Martin General Hospital closure sparks efforts to establish NC's first rural emergency hospital

Emergencies are unavoidable.

Responding to them in rural areas already presents unique challenges: weather, terrain, and available resources.

Take away an area’s sole hospital and the ripple effects of a lack of care will quickly stretch beyond county lines.

Michael Peaks, chief of the Williamston Fire-Rescue-EMS, has spent his career doing his best to prepare for the many unknowns of an impending 911 call.

“Our job, our business is, ‘What if?’” said Peaks.

Peaks and his staff are now having to navigate unchartered waters after the area’s only hospital closed last year.

Martin General Hospital abruptly shut its doors in August 2023.

Torn signs and chained entrances now notify people that care is unavailable. The hospital’s website points patients toward ECU Beaufort, 22 miles south.

Williamston Mayor Dean McCall still remembers hearing the news while working as a physical therapist in the hospital at the time.

“Quorum Healthcare was operating the hospital at the time,” McCall said. “On August 3rd at 8:30 a.m., they came in, had a meeting with the staff there and let us know they were filing bankruptcy and shutting down the hospital. They literally closed off the entrances and the emergency department at 10 a.m.”

McCall said it was a scramble to relocate doctors and patients while the remaining staff worked to find new roles elsewhere.

The area is served by 5 fire & EMS departments. Peaks said not having the option of Martin General isn’t just an inconvenience to his team, but to first responders throughout the region.

“Without Martin General not being an option that has certainly increased our patient-contact time.” Peaks said. “Prior to Martin General closing, our average transport time was 5 minutes 38 seconds. Today, our average transport time is 19 minutes 56 seconds.”

The Chief said he’s thankful the increased travel time hasn’t resulted in a major increase in negative outcomes.

He also shared the county provided some additional funding which the department used to increase staffing from 18 to 25. He noted his staff has handled the challenge well and said calling on air support from ECU Medical Center and UNC Health in Rocky Mount is another tool that may need to be used more often.

“Seconds do count in our job and our profession so yes it’s a concern and continues to be a concern,” Peaks said.

When asked what the best-case scenario would be, he responded: “It’s a plea to reopen.”

He also added, “And we have to think about our travel. We have Highway 64 and Highway 17 that run through our area, people are traveling through the Outer Banks, etc. We want those travelers and those visitors to have the same access to healthcare as our citizens do.”

The worst-case scenario is also one Yancey Warren is concerned about.

“It really kind of makes you sick to the gut because you’ve got nowhere to go, you’ve got no support,” said Warren.

Warren spotted a WRAL crew filming the exteriors of Martin General Hospital on one of his many drives on the stretch of road near the facility.

He told crews he hoped they were there to bring the good news of the hospital reopening its doors.

“As a patient, it’s kind of scary because your life-threatening issues could be within minutes,” he said. “You’ve got to then go to Greenville or Edgecombe or wherever you’ve got to go, and every minute is part of your life you could be losing.”

County Attorney Ben Eisner shared efforts are underway to bring good news to residents like Warren.

The county and state are looking into the possibility of reopening Martin General as a Rural Emergency Hospital (REH).

The designation would allow for the emergency room to reopen and re-establish immediate care, so long as the average patient stay doesn’t exceed 24 hours.

“The question is how do we go from a closed facility to an open facility in this REH designation,” explained Eisner.

If Martin General reopens as a REH, it would be the first of its kind in the state. It would also mark a first in the country as no hospital has ever closed entirely before reopening as a REH.

 “I characterize it as a real opportunity to reimagine what healthcare in a rural place like Martin County would look like for the next fifty years,” said Eisner. “It’s both a tremendous challenge and a real opportunity that we face.”

The UNC Cecil G. Sheps Center tracks hospital closures and REH conversions nationwide. It reports the model has been used more than 30 times throughout the country to allow some level of care to remain in rural areas.

Eisner shared there are still many questions left to figure out before it will be known if the doors will truly reopen.

“The building there has a long lifespan dating back to the 70s and it’s been built on in different ways,” he said. “Understanding what the state and federal regulators will allow to be in there, what requirements may be needed in terms of upfitting or modernizing or just maintaining, and what those things are going to cost. It’s all kind of a first step for understanding for potential providers and the county what can go into that space.”

Eisner shared it is unclear how much of the building could reopen if Martin General receives a REH designation.