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FORECASTING: How to predict closure of rural hospitals

From January 2010 to December 2015, 63 rural hospitals closed, and over 1.7 million people are now at greater risk of negative health and economic hardship due to the loss of local acute care services.”

A model to predict financial distress and the risk of closure for rural hospitals is described in this scholarly article out of the Cecil G. Sheps Center for Health Services Research at the University of North Carolina.  The model was validated in that all of the selected financial performance indicators were found to be associated with the likelihood of hospital financial problems.  A surprise was that investor-owned rural hospitals were found to be more likely than expected to be in financial distress; although, this might be linked to their tendency to be located in southern states, which – as a region – are more likely to be struggling financially.

Source: Holmes, G.M., Kaufman, B.G., and Pink, G.H. (2017, Summer). Predicting financial distress and closure in rural hospitals. Journal of Rural Health, 33(3), 239-249.  Click here for access to the publisher’s website: http://onlinelibrary.wiley.com/doi/10.1111/jrh.12187/pdf  Posted by AHA Resource Center (312) 422-2050, rc@aha.org

 

HOSPITAL CLOSURES: What is nurse executive’s role?

Five nurse executives who were employed at rural hospitals were interviewed about their experiences when their hospitals closed.  The researchers categorized key themes brought out in these interviews, which are discussed in this brief article.  They cover topics related to a flattening of the organizational structure of the hospitals, a strong sense of family among staff, development of crisis conditions concerning supplies and workforce and feelings of betrayal by the hospital owners.  They also mention the challenges of finding qualified board members and top administrators in small communities.  Another difficulty was the disposition of medical records after the closure.

Source: Warden, D.H., and Probst, J.C. (2017, January). The role of the nurse executive in rural hospital closure. JONA. Journal of Nursing Administration, 47(1), 5-7. Click here for publisher’s website: http://journals.lww.com/jonajournal/Abstract/2017/01000/The_Role_of_the_Nurse_Executive_in_Rural_Hospital.3.aspx   Posted by AHA Resource Center (312) 422-2050, rc@aha.org

CLOSURE: Why do rural hospitals close?

Characteristics of 42 rural hospitals that closed between 2010 and 2014 were compared to hospitals that remained open in this study out of the North Carolina Rural Health Research Program.

Rural hospitals that closed

  • Were in worse shape financially – lower margin, fewer days cash on hand, higher debt levels
  • Had a higher Medicare patient mix
  • Had lower utilization rates
  • Had lower volume in key services – surgery, outpatient services, and obstetrics
  • Had fewer employees

The researchers also took a look at critical access hospitals that closed compared to other rural hospitals that closed.

Source: Kaufman, B.G., Thomas, S.R., Randolph, R.K., and others. (2016, Winter). The rising rate of rural hospital closures. The Journal of Rural Health, 32(1), 35-43.  http://onlinelibrary.wiley.com/doi/10.1111/jrh.12128/pdf  Posted by AHA Resource Center (312) 422-2050, rc@aha.org