Rural hospitals across the U.S. continue to face mounting financial pressures, and Southwest Arkansas Regional Medical Center in Hope is no stranger to these struggles.
The 48-bed acute care hospital, which was purchased for $200,000 by Hope-based Pafford Health Systems in early September 2024 from Dallas-based Steward Health Care, requested $3 million from the state in late September to keep its doors open. Steward sought Chapter 11 protection in May 2024, making it the second bankruptcy the hospital had gone through under previous ownership.
“We do feel very driven that we needed to continue to serve our community, and if they needed to be put in the hospital, that there would be a local hospital to do that,” Shelby Brown, chief administrative officer for the hospital, said during a Becker’s Healthcare Podcast episode.
Originally, Pafford Health considered making Southwest Arkansas Regional a rural emergency hospital, but given its volume and role as the only facility to serve four counties in the area, the system moved to make it a critical access hospital. In February, Pafford Health requested from CMS that Southwest Arkansas Regional become a CAH. In August, the request was approved. The hospital is still waiting for its interim rate to be handed down from CMS to make it official.
“Rural healthcare in America is in a crisis mode, and for many of us, I’ll throw [ourselves] into it, time is a factor, and we’re running out of time,” said Ms. Brown. “It has to be addressed, and we are not sitting still. We are going after funding in different areas. Part of our strategic plan was to be a CAH, so we’ve taken that step. Our next step is to put in skilled nursing beds.”
Looking ahead, Ms. Brown said collaboration will be key.
“We are actually trying to work and collaborate with about six other small rural hospitals in southwest Arkansas,” she said. “We are early in our discussions, but how do we share services? Another hospital about 45 minutes from us wants to do the skilled nursing beds as well. You’re required to have occupational and speech therapy, but neither of us can afford to hire them full time. So, can we share that position, and they travel between hospitals?”
As the hospital awaits potential funding from the state, Ms. Brown said it has written several grants and will continue to look for other revenue sources. She also encouraged other rural facilities facing similar struggles to keep in mind both adaptability and accountability when making tough decisions.
“We want to be good at what we do, and we know that we can’t do everything,” she said. “Right sizing your operation is important. You always have to look at your staffing model to make sure that you’re efficient in what you do. You never want to compromise quality, but sometimes you have to think outside the box and make sure that you’re being efficient with the money that you have.”
