Perception of Administrators at Independent Hospital Regarding Stabilty

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to do with financial challenges. In an attempt to illustrate the reasons why Fallbrook hospital was closed, Sisson (2014) asserts that small hospitals will continue to close because they are confronted with financing problems. In the case of Fallbrook, for example, it had been facing massive losses for the previous years leading up to 2013 where it could no longer sustain the ever-increasing overhead costs. Essentially, the hospital, which had a 47-bed capacity, was no longer able to admit patients because they could not collect enough money to sustain the operations of the hospital. Consequently, the board had no option but to begin the process that would lead to the eventual closure of the facility. Miller (2016) underscores this position regarding troubled small independent hospitals in South Carolina and Georgia that will close the institutions altogether.

The report “California’s Closed Hospitals” (2001) authored by Nicholas C. Petris Center on Health Care and Consumer Welfare at the University of Columbia, Berkley, advances the argument that the closure of 23 hospitals that occurred between 1995 – 2000 is heavily linked to the financial challenges that these healthcare institutions faced on a massive scale. Incidentally, the report revealed that a majority of the hospitals closed were profit-making institutions and yet they were located in the urban centers. Central to the closures was related to the reduction of income that these institutions received per bed. Furthermore, the hospitals witnessed a marked reduction in the reimbursements from the Federal government, which was a major source of their profit since the money was received as a block when all other expenses had already been incurred.

Current and Specific Research Findings

Gugliotta (2015) argues that while cutting back on reimbursements is straining the financial expectations of hospitals, the major contributing factor is that the law now states that payments should be reduced, especially for hospitals that cater for the uninsured population. Essentially, the Federal government’s argument is that the Affordable Care Act is meant to make it possible for the bulk of the uninsured people to get access to quality and affordable care. Therefore, Federal government is working towards expanding Medicaid programs to reach such medical institutions. Consequently, small and independent hospitals in several states refused to abide by such requirements and that has heavily affected their financial positions. The most outstanding conclusion in the findings is that while hospitals are established with the aim of providing adequate, quality, and timely healthcare services to the citizens, some of these institutions have objectives of making financial gains. In the event that the finances are no longer viable because such institutions were more inclined to commercial interests, the small hospitals will be forced to close shop because the business is no longer profitable and, therefore, cannot sustain themselves. That is also compounded by the fact that there are many other reasons that drive down the anticipated profit margins for these small hospitals including reduced patient populations, the inability to offer specialty treatment services, and the need to pay doctors before other budgets are put into consideration. The biggest consequences of such closures are that it deprives off communities services that they knew that they would easily obtain from a nearby health facility. The residents are thereby forced to seek healthcare from other facilities, which, in this case, could now be located many miles away. The California Health Association (2014) asserts that the trend of small independent hospitals closing will continue to occur because these institutions receive very low and unfavorable reimbursements for Medicare and Medicaid. Usually, the amount of reimbursements is so small that it cannot be sufficient revenue generated to meet all the costs of treatment for patients. Furthermore, Demko (2015) outlines the numerous numbers of rural hospitals that had been closed from 2010 to the end of 2014 across the nation and the statistics are not only worrying, but they are startling. For example, 51 hospitals had closed between 2010 and 2014, as a result of serious financial challenges. In addition, he cites the projection of the National Rural Health Association, which states about 283 hospitals across the country are most likely to close because of serious financial problems, which makes it impossible for them to continue operations. Ellison (2015) conjures the same analysis by providing a comprehensive listing of all the hospitals that have been closed in 24 states beginning from the year 2010. This is a very tough indictment on the state of financial situation of the small independent hospitals. As stated, the verdict points to the fact that the closures will continue to escalate.

Technology plays a very critical role in healthcare reform, especially in respect to patients’ access, delivery of quality care, and even the possibility of reducing the cost associated with accessing care. Unfortunately, many benefits that technology brings to the health care industry have a very big cost implication in terms of the investments required to have hospitals install these new technologies. Technology involves installation of systems that are capable of storing and transmitting electronic records, and this is critical because it helps different doctors to easily and seamlessly share information about their patients making it possible to make effective diagnoses. Other technological features include very effective financial systems, online systems to make appointments for the physicians by the patients, and even systems to follow up on discharged patients. Clearly, technology is a gateway to efficient and timely delivery of care. However, small independent hospitals cannot afford the colossal amounts of money required to install and set up all these systems (Sission, 2014). Furthermore, they do not have the funds to hire experts who will run and manage these systems, hence creating another extra cost on their already meager resources.

There has been a marked improvement in the type of medical equipment used to aid in the diagnosis and general delivery of care all over the world. Essentially, hospitals are required to procure these equipment and have them within their facilities. At the same time, some of the equipment need full-time specialized staff who will manage them. However, since the small independent hospitals do not have the financial might to buy these state-of-the-art equipment and even hire staff to manage them, it becomes difficult for these hospitals to enhance treatment of their patient. At the same time, these equipment need continuous service, repair, and maintenance, this in itself is an expensive