Closure of rural hospitals negatively affects small town services and growth

by Terri Dee
Illinois News Connection

CHICAGO - The federal government is launching a new program to help hospitals struggling to stay afloat in rural Illinois.

Severe financial problems have put 360 rural hospitals nationwide at immediate risk of closing. Fifteen rural Illinois hospitals have closed since 2015, according to a Center for Healthcare Quality and Payment Reform report.


Rural hospital closures can negatively affect the nation's food supply and energy production

The National Rural Health Resource Center is launching the federal Rural Hospital Stabilization pilot program to prevent further closings.

Alyssa Meller, chief operating officer of the pilot program, outlined its objectives.

"It is a program that's aiming to improve the health care in rural communities by really helping keep health care services available locally to increase patient volume and improve revenue," Meller explained.

The report showed rural hospital closures can negatively affect the nation's food supply and energy production. Farms and solar energy facilities are located mostly in rural areas. Those without health care facilities have a hard time attracting and retaining workers.

Meller noted several things contribute to hospitals' financial woes, including people bypassing local services and going elsewhere, fixed costs exceeding reimbursement rates from Medicare and Medicaid, and a lack of services tailored to meet community needs.

"This program then will help stabilize their current service line but also will help them dive into what is needed at that local level and provide technical assistance and support," Meller added.

The report indicated of Illinois's 74 rural hospitals, 10 are at risk of closing, and six are at immediate risk of closing. Meller said the program will also help engage the hospitals' communities to promote services. The application period ends Jan. 15.



Going to the hospital? Here's what you should consider taking with you

Photo: Stephen Andrews/Unsplash

by Tim Ditman
OSF Healthcare


URBANA - You’re coming to the hospital to give birth. You’ve had a hip replacement and now will have a hospital stay to complete rehabilitation. There are a lot of things swirling through your mind, notably thoughts like “Am I going to be OK?” Questions like “Where is my toothbrush?” are probably on the backburner. That’s why it’s a good idea to make a “hospital essential items” checklist now.

Kurt Bloomstrand, MD, sees these scenarios plenty while providing care in the emergency department at OSF HealthCare. He says a hospital will provide basic toiletries, blankets, food and clothing like a gown and socks. But some people prefer their own toiletries, clothes and snacks.

Other things to do and bring:

• Write down your health information: health insurance, medications, medical history, name of your primary care provider, allergies and legal documents like power of attorney and a do not resuscitate order. Have an identification like a driver's license, too.

“Some people in the emergency department are not able to tell us their health information given what they’re presenting for. So, it’s so valuable to have basic health information written down,” Dr. Bloomstrand says. He adds that knowing your health information allows providers to care for you properly. You can also bring legal forms to your provider anytime to be added to your medical record.

• Bring other items essential to your well-being: eyeglasses, contacts, hearing aids, dentures and a continuous positive airway pressure machine (CPAP) for sleeping. Bring cases and batteries for these items, too.

• When choosing clothes, opt for loose-fitting and short-sleeved garments.

“If you have an IV, a short-sleeved shirt is much better to access it than a long-sleeved shirt,” Dr. Bloomstrand says. “You can bring a robe to cover up.”

• For moms giving birth, bring your birth plan in written form. Pack a few pairs of clothes for you and your baby.

“Babies notoriously spit up on their clothes,” Dr. Bloomstrand said.

• The hospital can provide diapers, wipes and a breast pump. But, you can bring your own if you prefer a certain type.

“Not only can you use your breast pump, the people at the hospital can teach you how to use it.

What babies don’t need at the hospital: rattles, books and toys. Save those memories for home.”

• Don’t overdo it with personal items and food. This can cause your room to get cluttered and create a trip hazard. Have someone who can take unneeded items home.

• Don’t bring valuable items.

Dr. Bloomstrand says a phone is OK to keep in touch with loved ones. But other electronics and jewelry should stay home.

Hospitals have security, but like any other place, there is a chance for theft.


The power of listening when helping those with a terminal illness

by Tim Ditman
OSF Healthcare
“I was in my early forties with a lot of life before me when a moment came that stopped me on a dime.”

Country music star Tim McGraw’s “Live Like You Were Dying” tries to sum up the emotions of a terminal illness.


Rita Manning
Pastoral Care & Bereavement Coordinator
Photo provided

It’s not just Hollywood. Rita Manning counsels patients and their loved ones as a pastoral care professional and bereavement coordinator for OSF HealthCare. She says there are ways to make the person’s final days more peaceful.

Getting the diagnosis

Before the “what’s next?” phase sets in, Manning says gut reactions to a terminal illness diagnosis can vary widely. Some have been in declining health, and they may show less of an emotional response. Others learn the news unexpectedly and abruptly.

“Those that are broadsided probably have more of an impact of mental and emotional things,” Manning says.

People might talk about being afraid of death or ask lots of questions. Some may want to go “full speed ahead,” as Manning puts it, and do things while they can. They may travel or catch up with old friends. Others may retreat and want to contemplate the future alone. Depression and other mental health issues can follow.

Helping out

Here’s a phrase to try when starting the conversation with a loved one:

“You may not want to talk about this now. Just know that whenever you are ready, I’m ready to listen and be there,” Manning says, putting herself in the shoes of a caregiver.

In other words, try to meet the person where they are. Don’t try to fix something that can’t be fixed. Acknowledge that the news is tough. Sit and cry with your loved one if that’s the emotion they show. Or if you don’t wear your emotions on your sleeve, offer help in other ways. Offer to mow the yard or take care of groceries.

Manning advises to avoid cliché phrases like “How are you doing?” Instead, try “How’s your day treating you?”

Another poor phrase: “You’re going to a better place.”

“Those types of phrases might be factual for them in their faith journey. It still may not be the time they want to hear that,” Manning says.

End of life discussions

It’s not uncommon for an adult with a terminal illness to put off talking about their funeral, estate and other matters once they have passed away. But there comes a time when there’s little time left to get things in order. Approach it delicately, Manning suggests.

“We just want to honor your wishes,” Manning says, again posing as a caregiver. “If you could help us understand what those are, that would help us to know how to move forward.”

Other phrases that may work: What is your greatest concern? What is your greatest hope? How can we make your final days full and comfortable?

Children and terminal illnesses

Consoling and supporting a child who will soon pass away requires a different approach, Manning says. You should still be honest, but they may not understand death. So, explain it in a way they understand.

First, reassure the child that the situation is not their fault.

Try something like: “Sometimes people just get sick. As hard as we try, we just can’t find that solution to make you well again.”

If they ask a question, an adult may need to ask one back to make sure they grasp what the child is thinking. For example: does the child’s stomach hurt because they are nervous or because of the illness? The response will shape what the adult says.

Relate to what children know, like a pet who died or even leaves falling off trees in the winter. But don’t be afraid to use words like “death” and “dying.” Using words like “lost” may cause confusion, Manning says. For example: a parent says, “We lost grandma today.” A child may respond, “Let’s go find her.”

Manning adds that there are books from trusted sources that talk about death.

“They’re still going to have questions,” Manning points out. “But it starts the hard task. Reading helps them engage and understand better.”

Learn more

Learn more about resources for people nearing the end of their life on the OSF HealthCare website.


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Expecting a newborn soon? Be flexible with your birth plan

by Tim Ditman
OSF Healthcare

URBANA -- "If you’re ever gonna find a silver lining, it’s gotta be a cloudy day.”

No one may epitomize that song lyric more than Erin Purcell.

OSF patient Erin Purcell

Photo Courtesy OSF

In July 2020, the Bement, Illinois, woman gave birth to her first child, Adalyn, via Cesarean section (commonly known as C-Section). Long story short, it did not go well.

"I was in a lot of pain afterward,” Purcell says.

Two years later, Purcell found herself at OSF HealthCare Heart of Mary Medical Center in Urbana, Illinois, preparing to deliver her second child.

"I was terrified to do another C-section,” Purcell recalls.

But a C-section became necessary, and her son, Elliott, was brought into the world without major issues.

"It restored my faith in doctors,” Purcell says.

Now, part of a happy and healthy family of four, Purcell is telling other parents-to-be to be flexible with their birth plan. And the woman’s care team is educating mothers about what to expect if a vaginal birth is not possible.

What is a C-section?

A C-section is when a doctor removes a baby through an incision the mother’s abdomen. The naming is a matter of historical dispute and may be tied to Julius Caesar, according to the U.S. National Library of Medicine.

Kelli Daugherty is a certified nurse midwife at OSF HealthCare in Urbana and was a member of Purcell’s care team. She says while a small amount of women will choose a C-section long before birth, health care providers prefer to perform them only when medically necessary.

"Baby is in the wrong position - maybe breach instead of head down,” Daugherty lists as a need for a C-section. "Maybe we’ve seen fetal distress that’s concerning enough that we need to deliver quickly. It could be that mom has an infection.”

Or, if labor is not progressing, doctors may consider a C-section, Daugherty says.

Regardless, Daugherty says providers will have a conversation with the mom-to-be about the risks and benefits. She says risks are like any other major surgery. There’s a chance for organ damage, blood loss (blood is on standby for every birth for a possible transfusion) and the rare need for more surgery later, like a hysterectomy.

The benefits of a medically necessary C-Section: the baby comes out quicker, and there’s less risk to the mom and baby’s health.

The procedure

Daugherty says a mother will start out in the labor room with antibiotics and an IV for fluids. Then, she goes to the operating room.

"She would sit on the operating table, and the anesthesiologist would place a spinal anesthesia,” Daugherty explains. "We always attempt to do a spinal. We try to avoid general anesthesia for a C-section unless it’s a true emergent situation.”

The mother lays down, and Daugherty says the anesthesia should have its intended numbing effect very quickly. The care team cleans and preps the skin, and the surgeon makes incisions layer by layer until they reach the baby in the uterus.

"We get the baby out usually in less than five minutes,” Daugherty says. "We hand the baby to the neonatal team. Then we start suturing everything back up in reverse. We start with the uterus, go layer by layer and do the skin last.”

Typically, moms stay at the hospital two days after a C-section to manage pain, Daugherty says. There are the standard follow-up appointments, and the new parents will have to keep mom’s incision site clean and dry to avoid infection or other issues. The incision usually takes six weeks to heal, Daugherty says.

"C-sections are not really as scary as you might think,” Daugherty says. "It’s certainly concerning because it is a major surgery, but it’s also a very common surgery. [Providers] are very confident that we can complete these surgeries safely, and you and your baby will be well taken care of.”

Daugherty agrees.

"I always tell my moms to please bring in your birth plan. We will follow that as closely as we can,” she says.

"But, you have to understand that sometimes labor just doesn’t go the way you planned it. We may have to veer from that birth plan,” Daugherty adds. "But if we do, we will always have the discussion with you. It will always be shared decision making.”

You can prepare physically and mentally, too.

"I just kept telling myself in my head ‘It’s only temporary. This pain is going to go away. You can get through it,’” Purcell says. "You have your nurses, too, in your ear saying ‘You got this. You’re so strong.'”

For more information on OSF HealthCare's pregnancy and child birth resources visit the healthcare facilities website at https://www.osfhealthcare.org/heart-of-mary/ .


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