with 25. Neither state has expanded Medicaid under the Patient Protection and Affordable Care Act, like Kentucky, where only four hospitals have closed.

Jellico Medical Center was a 54-bed acute care facility. When it closed, some 300 jobs were lost. Restaurants and other small businesses in Jellico have also gone bankrupt, said Brock, a member of the Tennessee Rural Health Associationof the legislative committee. And the city must deal with the empty shell of a hospital.

Dozens of small communities are wondering what to do with hospitals that have closed. Sheps Center researchers found that while a closure negatively affects the local economy, those effects can be mitigated if the building is converted to another type of health care facility.

In Jellico, the city owns the building that housed the medical center and Mayor Sandy Terry said it is in good condition. But the latest operator, based in Indiana Boa Vida Health, holds the license to operate a medical facility there and has yet to announce its plans for the building, leaving Jellico in limbo. Terry said local officials are talking with health care providers who have expressed interest in reopening the hospital. This is their preferred option. Jellico has no plan B.

“We’re just hoping someone will take over,” Terry said. Meanwhile, the closest emergency rooms are a half-hour drive away in LaFollette, Tennessee, and Corbin, Kentucky.

An hour and a half away in Fentress County, the building that once housed Jamestown Regional Medical Center has been empty since June 2019, when the Florida-based medical center Health Rennova — which also previously operated Jellico Medical Center — locked it down.

County Executive Jimmy Johnson said Rennova's exit from Jamestown was so abrupt that “the beds were all perfectly made” and IV stands and wheelchairs were set up in the hallways. Around 150 jobs disappeared when the center closed.

Rennova still owed Fentress County $207,000 in taxes, Johnson said, and in April the property was put up for auction. A local business owner bought it for $220,000. But Rennova was given a year to reacquire the building for what it owed in back taxes, plus interest, and did so within days.

Abandoned hospital buildings dot the map of Middle and East Tennessee. In West Tennessee, some shuttered hospitals have found new life.

The closure of McKenzie Regional Hospital in 2018 was a major blow to the local economy. But Baptist Memorial Health Carewhich operates a hospital in nearby Huntingdon, purchased the assets – including the building, land, equipment and ambulance service – and then donated the building to the Town of McKenzie.

Cachengo, a technology company, eventually took over the space. With the hospitals' electrical infrastructure, the site was ideally suited for a business like his, said Ash Young, Cachengo's chief executive. Young said Cachengo is now considering repurposing abandoned hospitals across the country.

Jill Holland, former McKenzie mayor and local government and special projects coordinator for the Southwest Tennessee Development District, believes the city can become a technology hub. “It opens a lot of doors for young people in the community,” she said.

But in Jamestown, the vacant hospital is “deteriorating,” said Johnson, the county executive. “It could have been used to save lives.” Rennova did not respond to a request for comment.

The University of Tennessee Medical Center has opened a freestanding emergency room elsewhere in Jamestown, saving residents a half-hour drive to the nearest emergency room. Johnson believes the old hospital building could serve the community as housing for the homeless or as a facility to treat substance use disorders.

Brock, the health care quality manager, believes things will improve in Jellico, but the community's hopes have been dashed repeatedly.

Brock believes a freestanding emergency room could be a viable solution. She urges her community to be responsive to “a new era” in rural health care in America, one in which a hospital must focus on the most urgent needs of its community and be realistic about what it can provide.

“Maybe this is just an emergency room, a sustainable emergency room, where you could keep patients for a while and then transfer them,” Brock said. “And then you build on that.”

She added: “There are options. »

KFF Health News, part of the Kaiser Family Foundationis a national nonprofit newsroom producing in-depth journalism on health issues.

Kentucky Health News is an independent news service of the Institute for Rural Journalism and Community Issues, based at the University of Kentucky School of Journalism and Media, with support from the Foundation for a Healthy Kentucky .

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