Closing of Burt County’s only hospital part of national trend

Rural Health

After more than 70 years, the community of Oakland, Nebraska, has no hospital.

Citing low in-patient and emergency room volume, hospital officials announced the closure of MercyOne Oakland in June—leaving all of Burt County without a facility. MercyOne will keep operating the associated medical clinic.

Burt County is home to the Center for Rural Affairs (Lyons is up the road from Oakland), and this closure means folks in our community will now have to drive 25 minutes each way to the nearest hospital—and some Burt County residents will have to drive farther.

Oakland’s first substantial hospital, Memorial, was built in the late 1940s through a combination of grant funding and community dollars and was owned by the Oakland community, while managed by the Lutheran Hospitals and Homes Society. In 1985, the Oakland Medical Clinic was added. In 1993, the Oakland Medical Hospital assumed ownership of the clinic and disaffiliated with Lutheran Hospitals, running the Oakland facility and Lyons clinic as an independent entity governed by a board of directors from the Oakland area.

Iowa-based MercyOne, a hospital system managed as a joint venture by CHI Health of Omaha and Trinity Health of Michigan, assumed ownership in 2006.

This closure is part of a massive national trend felt in rural places across the country, including in Nebraska. Since 2010, more than 120 rural hospitals have closed nationwide, and more than 700 hospitals sit on the brink of closure. Today, rural areas make up more than 60% of the nation’s Health Professional Shortage Areas. According to the Nebraska Rural Health Association, 71 Nebraska hospitals have a 2% or less operating margin, while 29 experienced negative operating margins in 2018. That means many of our state’s rural hospitals are in financial straits that may not put them far behind Oakland in closing.

This is a problem for rural areas where workforce injuries and trauma from operating industrial machinery may require emergency room treatment, where chronic diseases, such as heart disease, diabetes, and hypertension tend to be more prevalent, and where mental health needs and addiction treatment are under-addressed.

There are no easy answers for the growing lack of access to medical care in rural areas. Staff shortages were among the reasons cited for the Oakland hospital’s closure. Nebraska faces a stark staff shortage across medical professions, especially among primary care doctors, OBGYNs, and nurses. Finding policies to incentivize medical professionals to work in rural areas, strengthening the rural medical education pipeline, and simplifying the regulations and licensure around certain types of nurses could help close the gap in the number of health care providers in rural areas.

But, for this to work, rural hospitals, which rely on more Medicaid dollars, will have to be adequately reimbursed for services. This year’s budget bill saw a 2% increase in Medicaid reimbursement rates, which is a step in the right direction. 

In the coming years, the state will need to think creatively about this tough problem to ensure rural communities have access to the care they require.