Martin General Hospital has stood abandoned in Williamston for almost two years, leaving Martin County residents with limited access to local health care. But the hospital is now slated to reopen as a new type of hospital for North Carolina: a Rural Emergency Hospital.
This new designation could be a game changer for other struggling hospitals across the state.
ECU Health will likely manage this new incarnation of Martin General, though that depends on the outcome of a June 4 public hearing before the Martin County Board of Commissioners.
[Subscribe for FREE to Carolina Public Press’ alerts and weekend roundup newsletters]
The reopening of Martin General would bring back essential services in a health care desert creeping across Eastern North Carolina.
“Eastern North Carolina is a place with lots of inequities and lots of gaps in health care services,” said Deeonna Farr, assistant professor at the ECU College of Health.
“Reopening this facility, in an area without coverage, is huge.”
Rural Emergency Hospitals, though, are not full-service hospitals. They treat only emergency or outpatient cases.
They are not designed to provide inpatient services that would require overnight stays — think hip replacements, C-sections or appendectomies. For that kind of care, Martin County residents would still need to travel 30 minutes to the nearest full-service hospital, ECU Health Beaufort in “Little” Washington.
ECU’s proposal requires a significant state investment to expand inpatient capacity at ECU Health Beaufort, which is likely where any inpatient cases in Martin County would be transferred.
Rural Emergency Hospitals, or REHs, are a relatively new designation that the federal Centers for Medicaid and Medicare introduced in 2021. They’re a tool to save struggling, or recently shuttered, hospitals.
CMS doles out $3 million to each REH each year in order to keep their doors open. They also receive higher reimbursement rates for each patient visit.
“CEOs of REHs have an immense amount of pressure off their shoulders,” said George Pink, deputy director of the UNC Rural Health Research Program.
“Instead of putting out fires all the time, constantly asking, ‘How are we going to make that payroll in two weeks? Where are we going to get the money to pay that bill?,’ they get to plan ahead and rely on a predictable cash flow.”
Across the country but mostly in the South, 38 hospitals have converted to REHs since January 2023.
This would be North Carolina’s first.
The Martin County commissioners petitioned the North Carolina Department of Health and Human Services to work with the the state’s General Assembly to change the state’s Hospital Licensure Act to allow REHs.
It’s now an option available to any struggling hospital in the state.
In addition, a new state initiative called NC Cares, dedicated to preserving and expanding rural health care, allocated $35 million to aid in the reopening of the hospital.
“The Rural Emergency Hospital can offer everything Martin General did, and frankly more — with the exception of inpatient services,” said Dawn Carter, a member of the Rural Healthcare Initiative and health care consultant for Martin County.
Martin County lacks a sufficient population base to support inpatient services, Carter explained. The county is home to 22,000 people. Attracting physicians to the area has become increasingly difficult.
According to Carter, only 20% of Martin County residents actually sought inpatient care at Martin General to begin with. That contributed to the hospital’s deep financial problems.
Carter is delighted at the prospect of services returning to Martin County. So, too, the Martin County Health Department.
“Such a facility would be a substantial step forward and could one day lay the foundation for the return of a fully operational hospital,” said Nicole Barnes, health director of the Martin-Tyrrell-Washington District Health Department.
Martin Community College is celebrating as well. Having immediate access to health care would be a boon for staff and students who practice accident-prone trades like welding, electrical and HVAC. Plus, the school’s medical professions students are currently all sent to other counties for training. Going forward, they’ll have a local option.
But there’s one problem: the hospital building itself.
Due to the age and condition of the building, the new REH will be relegated to a corner of the old hospital building.
Luckily, Carter said, the wing of the hospital dedicated to emergency, outpatient and imaging services was the newer section. But it won’t be new forever.
“The building requirements for health care facilities get more stringent every year,” Carter said. “For us to use the entire building would require extensive renovations at exorbitant costs — firewalls, air conditioning, electrical systems. So there is going to be a space issue.”
For this reason, Carter doesn’t see the old Martin General Hospital building as the permanent home of Martin County’s REH.
“The commissioners have understood from the get go that there’s only so long we will continue to operate in that building,” she said. “We’re anticipating building a new one at some point.”
Another concern? Cuts to Medicaid in Washington.
House Republicans propose to cut $625 billion from Medicaid over the next decade. In rural places such as Martin County, hospitals depend on Medicaid reimbursements to stay open. In Martin County, 20% of residents live below the poverty line.
But because it took congressional action to establish the REH program, it is unlikely that President Donald Trump could successfully terminate the Biden-era program.
For now, ECU Health is gung-ho about the project.
“ECU Health is steadfast in its mission to improve the health and well-being of Eastern North Carolina,” wrote ECU Health spokesperson Brian Wudkwych.
“We submitted a non-binding proposal for consideration to the Martin County Board of Commissioners which outlines our desire to establish the state’s first Rural Emergency Hospital and create an integrated, high-acuity outpatient delivery model that meets the health care needs of Martin County.
“We look forward to the opportunity to present our proposal at the June 4 Martin County Board of Commissioners public hearing.”
This work is licensed under a Creative Commons Attribution-NoDerivatives 4.0 International License. You may republish our stories for free, online or in print. Simply copy and paste the article contents from the box below. Note, some images and interactive features may not be included here.
