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Rural hospitals at risk for closure

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122922 rural hospitals

By Jan White and Chris Edwards
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To say that rural hospitals face a challenge to remain open is not an overstatement. As of 2021, 71 Texas counties had no hospital.

According to a recent report submitted by Kaufman Hall, a healthcare management and consulting firm, Texas hospitals are at serious risk for closure, nearly doubling in total from the last two years. Rural hospitals were at 26% risk of closing, which, the Houston Chronicle reported, “… is a jump of 16% from 2020 and 2021.” The study found that total expenses in 2022 for Texas hospitals are $33.2 billion higher than pre-pandemic levels, “outpacing increases in revenue.” And data from the Cecil G. Sheps Center for Health Service Research shows that Texas led the nation in rural hospital closures between 2005 and 2021.

Charles Owens, with the Georgia State Office of Rural Health, has performed extensive research on why rural hospitals in America struggle to stay afloat. A large number of closures are due to higher poverty levels, poor local health, and greater reliance on Medicare and Medicaid. Combined with the population’s high demand for service, these factors make it hard for rural hospitals to keep their doors open.

“It’s hard to manage a physician practice in an area where the patient population has high percentages of patients with lower paying government coverage. Those markets are challenging to maintain a financially viable medical practice,” said Owens.

Adding to the dilemma is the number of patients in these communities that have a higher rate of obesity, diabetes, and other chronic conditions that require hospitalization. And the Kaufman Hall study suggests that post-pandemic hospital patients suffer more severe health needs.

In Tyler County, conservative budgeting and funding from the county has assisted Tyler County Hospital in its operational expenditures. TCH CEO Sondra Williams said that the hospital operates on a shoestring budget, but that many small hospitals are at risk.

TCH used to have 102 full-time employees, but the pandemic created the need for contract workers, which the county helps to cover. Williams said the hospital’s operating costs amount to $35,356 per week, and $1.8 million annually.

The county’s commissioners court voted to allocate $1.2 million to the hospital from the federally disbursed American Rescue Plan Act funding, over a period of a year, in two separate disbursements. The funding was set forth to cover contract expenses for the hospital. Williams and TCH address the shortage of staff in the wake of the pandemic by advertising for positions in regional newspapers, social media and in medical trade journals.

While federal funding sources in place during the pandemic have started to expire, workforce shortage and inflation have also contributed to higher expenses for labor, supplies, and drugs compared with pre-pandemic levels. The Kaufman Hall report states, “In the first year of the pandemic, Texas hospitals experienced $1.6 billion in lost income. And while conditions improved in 2021, Texas hospitals have experienced lost income of $3.2 billion to date in 2022, which is approximately a 30% reduction in total income across the state of Texas.” The report also says, “While CARES Act support helped hospitals weather the first two years of the pandemic, the proportion of Texas hospitals with negative operating margins skyrocketed in 2022 to 47.4% or nearly half of all hospitals.”

The difference in growth rates between expenses and revenues has led to significantly depressed margins for Texas hospitals, with average revenues rising 11% but average costs increasing to 20% or greater.

And the labor shortage has had its own domino effect – insufficient staffing means hospitals are unable to discharge patients in a timely manner, increasing their length of stay and incurring additional costs without commensurate reimbursement. Nurses suffering from “compassion fatigue,” brought on by extensive emergency room support, hospice care, or extra shifts due to staffing deficiencies, admit that they have reached burnout and are leaving the medical profession to seek other jobs.

Dr. Kia Parsi, executive director of the Texas A&M Rural and Community Health Institute, says that the effect of those closures could have a crippling impact on local programs like emergency medical services (EMS), where the EMS may become the primary source of healthcare for the area, resulting, again, in overworked employees and the increased strain of transporting patients to distant hospitals. Parsi also noted that mortality and morbidity rates increase by 6% in rural communities where health care is eliminated.
And closures could also affect the community on a more personal level - hospital facilities are sometimes the largest employers in a rural county. The shutdown of local hospitals results in not only lost jobs but also the loss of community leaders, as physicians and hospital administrators often serve in those capacities.

Adequate healthcare in rural communities is crucial but not easy. Support and funding, geographic isolation, transportation, and staffing struggles can be challenging, but a county hospital must maintain its presence in rural areas.

“Rural communities in Texas are the backbone of so much of our economy,” said Parsi. “We’re talking about resources with agriculture, with oil and gas. A large population is living in our rural communities, and they need to be supported.”

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Arrest made in chainsaw theft

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By Chris Edwards
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MUGSHOT JordanWOODVILLE –An investigation of stolen chainsaws led to the arrest of a Chester man last week.

Officers with the Woodville Police Department arrested 33-year-old David Brenton Jordan on a Class B theft charge at Walmart, according to the Tyler County Sheriff Bryan Weatherford. During an interview with TCSO deputies, Jordan confessed to the theft of multiple stolen chainsaws, which TCSO was investigating.

Weatherford said the robbery occurred on the afternoon of Dec. 6, when deputies were dispatched to Jerry’s Saw Shop on the south end of Woodville.

“Deputies were able to gather witness statements, as well as information on the missing chainsaws,” Weatherford said.

During the investigation, the deputies were able to locate one of the missing chainsaws at a pawn shop in Lufkin. The pawn ticket was dated the same day as the theft had occurred.

Jordan was booked into the Tyler County Jail on Sunday, Dec. 11 and charged with felony theft of property, which was enhanced due to previous convictions. In addition to the felony theft of property charge and the Class B charge, Jordan was also charged with an active parole warrant for possession of a prohibited weapon. Pct. 1 Justice of the Peace Trisher Ford set Jordan’s bond at $15,000. Records indicate Jordan bonded out of jail the next day.


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Trees’ removal concerns groups, environmentalists

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SaveTrees Stock

By Chris Edwards
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TYLER / HARDIN COUNTY –The plan to remove nearly 200 acres of trees along U.S. 69 as part of a road construction project has many environmentally concerned groups and individuals upset.

The Texas Department of Transportation (TxDOT) recently revealed in projections for the “Gateway to the Big Thicket” project that it will remove the trees along the 13-mile stretch, which spans Tyler and Hardin counties. The project route runs along the highway from FM 1943, near Warren down to FM 1003, which is north of Kountze.

Ellen Buchanan, of the Big Thicket Natural Heritage Trust, spoke last week before the Tyler County Commissioners Court on the matter. According to Buchanan, the tree removal will drastically increase the threat of flooding to the region.

Buchanan, who is a trustee of the Big Thicket Trust, has been on the frontlines of protesting the deforestation. In speaking to county commissioners and County Judge Jacques Blanchette last Monday, she addressed concerns, ranging from the public image of the region to eventual erosion posed by the trees’ removal.

Before Buchanan spoke to the Tyler County Commissioners Court, she had brought a resolution before the Hardin County Commissioners, which was tabled, in order to allow a TxDOT district engineer to be present, per the request of County Judge Wayne McDaniel. The Tyler County commissioners signed on to acknowledge that the resolution was brought before the court.

The construction plans, which included the tree removal, were presented in a pre-recorded video last month on TxDOT’s website, available at https://www.txdot.gov/projects/projects-studies/beaumont/us69-corridor-gateway-big-thicket.html. The measure also drew concern from the National Parks Conservation Association and the Sierra Club.

The project, according to TxDOT, is designed to enhance the safety and security of the heavily travelled route, and widen the two-lane stretch to four lanes, which will include shoulders, a northbound evacuation route and a median.

According to TxDOT, the removal of the trees is “in keeping with the revised TxDOT Design Manual to clear obstacles in the right of way, such as landscaping, TxDOT will clear the median and portions of the right of way removing trees and shrubbery. TxDOT recommends a roadside free of unyielding obstacles including landscaping for increased safety and reduce the extent of damage and injury of single vehicle, run-off-the-road crashes.”

According to Sarah Dupre, with TxDOT’s Beaumont District, the agency’s projects are never 100% final until they go out for bids, however, TxDOT does not anticipate any changes for this project, she said. TxDOT’s timetable for the project has the bidding process beginning in September of next year, but due to new safety guidelines, the plans to clear the trees from the medians and the acquired ROW could start sooner.

“If anyone has legitimate safety concerns, design concerns or anything, we are more than willing to listen to those,” Dupre said.

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Mycologist wins photo contest

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Big Woods Trail Photo

WOODVILLE – Alan Rockefeller, a mycologist (fungi biologist), who lives in Oakland, California, submitted the winning Big Woods Nature Trail Photo-of-the-Month for the month of November. 

The Tyler County Art League judge found the photo interesting and unique and commented on the amazing light. Rockefeller has traveled to various countries to collect and study mushrooms.  He has identified several species not described in the scientific literature. 

The strobilurus onigenoides mushroom pictured in the photo grows on magnolia seed pods.   

 All guests walking the Big Woods Nature Trail at Heritage Village are encouraged to read the contest procedures posted on the kiosk and submit photos. 

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Kim Cruse 003

Woodville’s own first lady of song, Kim Cruse, ended her run on NBC’s 22nd season of The Voice last week, having gotten to the semi-finals. She returned home on Wednesday evening, to a parade of well-wishers along  Eagle Drive, in front of her alma mater, Woodville High School. Cruse said she was thankful for the experience and for the professional relationships she made through the show. “Thank you for the overwhelming amount of support during my run on the show! Stay tuned for what’s next,” she said.PHOTO COURTESY OF KIM CRUSE

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