'Worst may be yet to come' for rural hospitals, Dartmouth CEO says

Though the pandemic's most imminent threats have waned, heightened patient volumes, workforce shortages, inflation and supply chain disruptions are still urgent issues for hospitals — and these challenges are even more significant for rural facilities, according to Joanne Conroy, MD, president and CEO of Lebanon, N.H.-based Dartmouth Health.

"Based on what we are now seeing, especially in rural hospitals and health systems, the worst may be yet to come," Ms. Conroy, who is also chair-elect of the American Hospital Association's Board of Trustees, said in a Feb. 16 news release.

Between 2010 and 2021, 136 rural hospitals have closed nationwide, including 19 in 2020 alone. Staffing shortages also weigh heavily on rural hospitals. Dartmouth Hitchcock Medical Center denies 350 to 400 requests for critical transfers every month and, on average, has 75 patients who are ready to be discharged but have no post-acute care setting willing to accept them, according to Ms. Conroy.

She said the industry is making small steps in the right direction to address these issues, but more work needs to be done. 

"When our communities experience natural disasters, we lament the shortcomings of our infrastructure, propose ways to make it more durable and resilient, and then, ultimately, do little or nothing," she said. "However, this storm-battering healthcare is different: We simply do not have the luxury of crossing our fingers and hoping for the best next time. Our inactivity has real-time implications for patients who are your parents, children and neighbors."

Ms. Conroy proposed numerous solutions to keep rural healthcare systems solvent and functional, including modernizing physician training, lifting the cap on Medicare-funded physician residencies, expediting visas for international healthcare workers and increasing support for nursing schools and faculty. 

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