St. Mark's Medical Center in La Grange, Texas, shuttered on Oct. 12 — not for a lack of trying.
The hospital had been financially strapped for years, and there were several attempts to save it, Board President and Chair Dudley Piland told Becker's. One of those attempts came on Oct. 11, when closure notifications had already been submitted to the state and CMS.
Quentin Whitwell, CEO of Progressive Health Group — an Oxford, Miss.-based hospital management group with experience in the rural sector — heard about the looming closure at St. Mark's. Hoping to save the hospital, he connected with the Hospital Center of Excellence, a nonprofit formed by five community members with the same mission.
HCOE had been working for two months to secure enough funding to keep the hospital afloat, its chief strategy officer, Sam Wilson, told Becker's. They received commitments ranging from $5,000 to $150,000 from local high-net-worth individuals, including all five members of their own organization. They turned to nine local banks in search of a participatory loan to refinance the mortgage, though all nine declined, citing concerns with the regulators. They even brought concerns to the state of Texas, which agreed to make $1.125 million in grant funding available over the next two years — $750,000 one year, $375,000 the next — and increase Medicaid reimbursement rates by 10%.
The nonprofit had secured more funding than had ever existed for the hospital, more than was needed to merely keep the doors open, Craig Moreau, CEO of HCOE, told Becker's. There was even money for new services: mental healthcare, noninterventional cardiology, dialysis.
But the efforts fell just short of the board's demands. HCOE still needed a $1.5 million loan for a line of credit, and a new operator to slot in for Community Hospital Corp. — the Plano, Texas-based consulting company that had been managing St. Mark's, and had one seat on its board.
Then Mr. Whitwell offered the $1.5 million and Progressive Health Group offered to be the operator, and there was hope again. Representatives from PHG and HCOE collaborated on a presentation and called an emergency meeting with St. Mark's board, less than 24 hours from the slated closure.
"It was a wonderful fit. It was an 11th hour find," Mr. Moreau said. "There was absolutely sufficient time to save the hospital."
But the board could not agree. After discussing the proposal, they declined Mr. Whitwell's offer and decided to see the closure through. Mr. Piland did not expand on the board's reasoning, but said they took legal advice into consideration. One concern was that HCOE and Progressive Health Group did not have a contract.
"There were just so many unanswered questions," Mr. Piland said. "We were unable to do our due diligence at the last minute before closure."
The Oct. 12 closure was a devastating blow to the small community. HCOE data predicts an annual financial impact of up to $100 million for the areas it serves, Fayette and Lee counties. And rural hospital closures have been found to increase inpatient mortality by 8.7 percent, according to a 2019 study from the National Bureau of Economic Research.
Mr. Whitwell is not ready to let the hospital go, he told Becker's Oct. 19 after a meeting with the county judge.
"Progressive Health is in communications with local officials and concerned citizens to see what can be done to reopen the facility, and as soon as possible, before anything is compromised in terms of equipment, pharmaceuticals, supplies, etcetera," Mr. Whitwell said. "We are looking into what options are available. And we certainly are open to assistance to get that accomplished."
"Every day that goes by with this hospital being closed is an eternity," he continued. "So the sooner the better. And the longer it's drawn out, the more difficult the hurt."