Tallahassee Democrat: This rural hospital remains 'the difference between life and death'
BLOUNTSTOWN — Off Highway 20, regulars shuffle in and out of a quiet thrift shop run by the Calhoun Liberty Ministry Center.
Judy Bailey knows everyone by name. The 73-year-old has been ringing people up at the community shop for seven years, and has lived in Scotts Ferry, a community south of town, for two decades.
The wounds from Hurricane Michael nine months ago are still raw in this river town.
“I can cry any minute talking about it,” Bailey said.
Along with the nearby Chipola River — whose banks are clogged by sunken, storm-snapped trees — she prays for the Calhoun Liberty Hospital. It’s the area’s only hospital, and it's been battered by the storm.
Her husband Sam Bailey was treated there several times for respiratory issues. She’s been rushed to its emergency room for viruses and a sudden fainting spell during prayer time at the shop, about two miles southeast of the hospital.
There used to be 25 beds for patients like her and Sam. After the Category 5 hurricane raked the town in October, there are only 10. Staff worried the entire place would be closed. Several areas of the building remain shut down. One in three patients now are uninsured.
Jennifer Hiers, a nurse, has treated patients at Calhoun Liberty for water moccasin bites, heart attacks, car wreck injuries. On a recent Tuesday afternoon, the 49-year-old was at the thrift store, chatting with Bailey.
“I’ve had burn victims in there that would have died if they hadn’t gotten care there,” Hiers said.
She broke her pelvis once and stayed at the hospital for 10 days. She had the option of going to a hospital in Dothan, Alabama, about a 90-minute drive.
“I stayed there, because it’s home.”
When Hiers heard the hospital was at risk of shutting down after the storm, “My heart broke,” she said. “I was really scared. I was afraid.”
'We're crippled – but we're hobbling along'
The shadow of past controversies loomed large before Michael's swirling storm clouds.
In 2015, a patient, Barbara Dawson, was discharged for abdominal pain and refused to leave the hospital. Police arrested her for trespassing, and she died in custody of a blood clot in the lung. The Florida Agency for Health Care Administration fined the hospital $45,000.
Former CEO Phillip Hill was indicted last year on charges of embezzling more than $1 million. He'd created a fake medical supply business and pleaded guilty to 24 counts of wire fraud and four counts of tax fraud.
"It really gave us a black eye," said hospital board chairman Mark Plummer. "We moved on. We handled it as well as we could."
A critical access facility, designated by Medicare, it has also toiled under a threatened rural health care industry. Since 2010, at least 107 rural hospitals have closed across the country, according to the University of North Carolina's Rural Health Research Program.
In the town of farmers and timber workers along the winding vein of the Apalachicola River, the hospital is one of the few health centers in rural Calhoun and Liberty counties, where Hurricane Michael’s pulse still beats.
Since the storm, it’s struggled to stay open. Eighty percent of its roof is peeled away, a temporary roof put on. Water-damaged sites – the main lobby and lab – were forced to close and relocate.
It wasn’t until this spring that the hospital reopened inpatient services.
“We cannot physically sustain being able to have 10 beds open, so our biggest challenge is trying to be as frugal as possible. We’re really two-thirds less of patients, so that’s a big revenue hit,” said Esther Stoltzfus. After the patient death case, the emergency nurse of three decades was recruited to manage the hospital's ER.
“The hospital is a heart of the community,” Stoltzfus said, who's now the hospital's quality, risk and infection control director. She estimates that in the past year, it’s served about 30,000 patients. “A lot of the time, we can be the difference between life and death for people in small, outlying communities.”
On Burns Avenue, Calhoun Liberty is tucked off a curving road lined by lush forest and blue tarp-covered homes, a few miles past the Trammell Bridge that stretches over the Apalachicola River. It’s housed in a 60-year-old building that’s had little refurbishing over the years. An ER expansion plan using $1 million granted two years ago was put on the back burner after Michael.
Hospital management didn’t allow journalists to photograph the inside of the facility, and multiple information requests to CEO Janet Kinney and Alliant Management were not returned.
But Plummer estimates damages add up to roughly $4.5 million.
"You spend that kind of money on an old building, you've still got old building problems to deal with," said Plummer, a retired pharmacist.
The goal is to build a new facility. But for now, a loan has kept the hospital afloat.
He said AHCA issued the hospital a $6.4 million advance loan to help it stay in business and make repairs.
"Had AHCA not provided us with that loan, we probably would have had to shut down," Plummer said. "They've been our lifeline since the hurricane."
Roughly 30% of staff were laid off or had hours cut due to the trough in patient stream and in turn, revenue. When the hospital reopened inpatient services in March, some staff were brought back.
This past legislative session, hospital staff started a social media and letter-writing campaign to lawmakers: Heal our hospital.
Sen. Bill Montford, who is from the small town of about 2,400 people, rallied for the county’s aid this past legislative session.
Florida lawmakers appropriated $3 million toward the hospital's recovery, to be dispersed later.
“Had Sen. Montford not been there,” Plummer said, “we wouldn’t have gotten a penny.
“We're crippled – but we're hobbling along."
Storm stress and the health care baseline
Dr. Laura Davis’ patient recently told her of a large, gaping hole in the roof of his family’s home. When rain falls, they move to a different room.
It makes a difference for medical staff to know how patients are doing after the hurricane, said Davis, a family medicine physician at a Tallahassee Memorial HealthCare Physician Partners clinic across the street from the hospital. A fifth-generation Blountstown resident, she grew up in the country town and returned to practice there.
She recalled one patient whose blood sugar kept escalating. After question after question, Davis discovered the patient’s prescription medicine had been thrown out after the storm.
Dr. Misbah Farooqi, an internist at the hospital, said many of his patients have come in with heightened stress levels. He and Davis also say their patients’ asthma, COPD and allergy symptoms can worsen in the months after a hurricane because of lingering debris.
Storm stresses often come up in conversations with patients.
"Eight months gone by, but still they are struggling to clean out their houses. Still they are struggling, some people, with their insurance companies to get adequate help. The houses are not fixed yet," Farooqi, 61, said in a June interview. During his naturalization process after his residency in New York, Farooqi came to Calhoun County. He wanted to treat an underserved area.
“They are not at the baseline so far. That is overwhelming,” he added.
Calhoun County homeowners were granted nearly $4.9 million for home repairs, according to FEMA, and 481 blue tarps were installed throughout the county. About $7.5 million in federal grants were approved through FEMA’s Individuals and Households Program.
FEMA issued $600,000 for home repairs in neighboring Liberty County and facilitated 586 blue roofs. More than $1 million was granted to people and households in the county, and the U.S. Small Business Administration doled out $5.1 million in low-interest disaster loans.
“It has affected the personal lives of the patients and the businesses,” Farooqi said. “Their home environments are not as good as they used to be and that may have increased their health problems.”
It’s not just patients. Staff too. Farooqi’s medical assistant lost her home and was living with in-laws. By summer, she was still struggling to find a permanent home.
The 'value of our hospital'
At Bailey’s thrift shop, where a resident orange kitten leaps atop the counter as she rings up customers, a “Miss Betty” yells across the room for 33 cents before haggling to buy a rug for a dollar. A fellow customer pulls out her wallet to hand her the change.
In the rural town of Southern charm, help is second nature. It’s a tight-knit place.
Davis knows that well. She’s had to get accustomed to practicing medicine with such close connections.
“It’s really weird when some of your favorite teachers don’t want you to do their pap smears,” she told a group of Florida State University medical school students touring the clinic and hospital on a late May morning. “People that changed my diapers when I was a baby didn’t want to see me for their physicals. It took trust on their part but also trust on mine.”
It’s a place “where if somebody sees you in the grocery store, they’re going to say, ‘Hey remember that wart? I got it taken care of – it’s good,’” she tells the aspiring doctors, who were on a rural health care tour.
Her clinic has a close working relationship with the hospital. Calhoun County has just two 24-hour ambulances, and Liberty County has one. Sometimes, clinic staff themselves rush to escort patients across the street if they’re having an emergency.
“We threw her in a wheelchair and ran her across the street because EMS told us it would be at least 15 minutes before they could get here,” Davis said, remembering one patient who began having stroke-like symptoms during an appointment.
Stoltzfus said the community "realized the value of our hospital" even more after the storm.
"They were faced with the realization that the hospital was so damaged, that it very easily could have had to shut down," she said. "And it did not."
How to help:
Checks can be made out to the Calhoun Liberty Hospital Association and mailed to 20370 N.E. Burns Avenue P.O. Box 419, Blountstown, Fla., 32424.Select Calhoun Liberty Hospital Association, Inc., as your preferred charity on Amazon Smile for Amazon to donate 0.5% of eligible purchases.