Counties in Crisis: Just plans and promises – not even a Band-Aid – 6 months after closing of hospital in Fentress County

Counties in Crisis

JAMESTOWN, Tenn. (WATE) – For six months, Jamestown Regional Medical Center has been closed to the people living in and around Fentress County. It’s left them relying on 911 and emergency transportation services to find critical care.  

Michael Alexander became the chief executive officer for Jamestown Regional Medical Center, owned by Rennova Health, less than a week before it closed.

In fact, his third day on the job was the first day the hospital began operating without any reimbursement coming from the Centers for Medicare and Medicaid Services, a federal agency that administers the nation’s major health care programs including Medicare and Medicaid.  

Alexander estimated that around 80% of the hospital’s patients have health benefits through those two programs. The cut from Centers for Medicare and Medicaid Services followed a report the agency did showing the hospital failed to pay more than 100 vendors. Without federal reimbursement, the hospital closed its doors.

Effort to reopen hospital making progress

Alexander said the mission to reopen the hospital is making progress. He explained the next steps include securing financing to get caught up on existing debts and make investments, such as personnel, which he said is required to pass state and federal inspections to fully reopen.

He said he still feels the pressure to get the doors open and that he often thinks about the lives that may have been lost by the closure.

“Every day we’re closed it’s worse. I know that there are people in this community that are suffering because we’re not here,” he said. “It’s sad to see, especially when I’m driving in the mornings and I meet an ambulance heading in the other direction. Every time I stop and I pray for the person in the ambulance and ask that we be able to open here so the ambulance doesn’t have to go in that direction.”  

Alexander explained, in the rural hospital business, you depend on commercial insurance patients to offset losses in those other categories, like uninsured or Medicaid (TennCare) and Medicare recipients.

“In a rural area … there are not a lot of factories and plants that used to be in these areas,” he said.  

While he said he believes expanding Medicaid would have made a difference for the hospital, prior to the closing, he couldn’t say whether it would have been enough to keep them open and out of debt. “It would have slowed the bleeding, for sure,” he added.

Some skeptical about Rennova’s plans

While many in Fentress County are skeptical about the hospital reopening, Alexander offered up that he drives more than an hour and a half to work from his home in Knox County and he wouldn’t make the commute every day, if he didn’t believe in a light at the end of this already six-month-long tunnel.

As far as timeline, he didn’t provide any hard estimates, but optimistically, he said he’d like to see it open early 2020. As soon as January, he said, they could be hiring staff, made up of former and new employees.  

While some express frustration Rennova Health isn’t willing to sell the property, Alexander said Jamestown Regional is “vital” to the company’s business plan. “They want to be back providing healthcare,” he said.  

The second part of his plan for reopening, – after the state inspects and reinstates their license – is opening the hospital with a limited bed capacity at first. Without those inspections from CMS, there will still not be any reimbursement for services provided to Medicaid or Medicare patients. Put simply, they’ll be providing a lot of free coverage until the federal government signs off on the operations at the hospital.  

He feels the closure is purely mistakes made in the billing process and said he’s been working on building the right finance team to correct them.  

Remembering the good days

When Jamestown closed in June, a 30-year career for Karen Cooper also ended. “We took care of strokes. we took care of massive fractures with wrecks and things. we took care of heart attacks … there were lives saved over there. lots of them,” she said.

An LPN, Cooper has since landed another job in the healthcare industry, in hospice care. While the end-result of her work now is much different than working in the emergency room, she still carries the same compassion and hardworking attitude to the new job.  

She remembers the good days at the hospital. “It was some of the best people, most skilled people, nurses and doctors and paramedics that I’ve ever worked with. I would trust my life, my grandchildren’s life, to anyone individual that I worked with,” Cooper said. 

She believes the loss of emergency room access to the county will lead to a loss of life for some who call Fentress County home.  

While she’d love to see the hospital reopened, and even love to work there again, she said after the closure and months leading up to it, she would only do so as a volunteer.

“I’ve been through a lot of tragedies in my life,” Cooper said. “You don’t get this old without having a tragedy or two, but I’ve never felt that complete, empty, hollow, feeling that I felt that night the ER closed, and we all walked out together.” 

Cooper also said for some of her friends, also former hospital staff, to return there would have to be some proof that insurance and other benefits were being paid.  

Fentress County executive working on ‘Plan B’

Jimmy Johnson, Fentress County’s Executive, said he’d be thrilled if the hospital reopened. While he’s doubtful it will under Rennova, Johnson said he’d help in any way he can.  

Johnson said private parties have extended offers for the hospital. He even said the county threw out some offers if something were to happen to their ownership of the building. Johnson said he still hasn’t received a response to the proposal.  

He’s compiled statistics from the state on the usage of the hospital and the need for one today.

His plan is to compile those facts, find a building or even build one, and find a partner that would help reopen the hospital, or at least an emergency care center.  

While Rennova Health currently holds the state-required certificate of need and an inactive license, Johnson thinks because the hospital sits vacant and has for so long, the county won’t have any trouble opening with the right financial partner.  

He explained he’s had to come up with a “Plan B”: because the “people of Fentress County deserve that.”

Impact of hospital’s closing rippled through the economy

He’s concerned for the loggers, horse riders, and ATV enthusiasts that could get hurt. But as the man in charge of county government, he’s also concerned about the other impacts of the closing.

“Not only did we lose healthcare service, not only did we lose jobs, it runs into your real estate, it runs into your purchases, your restaurants here in town, your stores here in town,” he said.  

Dr. Richard Clark treats patients directly across the street from Jamestown Regional, at an acute care clinic.  

He’s seeing a direct impact from the closed hospital. One story involved a patient arriving at the clinic who was not breathing. Two staff members were also paramedics and went outside to perform CPR and resuscitated the patient, he said.

The direct impact on healthcare

The patient was flown to Cookeville and died about 10 days later, Clark said. While he couldn’t say, definitively, an open hospital would have saved the life, he maintains it could have.

Clark also said his clinic has had to call emergency medical services multiple times to transport walk-in patients. “Initially they don’t know do I need to go to an emergency department. Well, they’ve got to drive a long distance to find out did they need to be there, so, they come here,” he said.  

The Tennessee Hospital Association shows Tennessee sits second nationwide in hospital closures since 2012. 

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