ASHEBORO, N.C. -- When visiting Randolph Health, the sights of people being wheeled inside and echos of sirens blocks away display the rural community’s need for care close by. But, while seconds matter in terms of what hospital staff do on-site, time for the hospital itself is running out.
"We really need a solution very, very soon,” said Angela Orth, Randolph Health CEO.
The hospital has been looking for a partner dating back to 2015. In 2016, it partnered with Cone Health in a management agreement, rather than full integration.
However, a “multi-faceted, complex sort of challenges” leads Orth to say if the hospital doesn’t find a partner within the next few months, they’re “really going to be faced with some difficult choices."
Of the challenges facing Randolph Health, and other rural hospitals, Orth cites current reimbursement structures. She says many rural communities have a high percentage of patients that are on Medicare and Medicaid, and with a good portion of them lacking insurance, the hospital is experiencing declining reimbursements.
"The fact that we haven't expanded Medicaid is a concern,” she added.
Studies have shown that expanding Medicaid could be critical to saving rural hospitals. However, although Orth says expansion would increase revenue for Randolph Health by about a million dollars annually, she doesn’t believe it would be a fix for the hospital.
"The issues are much more significant and we need a real solution for rural health,” she said.
Orth adds that recruiting physicians and qualified clinical staff to a small town can be challenging because call requirements are significant.
The hospital currently has about 1,150 employees, with 800 of them living in Randolph County.
Orth says rural hospitals need to develop ways to manage patients in the “right time, right place,” especially those who have chronic diseases, while doing so in the least expensive venue possible.
"We are a community partner, we're an important asset to the community,” she said.
In recent months, Orth has been with Gov. Roy Cooper, as well as members of the General Assembly in both the Senate and the House. She adds they’ve been open to developing sustainable solutions.
"Although I'm not able to go into the specifics around what we're talking with them about as it relates to our institution, I'm excited about the fact we have some creative dialogue going on,” she said.
In terms of daily operations, Orth says the hospital is stable. She adds, from a financial perspective, they’re posting a positive EBITDA (earnings before interest, taxes, depreciation and amortization).
"But we have a limited ability to purchase big pieces of equipment and reinvest in the plant,” she said.
The plant is fairly old, she says, dating back to the 1930s. The newer part of the building dates to 2008 while the bed towers were built in the 1990s.
“We want to be able to provide the community with new, fresh facilities and we need to be able to have capital to do that,” Orth said.
While a private 501(c)(3), Orth says the hospital generates “quite a bit of revenue.” She continued to say their salary base is about $55 million a year.
"It would be impactful, negatively impactful for our community if we were not here,” she said.
Hospital leadership has three main goals, Orth says. First and foremost, to protect local health care. Secondly, to improve their financial situation and lastly, to find a partner.
Although third on the list, Orth adds they “really need to get that partner within the next few months."
Overall, she believes it will take several years of planning to find a final solution for what health care should look like in a rural community.