The events leading to the abrupt closure of the hospital and services from the VNA, hospice, and other providers are complicated. What happens next is unclear. Federal and state lawmakers and local officials are scrambling to craft a fix.
Critical Access Death Spiral
This hospital closure is neither unprecedented nor unexpected. Small and isolated hospitals serving rural communities are vulnerable everywhere. More closures will come. In Georgia, one advocate for rural healthcare access bluntly states that critical access hospitals "have about a seven-year death spiral that's a function of the cost-to-charge ratio."
North Adams Regional Hospital is not a CAH, and that may have aggravated its financial distress. CAH designation was not granted because the hospital failed to meet at least two requirements—it is less than 25 miles from the nearest emergency department, and it has 36 inpatient beds, which is above the 25-bed cutoff.
But that special designation is just semantics for the people of North Adams, Williamstown, and other tiny communities in the region. NARH has provided critical access to the people living around it since its founding 129 years ago.