The future of rural health care is a problem all over the United States and the Pecos County Memorial Hospital is no exception.
Some hospitals across the country as closing because low populations can't support a hospital but, more often than not, Medicaid reimbursement rates are so low hospitals can't break even.
The Becker's Hospital CFO Report said that 21 hospitals closed in 2018.
“The challenges get worse, but they have been there for a while,” said Pecos County Memorial Hospital CEO Betsy Briscoe.
PCMH is a county funded hospital, instead of a hospital district, meaning they have no control over the taxes that they can charge.
They tried to break from the county and become a hospital district several years ago but it did not pass.
“It just wasn't the right time, but as time goes on we're not going to have an option,” said Pecos County Judge Joe Shuster. “We're running out of rope.”
Iraan General Hospital operates under a hospital district format. But even Iraan faced budget cuts and staff reductions last year to avoid going broke in 2020.
PCMH had 90,000 visits last year between admissions, surgeries, hospice, and their other programs.
“That's how much we do for the community, it's a lot,” said Briscoe.
In Texas, 32 counties have no physician and 72 counties don't have a hospital.
Only 66 of the 161 rural hospitals in Texas still provide obstetrical and baby delivery services because of the financial loss from OB care.
The Texas Hospital Association reported that no other state has more residents without health care and no other state has experienced more hospital closures in rural communities.
“The state of rural healthcare right now is in such a mess,” said Shuster.
In addition to having problems with getting medical bills funded by insurance, private or Medicaid, they also face rural problems of staffing.
All of the nurses have different trainings to accommodate different needs in the community, but finding people willing to move to Fort Stockton is a challenge when it comes to housing and payment.
The saving grace is that most employees stay for a long time, retiring after 25 years.
“Most people that are here are here for the long haul,” said Malissa Trevino, Director of Human Resources.
To combat these issues and ensure they stay open, the hospital bases their services around what the people need most since they are unable to offer everything.
“We are going in a positive direction,” said Trevino.
The hospital also offers payment plans and will work with anyone to help them cover the cost of their care.
“As the government and insurance companies pay the hospital less and less, it becomes more and more important for everyone to do their part to keep PCMH a viable service to our community,” said Briscoe.
The hospital was started in 1948 and has continued to serve the growing community of Fort Stockton, saving them a drive to a bigger city, like Odessa.
“We have fantastic services here and everyone is so invested in Fort Stockton,” said Briscoe. “Our goal is to continue to provide the services that we do.”