More than 20% of the nation’s rural hospitals, or 430 hospitals across 43 states, are near collapse. Rural hospitals are crucial for health care and also survival of their small communities. Infact 20% of America lives in a rural county. But, 113 rural hospitals across the country have closed since 2010, with 18% in Texas.

41% of rural hospitals nationally operate at a negative margin. Poor often struggle to have access to care.

Each time a rural hospital shuts, there are tragic consequences for the local community and surrounding counties. There is loss of sales tax revenue, reduction in supporting businesses like clinics and pharmacies along with the medical consequences. Also, there are fewer professionals, doctors, nurses and pharmacists. When a rural hospital closes its doors, unemployment often rises and average income drops.

There are no nurses, doctors, pharmacists or ER for people who love living and working in America’s rural regions. Rural citizens are left with no options for routine primary care, maternity care or emergency care. At times even basic medical supplies are hard to find.

There are few experts within small towns who are prepared to address ways to avoid the loss of rural health care service and rural hospitals.

Small, rural communities quite often don’t conduct formal comprehensive health needs assessments or invest in strategic planning to strengthen the ability of the community to adapt more quickly to changes in the local economy and changes in financial health care at the federal level. Health care services planning is limited to input from rural community leaders and “power brokers” instead of cross-section of the greater community.

Each rural region is unique, so rural solutions will be unique. In some communities, urgent care with radiology and lab services may be able to serve the majority of healthcare needs. In others, a “micro-hospital” with an ER and a swing bed option that allows rural hospitals to continue treating patients who need long-term care or rehabilitation may be a better fit.

Telehealth software, or providing care through televideo virtual face-to-face from remote sites to rural residents, can also be an option.