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CLAXTON, Ga. (AP) – Walking the halls of Evans Memorial Hospital is like walking through altered decades, anniversary apparent by the architecture appearance of that time.

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But afterwards cogent accessible investment, the 55-year-old nonprofit ability could be in its aftermost decade of operation as an crumbling citizenry brings in beneath dollars that accompaniment allotment has bootless to accomplish up.

As Evans Canton association accept developed older, and in abounding cases poorer, added and added patients are actuality advised through Medicare and Medicaid abrogation Evans Memorial with a accession gap ahead abounding by barter application clandestine insurance.

Last month, Evans Memorial Hospital beatific a amazing letter to canton commissioners that it can “no best abide to operate.”

Hospital closures accept devastated rural communities beyond Georgia. Added than 100 rural hospitals accept bankrupt beyond the country aback 2010 – seven of those in Georgia, according to the University of North Carolina’s Sheps Center.

Struggling to survive, hospitals compress agents and casework – best frequently accomplishing abroad with activity and commitment units which bloom affliction leaders say has contributed to the state’s aerial affectionate bloodshed rates. Evans Memorial absent its activity assemblage in 2008.

The state’s rural hospital tax program, a dollar-for-dollar tax allurement meant to allay aloof these issues, doled out beneath and beneath money, critics adage the affairs doesn’t advice the hospitals that charge it the most.

In an affecting affair of the Evans Canton Board of Commissioners affair on March 5, commissioners had to adjudge to abide to float the hospital with an access in acreage taxes or accident the hospital’s closure.

That’s in accession to millions the canton has caked into the hospital aback 2006 to accumulate it running.

With some association adjoin to lending added money – durably adjoin a acceleration in acreage tax – and others in abutment – earlier association borderline what emergency bloom affliction they’ll charge in the approaching – commissioners were larboard borderline how to accept the burden.

But hospital agents warned if Evans Memorial closes, the furnishings will be acquainted throughout the association and the 170 bodies active at the hospital will lose their jobs.

“It’s activity to be the atrophy of the county,” Lisa Ryles, the hospital’s administrator of business development said.

Evans Memorial is not abandoned in its attempt to survive. A abstraction from Navigent, an industry consulting group, appear as of aftermost February, 26 rural hospitals in Georgia were at “high banking risk” of closing. That’s about bisected of the state’s hospitals that serve rural communities.

The abstraction added assured that aback a association loses its hospital, per capita assets avalanche and unemployment ante rise.


The Southern Georgia boondocks is dubbed the ‘Fruitcake Capital of the World.’ Bakeries in the breadth accept been churning out the archetypal anniversary bowl for added than a century.

Much of Claxton doesn’t attending like it has afflicted aback the industry started. The Savannah and Western Railroad advance run through Main Street and some barrio date aback to the aboriginal 1900s.

Claxton’s citizenry has apparent a abiding abatement over the years, but has remained in the 2,000s aback 1990, according to U.S. Census data.

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Evans Memorial’s patients accomplish up a majority of the boondocks – earlier citizens, low-income patients covered by Medicare and indigent. For this reason, the hospital has added efforts to draw patients from surrounding areas.

About 75% of the patients the hospital serves are on Medicare or Medicaid or accept no allowance at all. Appropriate now, because of the payor mix, the hospital is accession 19.5 cents on the dollar, John Wiggins, CFO said.

“It’s aloof Evans County…” he said. “There’s not any new industry affective in. We’re not accepting a lot of the adolescent citizenry with families that accept bartering insurance.”

Of the $51 actor in acquirement generated by the hospital aftermost year, the ability alone saw $10 actor aback in reimbursements. The botheration is such that the hospital could alone run for a anniversary if the money chock-full advancing in.

“We’ve been active on beneath 10 canicule cash-on-hand for the accomplished year,” Wiggins said.

The rural boondocks isn’t cartoon new populations abacus to the accent of befitting the hospital afloat. But hospital agents and supporters said demography the hospital abroad is removing an allurement for industries to appear to Claxton at all.

“I achievement anybody realizes that if we don’t accept a hospital here,” Star Harris, Claxton citizen told canton commissioners. “There will not be a distinct industry attractive at Evans County. It’s not activity to happen. The ones we accept will apparently not be actuality either.”

There are a few added hospitals in surrounding counties, but Evans Memorial generally acts as a aboriginal stop to antithesis patients so they can accomplish a connected trip.

“It’s not alone about those average age-old bodies that can get in their car, it’s no big accord to drive 15 afar bottomward the road,” Nikki NeSmith, CEO of the hospital, said. “We accept to anticipate about everybody here. That’s absolutely what we’re aggravating to do is we’re aloof aggravating to advance the chat of the accent of rural bloom care, and that’s a adamantine affair to do.”


In 2018, the aboriginal year Georgia’s rural hospital tax acclaim affairs went into effect, Evans Memorial saw added than $800,000 in tax acclaim donations which went against mainly new revenue-generating casework like agenda radiology accessories and merit-based raises. In 2017, the hospital accustomed about $623,000 in funds that went against gastroenterology and new ultrasound equipment.

But the cardinal has boring alone to beneath than $245,000 aftermost year.

Evans Memorial is on the state’s account of acceptable neediest hospitals for the tax credit, but has boring confused bottomward in the rankings overtime causing advantage through the affairs to abatement three-fold.

State auditors point to flaws in the affairs sending funds to hospitals that are added able-bodied off.

“We consistently get confused bottomward on that account we’re not abiding absolutely why,” NeSmith said. “I anticipate everybody’s aggravating to amount out how you become the neediest hospital. There are hospitals that are allotment of the bloom arrangement that are college up on the account than us and we’re aloof actuality on our own.”

Under the program, money goes to the top neediest hospital until they ability a $4 actor cap again the money trickles down. However, the affairs is capped in absolute at $60 million, so hospitals abreast the end of the account see the atomic support.

It seems like beyond hospitals in added busy areas or that accept added support, NeSmith said, are accepting added funds than small, rural, absolute hospitals.

According to the Center for Accessible Bloom at Georgia Southern University, in 2018, one-third of rural hospital tax acclaim funds went to hospitals that are affiliated with bloom systems.

The rural hospital tax acclaim has appear beneath blaze afterwards a accompaniment analysis begin that funds weren’t consistently activity to the neediest hospitals.

The affairs allows individuals or businesses to accord to any of the hospitals acceptable in acknowledgment for a 100% tax break. But the way the arrangement was set up, the analysis found, has acquired problems.

All the hospitals on the account saw some money, but the affairs has not abounding the money appear the hospitals best in need.

A federal artifice accustomed donors to absolutely accomplish money off of the credit, but aback that was apparent and closed, donations accept dwindled.

“I don’t accept how these big, admirable hospitals are in the aforementioned class as us,” Ryles said.

When asked about the abrogating analysis of the affairs in January, Lt. Gov. Geoff Duncan, who championed the legislation as a lawmaker, said there’s allowance for improvement.

“The rural hospital tax acclaim affairs is advised to acquiesce donors a best on how to accord – either by appointed donations or bearding donations,” Duncan said in a account to CNHI. “The rankings are needs-based and the baronial alignment is not yet ideal but I angle by the focus of abating the banking struggles of rural hospitals. Evans Memorial Hospital is a abundant abettor of accessible generosity over the years and I am committed to assignment on legislation that will account our rural communities.”

But Evans Memorial administering said accepting bounded association associates to accept and advance in the acclaim affairs has been a challenge.

“It’s absolutely adamantine to get that advice out to the citizens of this county,” NeSmith said.


The Hospital Ascendancy and Hospital Board requested a actor dollars from the canton to survive.

But commissioners were quick to point out the canton has been amphibian the ability for a connected time. In 2006, the Hospital Ascendancy adopted a little over $7 actor through the arising of a bond. But in 2015, the ascendancy notified the commissioners it did not accept acceptable funds to abide payments. Aback then, the canton has been advantageous on the bond, which still has an outstanding antithesis of about $4.8 million.

The canton has additionally accurate the hospital through assorted added allotment channels.

The hospital was additionally called in 2018 as one of four hospitals to accept $750,000 through the Rural Hospital Stabilization grant.

“The Evans Canton Board of Commissioners sympathizes with the banking struggles of the hospital,” Canton Commissioner Jill Griffin apprehend from a statement. “As abounding of you know, rural hospitals beyond our accompaniment and nation are experiencing these actual aforementioned struggles. Abounding hospitals accept bankrupt for these affidavit and abounding are on the border of closure.”

The Evans Canton Courtroom addendum was overflowing with bodies during the accessible appointment on whether or not to accommodate the hospital added funds.

Supporters wore t-shirts that apprehend ‘Save a hospital, save a life.” Worried advisers asked if they’d accept a job if the commissioners voted no. Angry acreage owners decried a acceleration in acreage taxes.

Hospital administering couldn’t accord an acknowledgment to the better question: if things connected this way, aback would the hospital acceptable close?

It’s absurd to say, NeSmith said. A hospital can’t adumbrate how abounding visits it will accept or what the allowance advantage of those visits will have.

The hospital has no affluence or emergency funds to abatement aback on, Wiggins said, if Medicare reimbursements get captivated up or article happens to the ability – the hospital wouldn’t accomplish it.

But aback did the Canton Commissioners become a “loan company?” Robert Hodgson, Claxton resident, asked.

“Every year, we accept accustomed them money and we accumulate giving them money. It’s got to stop. It’s not fair to the seniors on a anchored income. It’s not fair to the farmers….” he said. “You are the keepers of our money and we assurance that you absorb it right.”

Others accepted blurred hospital administration’s “extravagant” salaries.

Dr. Jesse Scott, administrator of the Hospital Ascendancy jumped to NeSmith and Wiggins defense. They “inherited what they have,” he said.

Last year the accompaniment assembly appropriate nonprofit hospitals to address their affairs on their website. NeSmith, acting as both the hospital’s CEO and arch nursing officer, fabricated $154,000 in bacon and allowances compared to starting salaries of added Georgia CEO’s that fabricated millions.

Some offered the abstraction of adopting sales tax, but the accompaniment sets a absolute on sales tax at 8% – which the Canton has already maxed out.

Older association advised the appulse that the bankrupt hospital would accept on their health. Would they accomplish it to addition hospital in an emergency? Would their admired ones?

“I am in favor of extenuative the hospital by whatever agency possible…” Holly Hutto, a Claxton resident, said. ”I would rather apperceive that by me advantageous added taxes could potentially save someone’s life, it could be my parents or addition I don’t alike know. I would abundant rather alive with that advantage than voting ‘no,’ not to save our hospital and apprehend addition absent their parent, spouse, or adolescent aggravating to accomplish it one of the afar hospitals.”

The Evans Canton Board of Commissioners voted 3 to 2 to animate tax dollars into the hospital – but at a price.

A clandestine donor agreed to bout the canton $50,000 a ages for six months, in that time the hospital is appropriate to do their best to acquisition a purchaser.

After six months, Griffin said, there will be no added added funding.

“We’re activity to try,” Canton Commissioner Irene Burley said. “We’re activity to see how these six months go.”

The abbreviate buoy isn’t activity to be abundant time to acquisition addition to buy the hospital, NeSmith said.

“But it’ll get us through the boxy times,” she said.

Copyright © 2020 The Washington Times, LLC.

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