Giving Compass' Take:

• Rural hospitals are preparing to make significant changes to house coronavirus patients that will create substantial funding challenges.

• Rural hospital representatives say that federal relief packages haven't been that helpful, and would instead participate in loan forgiveness programs. How can governments pivot aid? Where can funders step in to provide targeted support? 

•  Read more about rural healthcare in the time of COVID-19. 

Rural hospitals have been planning for the arrival of the coronavirus, but the preparations for a virus that may not come are putting some already struggling rural hospitals in danger.

Mike Gruenberg, director of disaster preparedness at Salem Memorial Hospital, a 25-bed critical access care facility, said getting ready for coronavirus patents meant making major changes.

“We don’t usually admit patients on ventilators, so usually those kind of patients we would send to the urban facilities,” he said. “We have had to change our way of dealing with that. We have some extra ventilators in-house. We are able to keep these patients.”

The hospital, located in a town of about 5,000 about 125 miles southwest of St. Louis, set up special rooms to treat COVID-19 patients, bought more protective equipment like gowns and masks, and canceled all elective and non-emergency procedures to avoid cross-contamination of coronavirus to other patients.

Salem Memorial and Missouri Baptist Sullivan’s stories are similar to many of the 39 Critical Access Care hospitals in Missouri and hundreds of others in the Midwest and Great Plains. Those are federally designated and partially supported hospitals in rural areas that are deemed necessary to serve people that would otherwise have to go too far for basic services. They can have a maximum of 25 beds, must be at least 35 miles from the nearest hospital, and staff an emergency room at all times.

While they are ready to treat coronavirus, the mandate to cancel all elective and non-emergency procedures is hitting these small hospitals hard. Those patients and procedures make up most of their revenue.

Tony Schwarm, president at Missouri Baptist Sullivan, said the federal relief packages have not done much for him or his peer hospitals.

Read the full article about rural hospitals by Jonathan Ahl at Harvest Public Media.