Before the coronavirus pandemic took hold in the U.S., many rural hospitals faced significant financial challenges. For one rural hospital CEO in Missouri — one of five states that has seen the most rural hospital closures in the past decade — the impending pandemic has spurred layoffs and furloughs to ensure enough cash is on hand to buy protective equipment.
Preparing for a surge in COVID-19 cases is akin to seeing "a big storm coming across the horizon," Randy Tobler, MD, CEO of Scotland County Hospital in Memphis, Mo., told NPR in an interview aired April 4. While the force of the storm is unknown, it's coming "on top of a fairly fragile rural health economy to begin with. And so there's just a lot of anxiety, although we're ready, and we're locked and loaded and ready to go whenever it hits," he said.
With just 25 beds, seven physicians and nine nurse practitioners, Scotland County Hospital is particularly vulnerable to a COVID-19 surge that could quickly sicken a community and its small hospital workforce.
"You can't afford to have anybody get sick because then you're really in trouble," Dr. Tobler told NPR. "... all it takes is one or two of us to go down, and then we can't render the service to our community." Dr. Tobler decided to direct precious dollars toward full face mask respirators and Tyvek suits for nurses, physicians and respiratory therapists who spend concentrated time with COVID-19 patients.
Still, it's the question if COVID-19 will be the final blow that keeps Dr. Tobler up at night, as financial challenges have already tested the resilience of his workforce.
"I hope that we're able to weather the storm and serve our patients before we either run out of stamina, our personal health or our money. That's what keeps me up at night," he said.
Read or listen to the full interview here.