Haywood County is getting more good news.

In addition to Ford Motor Co. and SK Innovation moving into the Megasite of West Tennessee, the local hospital is reopening after being shuttered for seven years.

Operated by Braden Health, a North Carolina-based for-profit company, the Haywood County Community Hospital will have 49 beds, an emergency room, a pharmacy, a radiology department and roughly 150 employees. The company expects the hospital to have an economic ripple effect of nearly 700 jobs in the area and ease pressure on the local emergency medical services.

Leaders will celebrate at a grand opening Jan. 2 – delayed from the originally planned October opening date. Between now and then, Braden Health is executing a “soft opening,” ramping up operations a handful of beds at a time.

Ford to invest $5.6B in Memphis Regional Megasite

“It is going to be amazing,” Haywood County Mayor David Livingston said. Livingston referred to Braden Health as “a top-notch company.”

It’s an exception to the troubling trend of hospitals closing in rural areas, which has strained emergency services and led to health care deserts, especially in the 12 states that have not expanded Medicaid. Tennessee has had more hospital closures per capita than any other state.

Officials expect the population and economy around the Megasite to explode in the coming years, with temporary construction jobs and permanent electric vehicle manufacturing jobs, plus restaurants, services and – if Livingston gets his wish – a movie theater.

That growth likely will provide the hospital with more middle-class patients with private health insurance. That could mean more stable revenues than it would have earned without Ford and its workforce, which is reportedly likely to be unionized at the Megasite.

The hospital in Brownsville, about 20 miles from the Megasite, might have to add staff, beds and space if the area’s growth is anything like what Spring Hill has seen since General Motors built a plant there in the 1980s.

But that won’t be a big problem, according to Kyle Kopec, Braden Health’s chief compliance officer and director of government affairs. There’s more than enough space.

“It has the ability to expand very easily,” Kopec told The Daily Memphian.

30 minutes could mean ‘a death sentence’

The people of Haywood County badly need it.

With the nearest hospitals in Jackson and Memphis, some residents have gone without care at critical moments.

In a letter urging officials to approve the hospital, Brownsville resident Donna O’Brien said her husband has had multiple close calls during medical emergencies.

TennCare enrollment went up 15 months in a row

“Since the closing of Haywood County’s hospital a number of years ago, my husband has been taken by ambulance to the Jackson Memorial Hospital no less than 4 times due to various medical emergencies,” O’Brien wrote.

“My husband and I both feel that there is an urgent need for a County wide hospital/emergency room facility. Anyone in a life-threatening scenario, whether due to age, illness, medical condition, farming or other accidents, a 30+ minute trip to the nearest emergency room/hospital could be a death sentence.”

Residents calling 911 face long wait times, as ambulances return from the nearest hospital. Livingston said the average round trip for his EMS teams is two and a half hours, sometimes longer.

Livingston said there would be an emergency room at the Megasite, offering a closer option.

The two new locations will mean “more time devoted to responding to emergency calls immediately,” he said.

“The EMS people are doing things that shouldn’t be done in a moving vehicle,” said Michele Johnson, executive director of the Tennessee Justice Center. “They should be in a hospital.”

In another letter of support, county resident Heather Pennel said the news was a relief.

“When I saw that there was a possibility of the hospital reopening in Haywood County, it was like a weight lifted from my heart,” Pennel wrote. “It is scary to live in a community where the closest hospital is over thirty minutes away.”

‘You really don’t have a problem turning a profit’

Some say closures can be avoided with more prudent business models, while others say they’re largely inevitable without big fixes to Medicaid and Medicare.

The 2014 Brownsville closure was sudden, according to former state Rep. Craig Fitzhugh, whose district included Brownsville. Fitzhugh said the hospital “got the rug pulled out from under them and they closed immediately.”

Feds approve state’s Medicaid block grant waiver

Kopec said many rural hospitals close because they’re trying to copy the model of urban hospitals, with specialists and massive inventories. He said rural hospitals should provide roughly 80% of patients’ needs, sending them to big-city specialists for the other 20%.

“For us, we don’t really have any difficulty in getting the facilities to operate in a practical way,” he said. “People kind of laugh at it because it seems so common-sense, but you run your hospital like a rural hospital.”

Braden Health owns four rural hospitals in Tennessee. Kopec said the company has its eyes on all of the ones that have closed or are at risk.

“(When you) focus on the bread and butter of rural medicine,” he said, “you really don’t have a problem turning a profit.”

But Johnson said that view is too rosy, attributing too much of the blame on management.

The 2010 Affordable Care Act allowed states to expand Medicaid, but it also clawed back some of the money that went to care for people without health coverage. Rural hospitals are at much greater risk in states that haven’t expanded Medicaid; non-expansion states are among the least insured in the country.

“We’ve seen it play out like a slow-moving train wreck,” she said. “This isn’t poor management. It’s just a (situation) where the math doesn’t work out.”

Expansion is far from the only factor in closures; another factor, many agree, is that Medicare and Medicaid pay hospitals far too little compared to private insurance.

“It kind of simplifies the problem of rural health,” Kopec said of the debate over expansion. “But I also don’t want to say it’s the wrong solution.”

Without expansion, in five or 10 years, Johnson said, “I think there will be almost no rural hospitals in Tennessee.”

While Livingston is excited about Braden Health, Fitzhugh has reservations about for-profit hospital operators’ motives.

“We’re stuck with for-profit hospitals,” Fitzhugh said. “To be honest and frank with you, yes, I have very strong concerns with that.”

Fitzhugh, who is now the mayor of Ripley in Lauderdale County, recently helped revive the hospital in his hometown. It now has more than 150 employees after a low point of around 30, after a predatory bad actor “infiltrated” management.

He said he hopes Brownsville can have a similar outcome, if Braden Health keeps its word that it’s here for the long haul.

“We had ultimately just a wonderful story in Ripley,” he said. “I think there was a bit of divine intervention as well. I think somebody was looking after us in West Tennessee.”