Mississippi Today
Mississippi has more rural emergency hospitals than any other state. Can the ‘lifeline’ program save rural health care?
Mississippi has more rural emergency hospitals than any other state – and there could be two more on the way soon.
Some have hailed the federal designation, created in 2023, as a lifeline for struggling rural hospitals at risk of closure. Others say it forces hospitals between a rock and a hard place.
Rural emergency hospitals provide 24-hour emergency and observation services, and can also opt to provide additional outpatient services. But the program comes with a catch.
Hospitals must close their inpatient units and transfer patients requiring stays over 24 hours to a nearby facility. In return, hospitals receive $3.3 million from the federal government each year.
Rural emergency hospitals in Mississippi currently include Jefferson County Hospital in Fayette, Progressive Health of Batesville, Perry County General Hospital in Richton, Sharkey Issaquena Community Hospital in Rolling Fork and George County Hospital in Leakesville.
Progressive Health of Houston and Smith County Rural Emergency Hospital in Raleigh, a new department of Covington County Hospital established in collaboration with South Central Regional Medical Center, also intend to apply for the status.
Nationwide, 29 hospitals have received the designation, according to Centers for Medicare & Medicaid Services enrollment data. Over half of them are located in the Southeast.
State Health Officer Dr. Daniel Edney last year likened conversion to a rural emergency hospital to a closure because of the corresponding loss of medical services.
Quentin Whitwell, the founder and CEO of Progressive Health Group, said that in his experience, the designation has provided increased sustainability and financial viability for hospitals that have adopted it.
Progressive Health Group owns and manages six hospitals in Mississippi, Georgia and Arkansas, over half of which are rural emergency hospitals or plan to seek the designation. The organization previously served as a consultant for Jefferson County Hospital.
“A lot of people saw it as a place where hospitals would go to die. We, on the other hand, saw an opportunity for expanding ancillary and outpatient services and utilizing the federal subsidy to grow those hospitals,” he said.
He said the model has strengthened access in some areas to outpatient services like general surgery, gastrointestinal and primary care and specialty doctors.
Inpatient services are “the drag on small rural hospitals,” he said.
In Mississippi, 37% of hospitals are facing immediate risk of closure, according to a recent report. 52% face some risk of closure and 64% have experienced losses on services.
Nearly 200 hospitals have closed nationwide since 2005. Many of these hospitals had low patient volumes and revenues that were insufficient to cover their costs, said George Pink, deputy director of the Rural Health Research Program at the University of North Carolina.
The rural emergency hospital was designed to offset the financial challenges of running an inpatient unit, which is costly because it requires 24-hour-a-day nursing care, along with administrative and dietary departments, regardless of patient volume, he said.
“They’re not a model of health care for every rural community, they’re not a panacea for rural communities. They really are targeted at very small communities that are at risk of losing their inpatient hospitals,” he said.
Sharkey Issaquena Community Hospital converted to a rural emergency hospital after a tornado destroyed the hospital in March 2023. Board Attorney Charles Weissinger said the program made sense given the hospital’s circumstances, but noted that “it’s not the salvation for rural medicine.”
Pink said that among communities that have experienced hospital closures, emergency services are considered one of the most significant losses.
Progressive Health of Houston intends to apply for rural emergency hospital status to meet that need. The hospital reopened its emergency department in May after a decade without emergency services in Chickasaw County. Whitwell said that last December and January alone, the county saw 10 cardiac deaths out of a population of 17,000.
Without the ability to provide inpatient services, hospitals may have to give up valuable services, like an intensive care unit or obstetric services.
Though rural hospitals are allowed to provide obstetric services, “it’s not realistic for the reimbursement model,” said Whitwell.
Irwin County Hospital in Ocilla, Georgia, a Progressive Health Group facility, continued providing obstetric services after becoming a rural emergency hospital, but was forced to close the unit after just four months.
David Culpepper, spokesperson for Smith County Rural Emergency Hospital, said the new facility will provide emergency care to the area for the first time in two decades. This is possible by eliminating the cost of inpatient care, he said.
The hospital will offer “strictly emergency services with a full-on suite of imaging … and radiological services along with a fully functioning lab,” said Culpepper.
It will be located at the former Patient’s Choice Medical Center of Smith County, which closed in 2023.
Pink, who studies health care finance and rural hospitals at the University of North Carolina, said because the rural emergency hospital program is just over a year old, it’s too soon to say whether the designation helps hospitals surmount their financial challenges.
Several changes to the law could make the program more appealing to struggling hospitals, he said, like allowing facilities to participate in the 340B Drug Pricing Program, which requires pharmaceutical companies to provide outpatient drugs to certain hospitals at reduced prices.
Whitwell said he would like to see the program allow hospitals to operate inpatient psychiatric units and to shore up its definition of “rural.”
Republican Rep. John Lancaster of Houston proposed a bill this year to allow rural emergency hospitals to license psychiatric inpatient beds as a separate entity as a workaround to the federal regulations. The legislation did not make it out of committee.
Less than a year after Alliance HealthCare System in Holly Springs received rural emergency hospital status, the Centers for Medicare and Medicaid Services rescinded the designation, arguing that the hospital is too close to Memphis to be deemed rural.
As a result, the hospital closed its emergency room in April and began the process of becoming relicensed as an acute care hospital.
Harold Miller, the director of the Center for Healthcare Quality and Payment Reform, said the rural emergency hospital program poses a “problematic choice” for hospitals by forcing them to eliminate inpatient services in order to receive subsidies from the federal government.
“There is this narrow, narrow window in which a hospital actually could benefit, and then an even smaller window of the hospitals that could benefit that are willing to do what is necessary in terms of closing services to be able to qualify,” he said.
He said his research shows that hospital closures would be better prevented by ensuring that insurers pay hospitals adequately for their services. Because rural hospitals often have limited administrative resources, they are often not able to combat claims that are contested by insurance companies, he said.
“We need to be fixing that,” he said. “…We are letting the private insurers off the hook.”
This article first appeared on Mississippi Today and is republished here under a Creative Commons license.
Mississippi Today
On this day in 1867
Nov. 23, 1867
The Louisiana Constitutional Convention, composed of 49 White delegates and 49 Black delegates, met in New Orleans. The new constitution became the first in the state’s history to include a bill of rights.
The document gave property rights to married women, funded public education without segregated schools, provided full citizenship for Black Americans, and eliminated the Black Codes of 1865 and property qualifications for officeholders.
The voters ratified the constitution months later. Despite the document, prejudice and corruption continued to reign in Louisiana, and when Reconstruction ended, the constitution was replaced with one that helped restore the rule of white supremacy.
This article first appeared on Mississippi Today and is republished here under a Creative Commons license.
Mississippi Today
Crystal Springs commercial painter says police damaged his eyesight
CRYSTAL SPRINGS – Roger Horton has worked decades as a commercial painter, a skill he’s kept up with even with the challenge of having what his wife has called “one good eye.”
It hasn’t stopped him from being able to complete detailed paint jobs and create straight lines without the help of tape. But last year following a head injury, he and others said people have been pointing out a change in his work. Horton says the sight in his right eye is clouded, like he is looking underwater.
Affected vision, short term memory and periods of irritability – potential symptoms of concussion – followed after he was arrested last September. During an encounter with several police officers, Horton alleges more than one slammed his head into a cruiser and placed handcuffs on so tight that he started to bleed.
“(The officer) was kind of rough with me and all, and he takes my head and I said, ‘What’d I do?’” he recalled recently.
Horton ended up being convicted of two misdemeanor charges and has paid off the fines, but a year later he still has questions about the arrest and treatment by the police.
To date, he has not seen a doctor to evaluate his eye and check for vision or cognitive issues. Horton and his wife Rhonda don’t have a car, and transportation to doctor’s appointments in the Jackson area remains a challenge.
The Hortons have lived in Crystal Springs all their lives, and they have lived in the home the past five years that belonged to Rhonda’s mother.
More than a quarter of all people in Crystal Springs live below the poverty line, and that includes the couple. Rhonda Horton said it’s hard to make a living because there aren’t a lot of jobs, but they support themselves as painters.
That’s how they met Yvonne Florczak-Seeman, who lived in Illinois and purchased her first historical property in Crystal Springs in 2019. She splits her time between the two states.
“We painted that porch bar and the rest is history,” Rhonda Horton said, adding that they went on to complete detailed work on mantles, kitchen cabinets and a cigar room at Florczak-Seeman’s North Jackson Street residence.
Over the years, the couple built a relationship with Florczak-Seeman, who is seeking to open a women’s empowerment center called the Butterfly Garden, in the building next to city hall.
Florczak-Seeman has supported the couple numerous times, including helping them pay a late water bill and offering them work. She called them talented painters and hired them again to paint the interior of the future center, located at East Railroad Avenue.
In pieces, Rhonda Horton told Florczak-Seeman about her husband’s arrest and later the injuries she said he sustained from it. Florczak-Seeman had questions about the encounter and other potential injustices at play, so she offered to help.
“I just want them to pay for what they’ve done not just to him, but everybody,” Rhonda Horton said. “That’s what I want, justice.”
The Arrest
On Sept. 24, 2023, Horton was walking home from a friend’s house when officers approached him. One grabbed his arms to handcuff him, and he remembers them cutting his wrist and causing it to bleed.
Then, he said, a second officer slammed his head into the top of the police car, followed by another officer who slammed his head again. During the encounter, a bag of marijuana that Horton said he found fell out of his pocket onto the ground.
An officer put Horton in the back of the cruiser and took him to the station where Horton asked to speak to the police chief and call his wife. He said the police took his phone and clothes.
Afterward, he was taken to the Copiah County Detention Center in Gallman.
Police Chief Tony Hemphill disputed Horton’s allegation of mistreatment, saying he did not sustain any injuries that required hospitalization. He said Horton’s wrist was cut while he resisted arrest.
“He was not brutalized and targeted,” Hemphill said. “If he had just complied, he wouldn’t have had to come up there (to jail) that night.”
Two police reports from the night of the September 2023 arrest detail how officers had responded to a possible assault and were given the description of a white man. While in the area, they encountered Horton — the only person who fit that description.
Hemphill said a mother called police after her daughter told her she was assaulted. He said officers approached Horton on the street and tried to talk with him to rule him out as a suspect.
That’s when Horton began “fighting, pulling away, and kicking against (the officer’s) patrol vehicle, trying to run,” according to a police report from the night and Hemphill. Horton denies doing any of that.
The next day police took Horton from the county jail to the Crystal Springs police station. There, police informed him a teenage girl reported being assaulted. After learning about the assault allegation, Horton remembered feeling shocked and saying it couldn’t be true because he was not on the street where the alleged incident took place.
Hemphill confirmed the police investigated the assault allegation and found it not credible, meaning Horton wouldn’t face any related charges. He said he communicated this to Horton and his wife early on and since then, which the couple disputes.
As Horton was being arrested and detained, his wife grew worried because she had just spoken with him on the phone and expected him to arrive home shortly. Rhonda Horton and her adult son started calling Roger’s phone, each not getting an answer.
Then during one of the calls by her son, someone who did not identify himself answered Roger’s phone and said, ‘Your daddy’s dead’ and then hung up, Rhonda Horton said.
She was starting to assume the worst had happened. Rhonda Horton wouldn’t have confirmation her husband was alive until he called from the county jail in the early morning.
The next morning as she talked with the police chief, Rhonda Horton asked the chief about who answered the phone and told her son that Roger was dead. The chief told her the person who answered must have been from the county.
Hemphill later told Mississippi Today that he did not know about the call and that type of behavior by his staff “is not going to be tolerated.” Similarly, Copiah County Sheriff Byron Swilley said he had not heard about it and could not say whether a member of his department made the comment to Rhonda and Roger Horton’s son.
A Sept. 25, 2023, citation signed by Hemphill, shared with Mississippi Today, summoned Roger Horton to municipal court for the misdemeanor charges of possession of marijuana and resisting arrest and directed him not to have contact with the alleged victim in the assault case. No contact orders are typically for cases such as domestic violence and sexual assault and they are set by a judge.
LaKiedra Kangar, who works in municipal court services, said the no contact order was put in place because of the assault allegation. She confirmed Horton was not charged with the offense following the police department’s investigation of the allegation.
Weeks passed. Roger Horton went to court for the misdemeanor charges, to which he pleaded guilty. Felony assault charges were not part of the hearing. Municipal Court Judge Matthew Kitchens ordered Roger to pay over $900 in fines for the misdemeanors.
Horton was able to pay for some of the fine through at least 10 hours worth of court-ordered community service, which he said involved painting buildings for the city.
Months later after learning about Horton’s arrest and how he said the police treated him, Florczak-Seeman said she wanted to know more. Horton didn’t have access to his arrest documents, so she accompanied him and his wife to the police department to ask for them.
The first visit, Horton asked but did not receive the arrest report. Florczak-Seeman asked if he had a fine for any of the charges, which police said Horton did even after completing some community service hours. Florczak-Seeman paid for the remaining balance and had him work for her for two days to pay that off.
This year, they went to the police department a second time so Horton could ask for his arrest paperwork. An officer told him he didn’t need it and that the rape allegation had been investigated and found not to be credible, Horton told Mississippi Today.
Florczak-Seeman asked why Horton couldn’t receive the report. She said Hemphill asked if she was Horton’s attorney, and Florczak-Seeman clarified she was his representative.
The chief left for a few minutes and returned with two pieces of paper and handed them to Horton. Hemphill told Mississippi Today he did not recall whether he was the one who handed the report to Horton.
Florczak-Seeman took the document from Horton and began to read it as they stood in the lobby. She said she was horrified to see the name of the alleged, underage victim and her address in the report.
Hemphill said the victim’s personal information should have been restricted and not doing so was an oversight.
After reading the report, Florczak-Seeman went down the street to the mayor’s office at city hall to explain what happened, and how she believed the mayor had grounds to fire the police chief because he provided that document to Roger with the alleged victim’s information.
Mayor Sally Garland confirmed she had a conversation with Florczak-Seeman about the police chief’s employment.
She said she reviews all complaints about city officials, and Garland said she goes to the department head to get a better understanding of the situation. If she determines there are potential grounds for termination, a hearing would be scheduled with the Board of Aldermen, and the group would vote on that decision.
Garland did not find grounds for termination, and Hemphill remains police chief.
A Strange Visit
The Hortons and Florczak-Seeman hadn’t given much thought about the 2023 arrest, until weeks ago when a teenaged girl suddenly showed up in Florczak-Seeman’s yard.
At the end of September at the North Jackson Street home, Florczak-Seeman heard screaming and found the teenage girl who came onto her property. She asked what was wrong, and the teenager said she was chased by a dog, which Florczak-Seeman and Rhonda Horton did not see.
The teenager asked for a soda, and Rhonda Horton went inside to get one. Florczak-Seeman asked where the teenager lived, and she gave an answer that Florczak-Seeman said conflicted with what two girls who were standing nearby on the public sidewalk said she told them.
Then Florczak-Seeman asked the teenager’s name and recognized it as the name of the alleged victim on Horton’s arrest record. Immediately, Florczak-Seeman said she turned to Horton and told him to stay back, and she told the teenager to get off her property, which she did.
At the moment, they were not able to verify whether the teenager was the alleged victim from the report. Neither the Hortons nor Florczak-Seeman had seen her before, and they only knew her name from the arrest report.
“That didn’t make sense at all,” Rhonda Horton told Mississippi Today.
Florczak-Seeman called 911 to report the situation and ask for police to come, which they did not. Hemphill told Mississippi Today a dispatcher informed him about the call with Florczak-Seeman, including details with the teenage girl and how she wanted to report the girl for trespassing.
Florczak-Seeman is one of the people who have noticed a difference in Horton’s vision. It’s clear when comparing the detailed and clean paint job Roger completed at her Jackson Street property in 2019 and the center where he painted last year.
During an interview at the center in October, Florczak-Seeman pointed to the ceiling and noted spots that Horton did not paint. She remembers telling him about them and realized that he couldn’t see them.
“The spots on my ceiling are still not painted, and they’re not painted as a reminder of the injustices that happened in this situation and why I got involved,” Florczak-Seeman said.
This article first appeared on Mississippi Today and is republished here under a Creative Commons license.
Mississippi Today
Job opening: Jackson Reporter
Mississippi Today, a Pulitzer Prize-winning newsroom focused on investigative and accountability journalism, is building a dedicated team of reporters to provide in-depth coverage of Jackson, Mississippi.
As the state’s largest and capital city, Jackson matters greatly to us and all Mississippians. Launched in 2016 as the state’s flagship nonprofit newsroom focused on Mississippi government and policy, Mississippi Today is focusing our lens beyond the statehouse and to the city of Jackson, serving our readers with the watchdog reporting they’ve come to expect from Mississippi Today. Our newsroom, with a proven record of providing impactful government accountability, aims to serve the city more directly with this team.
Our Jackson team will focus on sharp investigative reporting, watchdog accountability journalism and meaningful cultural storytelling. We aim to both elevate the voices of those working for positive change in the community while offering a balanced perspective on the city’s obstacles and triumphs. Our goal is to deliver impactful, honest journalism that will inform, inspire and empower Jackson’s citizens.
The team will be led by Pulitzer Prize winner Anna Wolfe, an investigative reporter with a decade of experience covering Jackson.
Roles and Responsibilities:
- We are purposefully casting a wide net, hoping to connect with journalists of many different backgrounds who may be uniquely qualified to help us launch this team. If you’re a reporter with any of the following experience or attributes, this team may be for you.
- Investigative reporting focused on uncovering systemic issues within government and politics. The bigger the impact of your reporting on government leaders or systems, the better.
- Political reporting covering not only high-profile candidates for offices, but experience delving into issues and ideas that affect a community. We hope to delve deeply into a deep distrust in the city’s institutions.
- Cultural reporting that highlights the often-overlooked success stories of citizens who are making a positive impact on their communities.
- Strong understanding of Jackson (or similar large urban centers) and the unique challenges facing the city and its residents.
- Commitment to the mission of balanced, impactful journalism that centers and respects the voice of the community.
- Collaborative mindset and ability to work within a team-oriented newsroom.
The starting salary for this position is $58,000. Compensation is commensurate with experience level.
Expectations:
- Work with a small team of journalists who are focused on social inequities and racial equality in our area.
- Willingness to collaborate closely with a small team of like-minded journalists.
- Get people to talk, find willing sources and protect them while telling sensitive and timely stories.
- Build trust: Many people who have been impacted by inequities in Mississippi have been victims of predatory practices and forces. This will require empathy, patience and savvy.
- Work with our Audience Team and data and visual journalists to create compelling story presentations.
Qualified candidates should have:
- Experience working as a reporter in a newsroom.
- Ability to work quickly, with accuracy and good news judgment.
- Comfortability in digital or multimedia journalism spaces.
- Ability to independently develop and cultivate sources.
- Ability to use social media for research and to engage readers.
What you’ll get:
- The opportunity to work alongside award-winning journalists and make significant contributions to Mississippi’s top nonprofit, nonpartisan digital news and information sources.
- Highly competitive salary with medical insurance, and options for vision and dental insurance.
- Use of appropriate technology and equipment.
- 29 days paid time off.
- Up to 12 weeks of parental family leave, with return-to-work flexibility.
- Simple IRA with 3 percent company matching. Group-term life insurance provided to employees ($15,000 policy).
- Support for professional training and attending industry conferences.
How to Apply:
We’re committed to building an inclusive newsroom that represents the people and communities we serve. We especially encourage members of traditionally underrepresented communities to apply for this position, including women, people of color, LGBTQ people and people who are differently abled. Please apply here.
This article first appeared on Mississippi Today and is republished here under a Creative Commons license.
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