WILLIAMSTON, N.C. (AP) — Weeds have pierced the empty parking lot of Martin General Hospital’s emergency room. A makeshift blue tarp covering the hospital’s sign has worn away from flapping in the wind. The hospital doors are locked, leaving many in this county of 22,000 people permanently afraid.
Some residents fear the hospital’s sudden closure last August could cost them their lives.
“I know we all have to die, but since the hospital closed, a lot more people seem to be dying,” Linda Gibson, a lifelong resident of Williamston, North Carolina, said on a recent afternoon as she delivered snacks to children at a hospital prepared near the elementary school kitchen.
In rural communities like Williamston, where people openly wonder whether they would survive the 25-minute ambulance ride to the nearest hospital if they were in a grave car accident, more than 100 hospitals have downsized or downsized in the last decade completely closed.
When Quorum Health closed the 43-bed hospital in Martin County, citing “financial challenges due to declining population and utilization trends,” residents here didn’t just lose a sense of security. They also lost faith in the leaders they elected to make their city a better place to live.
People like 73-year-old Bobby Woolard say they don’t believe any politician – from local county commissioners to the presidential candidates who will parade through this swing state in the coming months with substantial campaign promises – is committed enough to solving the problem interested in helping them.
“If you’re seriously ill, there’s no help here,” Woolard said on a radiant April afternoon as he trimmed his neighbor’s hedges. “Nobody seems to care. There’s a building sitting empty and no one seems to care about it.”
PROBLEMS FOR BIDEN’S HEALTH CAMPAIGN?
The mood in this highly polarized and segregated eastern North Carolina county could portend trouble for President Joe Biden, who has made health care a key part of his re-election campaign against Republican rival Donald Trump.
His TV campaigns have seized on Trump’s promise to repeal the Affordable Care Act. On social media, Biden regularly reminds his supporters of the law he signed that caps the cost of insulin. And in North Carolina, the campaign is narrowly focused on promoting Democrats’ successful effort to expand Medicaid, extending near-free public health insurance to thousands of people and reducing the needy population for hospitals.
Biden and Trump are engaged in a bitter competition for the state, which is also home to the most prominent gubernatorial election of the year. Martin County, where Williamston is located, voted for Trump in 2020.
“Health care is on the ballot this year, and voters will remember that when they reject Donald Trump in November,” said Dory MacMillan, communications director for the Biden campaign in North Carolina.
But Biden’s successes may not be enough for key voters in cities like this one in North Carolina, where people there find it challenging to get even emergency care when they need it.
Emergency room wait times have risen sharply nationwide, with the average emergency room visit lasting nearly three hours last year, according to the Centers for Medicare and Medicaid Services. Health systems are also grappling with a health care workforce shortage that worsened after burned-out employees weathered the pandemic.
These problems are particularly pronounced in rural communities, where more than 68 hospitals have closed in the past decade. Closures slowed during the COVID-19 pandemic, when the federal government provided billions of dollars in additional funding for hospitals. But with that money spent, hospital closures could escalate again, said George Pink, deputy director of the Rural Health Research Program at the University of North Carolina’s Sheps Center.
Often residents miss emergency room care the most, Pink said.
“If you have a heart attack, if you have a stroke, if you give birth, these are all life events where you need quick and proper access to emergency care,” Pink said. “The communities that lost their rural hospitals don’t have them.”
A “ENDANGERED” SYSTEM
Months before Williamston’s hospital closed, an outside consultant sent a dire warning about emergency care in the county.
The county’s volunteer first responder system is ineffective and long response times, exceeding 15 minutes in some areas, are “endangering lives,” the consultant told county commissioners last April.
The system “urgently needs vision, leadership, guidance, direction and control, as well as additional financial support,” the consultant told the district, according to meeting minutes.
Since the closure of Martin General Hospital, the situation has only gotten worse.
Longer trips to hospitals outside the county mean ambulances and their crews are sometimes on the run for hours, said Capt. Kenny Warren of Williamston Fire and Rescue.
“A call that used to take 20 to 30 minutes now takes one to two hours, depending on where we need to transport,” Warren said. He added that while the agency is staffed with paramedics, it is not staffed with paramedics trained to provide more comprehensive care to patients in emergencies.
However, Warren said he doesn’t believe anyone died as a result.
“Most of the results probably would have been the same anyway,” he said.
In December, first responders arrived on a Williamston street within three minutes of receiving 911 calls to report that multiple shots had been fired and a newborn man was possibly dead.
They tried unsuccessfully to get a rescue helicopter to transport the 21-year-old gunshot victim. The closest option was a six-bed hospital, a 21-minute ambulance ride away. All in all, it would take 34 minutes from the time of the emergency call to get there, according to police dispatch logs. He was transferred from that hospital to a higher trauma center, where he died a few days later.
The scene of the shooting was just four minutes from the Martin General Hospital grounds.
‘DO YOU REALLY CARE?’
More than a dozen Williamston residents interviewed for this story blamed the Martin County Board of Commissioners for failing to prevent the closure of the struggling hospital.
Last month, Williamston resident Verna Perry told commissioners that her sister made a 25-minute drive to the nearest hospital only to find she wouldn’t receive the treatment she needed there.
“Are you really interested, Commissioners?” Perry asked. “If you cared, you would do something to get us a hospital here.”
Kaitlyn Paxton sought treatment for her asthma in the emergency room at Martin General Hospital on the day it closed. She watched as staff removed patients from the hospital on stretchers to be transported to other hospitals.
Since then, she has struggled to find primary care physicians and specialists to replace those who left when the hospital closed.
“As far as day-to-day doctors and appointments go, in my personal experience, finding someone was a nightmare,” she said.
She used the federally qualified Agape Health Center, which is one of the few facilities in the county that still offers primary care. There are over a thousand such health centers in the United States. They receive government funding and treat patients on a sliding pay scale, regardless of their insurance status or ability to pay.
Agape Health extended hours Saturday due to an influx of recent patients following the closure of Martin General, said the clinic’s CEO, Dr. Michael McDuffie. Last month, Agape partnered with the hospital to reopen one of the orthopedic clinics that had been closed.
McDuffie would like to reopen Martin General next, even if only as a stand-alone emergency department.
“It could mean life or death,” McDuffie said. “They need an emergency room here that can at least stabilize them.”
The county, which still owns the hospital and property, is consulting with state officials and federal health and human services officials to determine whether the facility can reopen as a rural emergency hospital, interim county manager Ben Eisner said. Gov. Roy Cooper helped introduce a recent state law allowing North Carolina’s rural hospitals to make the transition.
The Rural Emergency Hospital program was developed by Congress, signed into law by Trump and refined by the Biden administration. The award allows rural hospitals to unlock millions of federal dollars and escalate Medicare payments if they remain open for 24-hour emergency care.
“The simple question we are trying to answer is how can we move from closed to open in a way that makes sense for the citizens of Martin County,” Eisner said.
If successful, Martin County would be the first hospital in the country to reopen its doors after closing with the recent federal designation.
“It’s a top priority for us, we live it every day as a community,” Paxton said of the hospital’s reopening. It will be at the forefront of her mind as she votes in the presidential election this fall.
Still, she said, “I don’t think it’s even a top priority for any of them – for the president, for the senators – for any of them.”
