rural health | KCUR

rural health

Dan Margolies / KCUR 89.3

In the latest in an ever growing pile of legal challenges, the principals behind a questionable lab billing scheme at 10 small rural hospitals in Missouri, Kansas, and three other states have been sued by a Mission Hills couple for fraud and conspiracy.

The couple, James and Phyllis Shaffer, allege the defendants fraudulently took majority control of a company, HMC Hospitals, that owns the hospitals and used them as “instrumentalities in the operation of an illegal billing scheme.”

Dan Margolies / KCUR 89.3

Nearly a year after Missouri state Auditor Nicole Galloway released a scathing audit of Putnam County Memorial Hospital in Unionville, Missouri, the tiny hospital is still struggling to recover from a lab billing scheme that's now the subject of criminal investigations. 

Tatiana Vdb / Flickr-CC

Segment 1: Leaders of the Kansas and Missouri chapters of the ACLU discuss their organizations' goings-on.

With a federal court ruling Kansas Secretary of State Kris Kobach's voter I.D. laws unconstitutional, the ACLU has something to celebrate. In the meantime, they're still fighting restrictive abortion laws in Missouri and for more funding of the state's public defender's office. Today, they updated us on these lawsuits and more.

Rural hospitals are more likely to close in states such as Missouri that have not expanded Medicaid.

A recent report from the pro-Affordable Care Act organization Protect Our Care analyzed 84 rural hospital closures since 2010. It found 90 percent of those hospital closures were in states that had not expanded Medicaid coverage. Missouri remains one of the 14 states that hasn’t amended its program to cover people who earn up to 138 percent above the poverty line.

Taja Welton is ready for her daughter to be born. She’s moved into a bigger house, one with room for a nursery. She has a closet full of pink, Minnie Mouse-themed baby clothes. Her baby bag is packed right down to the outfit she plans to bring her baby home in that reads, “The Princess Has Arrived.”

“I can’t wait to put it on her,” Welton smiles. The princess even has a name: Macen.


Dan Margolies / KCUR 89.3

U.S. Sen. Claire McCaskill is calling for a federal investigation of billing practices at Putnam County Memorial Hospital, which was the subject of a highly critical state audit last year.

Dan Margolies / KCUR 89.3

The same lab billing arrangement put in place at a small, rural hospital in Unionville, Missouri, is the subject of a federal lawsuit in Georgia that calls it a fraudulent scheme designed to enrich its architects.

The lawsuit, filed by Blue Cross and Blue Shield of Georgia, alleges that since August 2016, a 49-bed hospital in rural north Georgia has billed it more than $174 million for lab tests Blue Cross did not agree to pay for.

Dan Margolies / KCUR 89.3

As he fights to retain control of Putnam County Memorial Hospital in Unionville, Missouri, Jorge Perez’s woes continue to pile up at other rural hospitals where he was once hailed as a hero.

Last month, in the second of a three-part series, CBS News aired a piece about Empower, a Perez-run company whose affiliates have been involved in many of the rural hospital takeovers orchestrated by Perez and his associates.

Dan Margolies / KCUR 89.3

A battle royale has erupted in tiny Unionville, Missouri, over the town’s endangered community hospital.

Trustees of Putnam County Memorial Hospital in the north central community are trying to get rid of the company that took over the ailing institution in 2016 and then ran more than $90 million in questionable lab billings through the hospital.

When the hospital closed in rural Ellington, Missouri, a town of about 1,000, the community lost its only emergency room, too. 

That was 2016. That same year, a local farmer had a heart attack.


White residents in Missouri are dying at a higher rate than they did nearly two decades ago, according to a report from the Missouri Foundation for Health.

The increased death rate largely is occurring in the state's rural counties, especially in the Ozarks and the Bootheel region and substance abuse appears to be a major factor. For example, deaths by drug overdose have increased by nearly 600 percent in many rural counties. Poor mental health also plays a significant role, as suicides among young and middle-aged adults have increased by 30 percent since 1995. 

It’s a familiar story in rural America. Four years ago the Pemiscot County hospital, the lone public hospital in Missouri’s poorest county, nearly closed. What’s keeping it in business today has also become increasingly common in rural healthcare: relationships with a handful of local pharmacies.


Dr. Warner / Creative Commons-Flickr

This story was updated at 4:24 p.m. to include comments from the CEO of McPherson Hospital.

Two Kansas hospitals have been selected to take part in a federal demonstration program aimed at ensuring access to health care in underserved areas.

The two, McPherson Hospital in McPherson and Morton County Health System in Elkhart, were among 13 nationwide chosen for the demonstration project being conducted by the Centers for Medicare and Medicaid Services (CMS).

Sarah Scantling's daughter, Abilene, was born in Dryersburg, Tennessee, 30 miles from their home in Pemiscot County, Missouri.
Bram Sable-Smith / Side Effects Public Media

When Sarah Scantling went into labor this summer, she had to drive 30 miles and across state lines.

Three years earlier, the only maternity ward where she lives in Pemiscot County, Missouri closed down. Scantling had to choose between a handful of other hospitals in the region between 20 and 70 miles away. She chose to give birth in the hospital in Dyersburg, Tennessee.

Earl Bullington is an advisor for Focus Bank, which rescued the struggling Pemiscot County Hospital in 2013.
Bram Sable-Smith / for Harvest Public Media

$1.25 million.

That’s the size of the bill that could have shuttered the only public hospital in rural Pemiscot County, Missouri in August 2013.

Bryan Thompson / Kansas News Service

A brick building that was the only grocery store in St. John sits vacant, its glass doors covered with paper since it closed early last year.

St. John is the county seat of Stafford County in south-central Kansas — but it’s home to fewer than 1,300 people.

Now, the closest grocery store is 12 miles away, in Stafford.

St. John resident Amy Collins said that means meals and shopping require more effort.

“Now when we make a trip to the grocery store we are planning four, five … six days out in advance, so you have to be much more efficient,” she said.

Jim McLean / Kansas News Service

Nearly two years after Mercy Hospital closed its doors, the southeast Kansas town of Independence is still without a hospital.

But it may have the next best thing: a new state-of-the-art clinic with an emergency room and a small cancer treatment center.

The nearly $8 million Independence Healthcare Center operates as an extension of Labette Health, a regional hospital about 30 miles to the east in Parsons.

“This is a department of the hospital,” said Labette Health head nurse Kathi McKinney, while giving a tour of the center during its dedication Saturday.

Google 2017

This story was updated at 1:47 p.m. and at 3:36 p.m. to include comments from the Putnam County prosecuting attorney and a spokeswoman for Missouri Attorney General Josh Hawley. 

What began as a routine audit of Putnam County took an extraordinary turn when Missouri state auditors uncovered what appears to be a massive, fraudulent billing scheme in tiny Unionville, Missouri’s lone hospital.

We take a look at the challenges of bringing quality healthcare to people in urban and rural communities, from a KCK clinic that serves the homeless to a program in a remote county that sends case workers to see patients.

Guests:

New data from the Centers for Disease Control and Prevention show a new dimension to the urban-rural divide: death rates related to cancer.

Cancer death rates are falling nationwide, but they remain higher in rural areas (180 deaths per 100,000 persons) than in cities (158 deaths per 100,000 persons), according to the CDC’s Morbidity and Mortality Weekly Report.

Broch Slabach

The health care plan unveiled last month by the Republican-controlled U.S. Senate met with fierce opposition from hospital, doctor and patient advocacy groups. Among them was the National Rural Health Association, which is based in Leawood, Kansas, and represents doctors, nurses and hospitals in rural areas nationwide. 

Alex Smith / KCUR 89.3

Twenty-four-year-old Kalee Woody says that when she was growing up in Bronaugh, Missouri, she saw the small town slowly fading, as businesses closed, growth stagnated and residents had to drive to other places to see a doctor.

Luke X. Martin / KCUR 89.3

Jacie Hoyt is making waves in the coaching world. At just 29, she's one of the nation's youngest Division I head coaches. Today, she talks about her playing days, coaching influences and vision for UMKC women's basketball.

U.S. Sen. Pat Roberts website

Kansas U.S. Sen. Pat Roberts is not enthusiastic about the Senate’s version of the Obamacare replacement bill.

Nevertheless, he supports it.

Bryan Thompson / Kansas News Service

When evening falls, Brian Hunt makes his way to a comfortable chair in a sun room on the south side of his house near La Cygne, Kansas. But he’s not settling in to relax. He’s going to work.

Kansas City University of Medicine and Biosciences

Joplin city leaders and school officials held a ribbon cutting ceremony for the new Kansas City University of Medicine and Bioscience campus on Tuesday.

Built near the site of what was the parking lot of the old Saint John’s Regional Medical Center, which was destroyed in a 2011 tornado that killed 161 people, the new medical school was described as a “phoenix rising from the ashes.”

A new hospital, financed by a USDA loan, is under construction in Syracuese, Nebraska, a town of under 2,000 people.
Grant Gerlock / Harvest Public Media

President Donald Trump spent the campaign pledging to revive rural communities, where many voters have felt ignored by previous administrations. But after announcing staffing changes and budget plans that would make cuts to programs aimed at rural areas, critics are questioning whether the White House remains committed to that goal.

Until a few years ago, Addie Blankenship saw herself as a relatively healthy mom of three. She didn’t recognize that she was exhibiting symptoms of Obsessive Compulsive Disorder—a mental condition that leads to obsessive thoughts and compulsive actions.

“So I would spend hours and hours washing things. Or I would have a thought that something may be on my clothes, so I would change my clothes every time I’d have a bad thought, which sometimes was 10 times a day. Sometimes more,” Blankenship said.

Drive down a dirt road in Dallas County, under a thick canopy of walnut trees and over three cattle guards, and you’ll come to Rachel Harrison’s home in Windyville, Missouri.  

A few years ago, Harrison was using her Bachelor’s degree in biology in a hospital laboratory.

“I was a generalist, which means I was in charge of urinalysis, chemistry, special chemistry, hematology, blood banking, coagulation, I think I got it all—phlebotomy, all that kind of stuff,” Harrison said.

But at age 25, she began to hear what sounded like people talking.

Tech. Sgt. Linda Burger / Iowa National Guard

Midwesterners are used to extreme weather. We take pride in enduring everything from torrential downpours to the most desiccating drought.

Climate change is expected to increase the frequency of these fluctuations between drought and flood, though, according to new research published by scientists at the University of Kansas, and this "weather whiplash" will deteriorate the quality of drinking water.

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