Hospital at a Crossroad

To the Editor:

I’d like to commend the FCR for bringing to us the complex, evolving saga of St Mark’s Hospital (SMMC), with the efforts to keep it going and the recent attempts to rebuild and reorganize. I also thank Sam Wilson and members of the newly formed HCOE group, for the extended and enlightening series that appeared in the paper, recounting the story of the hospital from its inception through the ongoing efforts to restructure the hospital to serve out-patient care. SMMC can serve the community even better, with new more transparent management and a clear plan for putting finances on a firm footing. Wilson’s columns, which did much to highlight and elucidate the facts surrounding this almost tragic tale of a struggling rural hospital, is in truth, but one reflection of the troubles that befall rural community health services as expectations collide with realities of change and the vagaries of the reimbursement rules that govern our healthcare industry as a whole.

That said, the article appearing in the August 11 issue was especially disheartening, coming as it did barely two weeks after the much more hopeful tone of earlier columns. I do understand that raising $8.5 million in new funding in this financial and credit climate of high interest rates is not an easy task. Raising such funds is difficult enough even under the best of circumstances for the most laudable of causes. Yet, I also find it especially disappointing that in a thriving community like Fayette County, one boasting ever increasing tax revenues and fast rising property values, it is so difficult to raise funds for a local hospital, especially one that has become known over the years for providing caring first rate healthcare to citizens in both Lee and Fayette counties.

I hardly need to remind people of the enormous generosity that propelled numerous successful fund raisers for so many excellent causes in this area. Be they for the Round Top Festival hill, a veritable center of musical excellence, the Arts for Rural Texas now providing arts education and exhibits for children and adults, the ever-popular county fair, the Czech heritage museum, the new community center to be built in Fayetteville, the volunteer fire brigades, and the many churches and thriving charitable organizations. This spirit of generosity from so many residents contributes greatly to keeping the county economically viable and commercially healthy, with strong tax receipts and a great quality of life. This state of overall health is in large part what attracts people from cities like Houston and Austin to come and live here, an influx of both human and financial capital that is likely to continue unabated.

It is partly against this background that I feel so disheartened by the seeming failure to raise the funding needed to save a hospital credited for greatly contributing to the actual physical and mental state of health of the individuals who live and/or work in this area. SMMC has been not only a community anchor and a first rate healthcare provider; but, is a prime provider of gainful employment for 100s of healthcare workers while supporting numerous local vendors and suppliers. I know for a fact that many of our older residents, are hardly in a position to undertake long commutes to neighboring county hospitals, be it for acute or chronic conditions, much needed surgeries, medical tests, and a steady stream of follow-up appointments.

We are all aware of the serious headwinds encountered by SMMC, including issues associated with the original HUDbacked funding mechanism with its Byzantine bureaucracy that is hardly amenable to rapid response in addressing immediate and serious challenges. The challenges are made all the more taxing with the rise of the medical advantage plans that purport to save money for patients but often at the cost of quality care and still lower reimbursement models for providers. A costly ransomware attack a few years back has greatly exacerbated SMMC’s financial outlook, effectively costing millions to ameliorate. Also, on the negative side, it is true that many of the wellheeled senior residents who moved to Fayette County prefer to use the metro healthcare services they are accustomed to, and are perhaps not as personally vested in supporting local healthcare services. Such difficult factors are further compounded given the observation that many longtime residents are opposed in principle to any form of taxation from a hospital district, not unlike the ones supporting the Columbus Hospital and over 130 other rural Texas counties.

The question now is whether there is enough good will and trust to allow a rejuvenation of the hospital, complete with a cost-effective, transparent and competent management structure, better and cleaner balance sheets, and a more innovative vision for increased services in this city as well as to nearby communities. The opportunities are here, and I believe the operational plans I saw from HCOE are feasible. All the more so in light of the likely support and commitment of members of HCOE, the hospital foundation, the physicians and staff who have so faithfully served these two counties, and the many wellmeaning and capable residents ready to lend their support, in whatever form they can.

I also gather that time is of the essence, and herein lies the main challenge. Despite the pressing near-impossible time constraints, I hope some arrangements can still be made before it is too late. Will the needed resources, including individuals with sources of capital come forth to save and rebuild this important institution? One which I believe is far more critical to the well being of both part and full time county residents than is realized. In particular, I feel that should the hospital have to eventually close down altogether including emergency services and medical testing facilities (as will likely happen in the event of bankruptcy proceedings), it will have a serious demoralizing effect on the entire county. A healthy local hospital is in many ways, the beating heart of the community, which like the human heart, is often taken for granted, until the day it flutters and stops.

Hanna Hoffman Fayetteville