1. What’s so about Rural Hospitals? Bob Pascasio, FACHE CEO, Bayside Community Hospital, Anahuac David Pearson, FACHE President/CEO, TORCH, Austin PO Box 398, Anahuac, TX 77514 Phone: (409) 267-3143

2. Texas is largely a rural state. 177 rural counties (about 75% of the state) 3.2 million people in ~530 small towns 94% of all rural towns in Texas The population of rural Texas = population of Alaska + Delaware + North Dakota + Vermont + Wyoming Texas has almost twice the farms and ranches of any other state. 78% of total acreage.

3. 70% of the counties in Texas have been designated as primary care health professional shortage areas (HPSA); 112 of these counties have whole and 46 have partial designations. Fully three-quarters of the counties with whole county HPSA designations are in rural areas. Some 177 counties are designated as medically underserved areas.

4. There are 580 hospitals in Texas, of which 164 are rural, acute care facilities. Of the total 72,073 licensed beds in the state, 8,393 (11.6%) are rural. Texas has 74 Critical Access Hospitals (CAH), which are hospitals with 25 or fewer beds. The state ranks fourth in the nation with the most number of CAHs.

5. Sixty-three counties in Texas today have no hospitals. 117 counties are served by a single hospital. With rare exceptions, they are the only sources of primary care in their county and communities.

6. Analysis by The Perryman Group shows that “the healthcare industry is crucial to the state economy.” 15% of overall state output 16.5% of earned personal income 17.2% of all employment The medical sector and associated spin-off productions also yield $6.6 billion in annual state revenue. The impact of hospital facilities on the Texas economy is enormous, supporting almost 700,000 permanent jobs in the state and almost $87.5 billion in economic activity every year.

7. According to the National Center for Rural Health Works, in most rural communities health care is the largest employer and accounts for at least 10 percent of total local employment. On average, every dollar spent at home on health care recirculates inside the community one-and- a-half times. For every five jobs in the health sector, four jobs are generated inside the community.

8. Here are some of the issues that hospitals are always facing: Changing state and federal regulations Complex reimbursement methodologies Quality and performance improvement Insurance, uninsurance and managed care Health careers promotion and training

9. Here are some more issues that rural hospitals are facing: Access to health care services Provider recruitment and retention Aging physical infrastructure Rapidly changing technology Economic and demographic shifts

10. Been in continuous operation for over 56 years, providing for the general acute needs of Central Chambers County and surrounding communities. Recognized by the Texas Rural Health Association in 2002 with the “Community that Cares” award. Recognized by the Texas Medical Foundation in 2005 with the “Award of Excellence in Healthcare Quality Improvement,” Bayside offers the only state designated Trauma Center (Emergency Room) in Chambers County. Designated a Nurse Friendly Hospital by the Texas Nurse Association. Recently awarded funding to establish and FQHC.

11. Since 1990, TORCH has been the voice for rural hospitals in Texas, and is a model for rural hospital organizations across the US. TORCH is a full-service trade association offering advocacy, education, programs and services targeted at rural hospitals. TORCH has six affiliated organizations, including a for- profit corporation, a non-profit foundation, an insurance pool, and three other healthcare-related trade associations. Taken together, the entire enterprise includes 150 rural and community hospitals, 137 rural health clinics, 100 provider-based home care agencies and 147 corporate members and endorsed business partners.

12. Rural and community hospitals are an important part of the overall health care delivery system for the State of Texas. Rural hospitals are resilient and they’ll continue to evolve in order to meet the healthcare needs of the many small and isolated rural communities in Texas.