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Despite a final attempt to rescue St. Mark’s Medical Center, the sole hospital in Fayette County, its closure became inevitable due to continuous financial challenges.
Last week, the hospital, which has been serving the community for 18 years, made the disheartening announcement that it will be shutting down on Thursday. This unfortunate decision will result in the loss of over 50 jobs, both full and part-time, in La Grange, a peaceful rural town with a population of approximately 4,400 residents.
A private company called Progressive Health Group came forward on Monday to assist the hospital in staying afloat, while patients visited the hospital to bid farewell to their beloved receptionists and collect their medical records.
Despite an emergency meeting being called on Wednesday afternoon, the hospital board ultimately proceeded with the planned closure. Dudley Piland, the board president, cited numerous unanswered questions and a lack of time to thoroughly examine the finances of Progressive Health Group as reasons for their decision.
Piland expressed, “That hail mary was truly impressive. If only it had occurred a few weeks earlier, we might have been able to choose a different course of action. However, at that point, we were already deeply committed to our current path, and it wasn’t practical to reverse it without reliable information.”
St. Mark’s closure marks Texas’ first rural hospital closure since the COVID-19 pandemic started in early 2020. Federal relief funding helped stave off hospitals’ closures over the past two years, but now that the funding has dried up, Texas hospitals, especially those in rural areas, are again at risk of shuttering. A 2022 report found that the percent of Texas hospitals at risk of closure nearly doubled since 2020.
During the decade preceding the pandemic, Texas already led the nation in rural hospital closures, with 26 closures across 22 communities, including one community hospital in Colorado County about 21 miles south of La Grange, which closed its doors in 2016. Other hospitals near Fayette County, including hospitals in Rockdale, Cameron and Bellville also shuttered within the past 20 years, leaving a health care desert in the region. Without St. Mark’s, patients now have to travel about 20 miles to Smithville or 26 miles to Columbus for the nearest emergency care.
During this period, over 120 hospitals have closed nationwide, with rural hospitals facing a higher risk due to low patient volumes, a relatively high uninsured population, and inadequate reimbursement rates. Texas, one of the ten states that have decided against expanding Medicaid access, holds the highest uninsured population in the United States.
Due to the job losses and limited access to health care, residents of La Grange, situated between Houston and Austin, now worry about the potential stagnation and economic decline of their once proud St. Mark’s Medical Center.
“I foresee a grim outcome,” expressed Twila Thurman, a former patient at St. Mark’s. “Although I wish for its continuity, the institution has been grappling with difficulties for an extended period.”
Efforts to save St. Mark's
Prior to this week, both the community members and the board had made efforts to preserve the facility. However, in 2019, the voters of Fayette County declined a proposition to establish a taxing district for St. Mark’s, which could have provided assistance in maintaining the operation of the hospital.
In February, the 65-bed hospital suspended inpatient services and applied for the Rural Emergency Hospital designation, a federal program that offers financially struggling rural hospitals the ability to maintain emergency and critical outpatient services if they can’t sustain a full community hospital. Hospitals that receive the designation get increased reimbursement rates and a monthly facility payment from Medicare.
Since its launch in January, the program has designated St. Mark’s as one of the four Texas hospitals to receive this recognition.
According to CEO Mark Kimball, although the program provided temporary relief to the hospital’s financial situation, it was insufficient to prevent them from facing financial difficulties. The hospital’s financial challenges were primarily attributed to the escalating healthcare costs, inflation, and a significant $13 million mortgage. Consequently, in February, the hospital had to let go of 64 employees, and currently, they are also experiencing losses of 49 full-time positions, 7 part-time positions, and 37 contract roles, as stated by Kimball.
Kimball expressed her sorrow for both the community and the employees, emphasizing that the closure of St. Mark’s is indicative of a larger nationwide issue. She believes that unless the federal government intervenes, the trend of small rural hospitals shutting down will persist.
During the spring season, a dedicated collective of La Grange residents united with the aim of rescuing the hospital. Their efforts culminated in the establishment of a nonprofit organization known as the Hospital Center of Excellence. After investing approximately 1,300 hours collaborating with the hospital’s management, they determined that a sum of $5.3 million was necessary. To secure a loan of $1.5 million, the group sought the support of the city as a guarantor.
Last week, council members convened a special-called council meeting and, in a closed session, postponed further deliberation on the matter. Interim City Manager Frank Menefee stated that, in order to make a decision, the council needed to conduct research to ascertain the legality and advisability of guaranteeing the loan. However, the Hospital Center for Excellence expressed their inability to tolerate any further delay in reaching a decision.
Sam Wilson, the organizer of the Hospital Center of Excellence, expressed disappointment in the lack of support from both the county and city in their efforts to rescue the hospital.
If it hadn’t been for the COVID-19 relief funding, St. Mark’s would probably have closed earlier, according to John Henderson, the executive director of the Texas Organization for Rural and Community Hospitals.
According to Henderson, the closure of the hospital in La Grange does not bode well for the town’s future, considering the negative impact experienced by other hospitals.
Henderson expressed concern about the potential consequences faced by other communities when they lose their hospital. He emphasized that the absence of a hospital can lead to subsequent losses of vital services such as pharmacies, grocery stores, and banks. Henderson worries that without the presence of a hospital, the community may suffer a decline in the coming years as it was the healthcare facility that provided essential support.
