Cash-strapped rural hospitals struggle to stay open, brace for coronavirus

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CHEROKEE COUNTY, Iowa – Shortages in personal protective equipment and limited COVID-19 testing kits are just some of the difficulties for health-care facilities across the country during the coronavirus pandemic.

But there’s another issue looming for hospitals in rural America: a labor shortage.

“Respiratory therapists are very difficult to find,” said Gary Jordan, CEO of Cherokee Regional Medical Center in Iowa. “Medical laboratory technologists. They’re very difficult to find for rural communities.”

Cherokee Regional Medical Center is one of roughly 2,000 rural hospitals in the country, according to data from the National Rural Health Association (NRHA).

Rural hospitals represent more than half of all hospitals in the United States, providing essential access to inpatient, outpatient and emergency medical services in rural communities.

What makes rural hospitals different than urban facilities is typically the number of beds,  services offered, and proximity within a community.

On average, rural hospitals have 25 beds, which is less than one-third the beds compared to the urban average of 76 beds. In addition, some rural hospitals do not have intensive care units, and some are 35 miles away from the next nearest hospital. 


"For rural communities, the population is older, sicker, has a greater percentage of chronic health care needs. I just described the population most at risk for COVID-19,” said Alan Morgan, CEO of the NRHA.

According to the NRHA, rural providers are overwhelmed with COVID-19 patients and their limited resources are being strained to the breaking point.

Blaine County, Idaho, has more than 300 positive COVID-19 patients but is only a small rural hospital with 25 beds for the community. Eagle County, Colo., has more than 300 positive cases, but its county hospital has only 56 beds.

Making things worse is some rural hospitals can’t afford to keep their doors open.


Data from the NRHA revealed that 47 percent of the nation’s rural hospitals were operating at a loss prior to COVID-19.

Rural hospitals are being forced to stop outpatient services and elective procedures to keep up with the possible demand from the coronavirus.

“It’s really an unusual circumstance where they’re desperate for cash now but they need to keep their hospitals open to prepare for a surge to come," Morgan told Fox News. "It’s the worst possible situation for many of these rural hospitals.”

Congress recently approved a $2.2 trillion stimulus package that would allocate $100 billion to health care.


The NRHA sent a letter to Congress asking that a portion be set aside for rural hospitals over fears that funds will be depleted before reaching rural communities.

“Rural providers care for 20 percent of the nation’s population. Because they are proportionately older and have higher percentages of comorbidities, rural Americans are extraordinarily vulnerable to COVID-19,” the letter reads. “Without at least 20 percent set aside rural, we believe small, rural, and isolated providers may not be able to access the funds before they are depleted by other facilities.”