After clawing itself out of closure several months ago, Greenwood Leflore Hospital once again faces that reality after being denied money from the county. 

The hospital, one of the largest in the Mississippi Delta that has drawn national attention for its struggles over the past year, was bled dry by the pandemic. To keep its doors open, Greenwood Leflore Hospital has shut down departments, applied for grants and pursued a new federal designation aimed at bringing in more money. It’s even gone up for lease again after a potential agreement fell through last year.

Additionally, in early April, the Leflore County Board of Supervisors voted to obtain a $10 million line of credit to support the hospital. At the time, the hospital said that money would allow them to stay open until 2024.

But one by one in recent days, nearly all those backstops have crumbled. 

State grant money that was previously promised has proven difficult for hospitals to get their hands on, if at all. As of August no grant money has been awarded. And last month, the regional Centers for Medicaid and Medicare Services office denied the hospital’s application to become a critical access hospital, which would allow them to be reimbursed by Medicare at a higher rate. 

Though the application is still being considered on the federal level and hospital administration insists that the decision from the regional office was expected, it’s largely why the Leflore County Board of Supervisors on Wednesday voted 3-2 against the hospital’s request to draw down $1 million from that line of credit to cover hospital payroll in September. 

Now, hospital administration say they have enough cash to pay employees until the end of the month. Beyond that, hospital leaders say the future is uncertain. 

Interim CEO Gary Marchand said the board of supervisors’ decision came as a surprise.

“We have disclosed all our efforts to sustain hospital services and (are) trying to understand what changed the county’s thinking about the path we have all been on together,” he said. 

Greenwood Mayor Carolyn McAdams was also baffled and called the move “reckless.”

“I don’t understand why they did that,” she said. “The whole point of the line of credit was for the hospital to use that money to make payroll until a long-term solution could be found.” 

But Supervisor Reggie Moore, who voted against the hospital’s request, said the board is just acting on the desires of their constituents who don’t want the board to put “more money on a burning fire that leads to a tax increase.”

“What do you do when you have the Pharaoh’s army behind you and the Red Sea in front of you?” he said.

Moore said the board announced they were holding a meeting earlier this week, and they wanted to hear from the hospital board, hospital administrators and city officials to collaborate on a long-term plan before they took on additional credit. Most of those stakeholders didn’t show up, and Moore said he still hasn’t heard from any of them since Wednesday’s vote. Only Marchand, the hospital CFO and one person attended the Wednesday special meeting, Moore said. 

“We want to be good stewards of taxpayer dollars,” Moore said. “I just didn’t feel comfortable with turning loose another $1.3 million on the hospital without more answers.” 

The hospital has already withdrawn $5 million of the total $10 million. Moore said that the board would consider approving a new request for some of the credit in the future, but not until there’s more collaboration and strategy. He said he sees the hospital’s reliance on the critical access designation as shortsighted. 

Hospital administration won’t hear if their critical access application is accepted for several months. Moore said if they’re denied, the hospital will be out of options. 

Marchand previously told Mississippi Today that he was not considering suggestions of a consultant hired by the county to improve the hospital’s finances, including cutting administrative pay. 

“Then there’s no healthcare, and there’s no plan,” he said. “It’s almost criminal, isn’t it? Because it is 2023, and every citizen … deserves access to good health care. We’re not a third world country, but the Delta is turning into a healthcare desert. And no one seems to be concerned.”

He cited the hospital’s small census count — which hovers between 10-20 patients at a time.

“Without critical access designation and a restructuring of the leadership, there’s a high chance the hospital closes,” Moore said. 

Robert Collins, another supervisor who voted to deny the hospital’s request, cited how much money the hospital is losing each month, which Marchand confirmed was around $1 million.

“They’re steady losing a million dollars a month,” Collins said. “That’s just too much. Critical access wouldn’t even save them.”

Moore stressed that closure was not his nor the board’s intention with their vote on Wednesday. When pressed on the hospital’s importance to the community, Moore interrupted to say the hospital held personal significance for him, too — it’s where he was born and where he worked for almost a decade. 

“No one cares about the hospital more than myself,” he said. “But it is my obligation and my duty to listen to constituents.”

However, despite the board’s intention, closure might be the reality the hospital now faces. 

One report puts nearly half of the state’s rural hospitals at risk of closure, and when hospitals close, the effects reverberate, especially in rural communities. 

Sen. David Jordan, D-Greenwood, said the hospital’s closure would be “devastating.” 

“This is a frightening situation to those of us who live here in this town and county,” he said. “People are already sick and dying. We’re already losing so much population, and people don’t want to move to towns where they can’t get health services. It’s going to be just a total tragedy to our community.”

In a memo to staff on Thursday, Marchand said the hospital was “assessing its legal options” and still awaiting final decision from CMS on its critical access application. 

By the time they hear the final decision, it’s not certain that the hospital will still be open.

When pressed on Thursday about the likelihood of the hospital’s closure, Collins conceded it was a possibility. He said he hopes the hospital comes up with a plan, but he couldn’t offer any suggestions beyond that.

Collins cut the phone interview short, saying he was on the golf course and in the middle of a swing.