Small rural hospitals in Illinois struggling to stay viable in 2023

[January 14, 2023]  By Zeta Cross | The Center Square contributor

(The Center Square) – Nearly a million and a half Illinoisans depend on small rural hospitals for care, but most under-25-bed hospitals are fighting to keep their doors open.

Randall Dauby is CEO of Pinckneyville Community Hospital, a critical care hospital with 21 inpatient beds in southern Illinois.

“Small rural hospitals are struggling to the point where many of them will have to close,” Dauby told The Center Square. “Based on how the federal government pays, they cannot make it financially.”

Reimbursements that small rural hospitals receive from federal and state governments are inadequate and subject to across-the-board cuts every year, Dauby said.

“Medicaid in Illinois pays terribly,” Dauby said. “It’s one of the lowest paying programs in all the states across the country.”

Meanwhile, the cost of remaining viable has doubled in the past two years, he said. When the federal government “sequestered” the budget two years ago, rural hospitals lost 2% of reimbursement revenue across the board. This January, unless Congress acts, a new federal program called Pay As You Go is set to cut another 2-4% percent, Dauby said.

“We are getting less and less reimbursement while our costs have been driven up over 100% in just the last couple of years.”

Finding enough nurses is another top-of-the-list concern for Dauby. One vacant nursing position in a small hospital makes a huge difference, he said. In 2023, the United States will face a shortage of 100,000 trained nurses, Dauby said, citing a recent article in the American Nurses Association magazine.

“Where are they going to come from,” he said.

Pinckneyville Community has a Grow Our Own program to encourage high school students to train as certified nursing assistants, Dauby said. The idea is to introduce young people to nursing careers.

In one year, a student with a high school diploma can earn the licensed practical nurse degree, he said. With two years of training, students can become licensed registered nurses.

“Where else can you go with a two-year degree and come out making $65,000 to $70,000,” Dauby said.

Community colleges can’t turn out enough new nurses because they don’t offer enough programs, he said. Community colleges can’t find enough nurses with master's degrees to teach the classes. Nurses with master's degrees don't want to teach because they make more money working in hospitals or in other jobs, Dauby said.

“We need nurses. Can’t we find a way to get new nurses trained and on the job quicker,” he said.

Illinois lawmakers recently approved a one-time payment of $460 million for hospitals across the state to help with nursing shortages and other issues.