On October 29, 2019 I took the opportunity to attend the open portion of the monthly board meeting of the Scotland County Hospital. I had received several inquiries as to what was occurring with the hospital since I had spent a decade as the Director of Nursing there. I was told several accounts that honestly had me concerned regarding the viability of this critical access hospital and the impact losing this level of health care could mean to the taxpaying people of the area. One such question arose from a health-related friend who had been told of the hospital’s sale at a meeting in Columbia, Missouri. Having been an RN for many years, a Director of Nursing for 10 years, the Chair of Northeast Missouri Health Council for 6 years, a home health nurse, and Health Department Administrator for 5 years, I have witnessed a great deal of health care at its best and at its worst.

Experience has taught me that where there is smoke there most likely is fire, so I made an appointment to meet with the man that holds the vision. My meeting with the CEO was very cordial. I was invited to attend the board meeting which left me with more questions than answers. Remember the board meeting is open to any of you as well.

I lived in Scotland County, namely Memphis, MO during a time when there was no ambulance, no ER room, no hospital, and no urgent care. Back in the day it was 40 to 50 miles to the nearest hospital and a man with a heart attack would easily do an hour worth of damage to his heart before receiving basic care. My father was not the only person to be a victim of delay in health care.

Following this era, a number of worthy, willing, and committed people set about obtaining funding for the hospital/nursing home to be built. They eventually became separate entities, each providing their specialty to the people of Scotland County and surrounding areas.

Change has always been the name of health care, creativity and compassion is what kept it viable. Anyone who believes this is easy has never worked it. Patients do not come and set on your doorstep. A hospital like ours needs to be the best at what it does. Patient Care.

I had been told that a deal had been cut with Blessing Hospital to acquire Scotland County Hospital so there were questions that begged to be asked.

1. Is this true? Simple yes or no.

2. Is this an affiliation, or acquisition in the form of lease or management. Three very different things. If this is a necessary move then a shared line item of what Blessing will invest, what Blessing will gain, What SCH needs, what it will gain through Blessing would enlighten the taxpayers as to what is occurring with their hospital.

I have been in the position to see three different hospitals go under the affiliation of a much larger network and in all three, the network sent specialist who referred those higher payers into the larger facilities. This leaves low or no payers for the smaller hospital and when the tax advantage of the little hospital as a write off is no longer a reality, then the network pulls out and the smaller hospital has no chance to recover.

3. What is the length of the agreement?

4. What tools will be used and at what intervals will the assessment of the success of the program be conducted, who will do it and will results be made public.

5. Will there be an exit clause allowing either to withdraw and what safety net will there be for SCH if Blessing pulls out. (Shared revenues, continues specialist for a period of time, etc.?

6. What are the plans for SCH staff? I have been assured that there is no plan to close OB or Surgery which is one of the rumors. On the other had I have had people give me specific dates for their last day working at the hospital. ??? Which is it.?

7. What is the target date for signing of the agreement.? I have been told how hard the hospital is working to be transparent in this, yet these are simple questions it seems to be very difficult to get straight answers to. It gives pause as to why?

If you have an interest in the future of SCH, I would encourage you to conduct a face to face with the CEO, Dr. and or the board chair. They cannot address our concerns unless we make them known. It is our future healthcare in the county we are talking about and the patient must be at the center of the concern. Attend the next hospital board meeting. The agenda is published before hand in the Memphis Democrat.

In the mid nineteen hundred a push was on for all small rural hospitals to go strictly regional at that time I put some personal appeals to paper and I think they are equally sound today.

Sincerely, Brenda Wilson, R.N.

Scotland County Tax Payer

“Dear Brother and Sister Bigger 1900-2000”

I have long envied your vast wealth of knowledge. I’ve marveled at your halls teeming with new technology and been ever grateful when you have reached out with understanding compassion transcending miles to help hold the reaper at bay outside my door rather than let him snatch one more life from my grasp.

You have been a source of strength and hope in the heat of many battles although the lines are drawn on different fronts. You, constantly seeing newer, better,  bigger, Ever stalking the elusive cure. Me providing my best with a familiar face, a gentle touch and at times standing between life and death that you might have the opportunity to further diagnose, treat and cure. Both of us pursuing health for our fellow man.

Today I stand with gloved hands at my throat and scalpel to my back. You, my mentor daring me to presume I might stand independently doing that which you’ve taught me and given me the means to do. I must ask you why? Is it numbers or dollars? Has our relationship degenerated so far, our focus on the cause become so dim that you would allow an outsider, someone not even in our battle, to convince you to mercilessly slay a smaller sibling and willingly sacrifice those who would not survive to reach you without me.

I would that the hands at my throat might once again be my strength and the scalpel at my back might swiftly and clearly sever the strings of greed and bureaucracy that puppeteer you so we might stand united again, each in our own field of battle, fighting against ignorance, pain, disease and death.

Hopefully your Comrade,

A Small Rural Hospital

Brenda Wilson, RN