A little over two years ago, a piece of paper was taped to the front doors of the Jellico Regional Hospital near the Tennessee-Kentucky state line.
“The hospital is currently on diversion and will be closing the hospital and emergency room,” the paper read.
For many locals, it came as a shock. Beldon Stanaford says he knew for several years that the 25-bed hospital was struggling, but didn’t expect its closure to be so sudden.
“It was open one day,” he said, “and it was closed the next.”
Stanaford’s wife, Debbie, said she had been in the hospital just a handful of days earlier.
“I have a tumor on my back, and I was there right before [it closed] and was taken care of,” Debbie said. “It was a great hospital then, and it’s very sad that it’s closed now, because we need it.”
The Jellico Regional Hospital has now been closed for over two years. In that time, this former coal mining town has courted a handful of companies who have expressed interest in reopening its sole hospital, only to pull out at the last minute. For many locals it’s become a controversial topic that prompts embarrassment or outrage, and is best avoided when speaking to strangers.
When a rural hospital closes, it disproportionately harms people with low-income who often rely on government-subsidized health insurance and who may not be capable of driving hours away for care.
The Cecil G. Sheps Center for Health Services Research at the University of North Carolina says at least 153 rural hospitals have closed since 2010 as they become less and less profitable. Tennessee has the most closures per capita, with 14.
There are federal subsidies to help rural communities keep their hospitals afloat, but Jellico remains ineligible. It doesn’t help that the building has fallen into a state of disrepair and the town remains committed to charging operators for the privilege of running its hospital.
For now, the town is getting by without the hospital. The Stanafords still see local doctors and get their prescriptions filled at a nearby pharmacy. But they say the lack of access to an emergency room or inpatient services makes their lives more difficult.
“We need our little hospital here,” Debbie said. “There’s so many sick people here — elderly people here — that need a close hospital that don’t have transportation to go an hour away.”
‘As a capitalistic endeavor, it just doesn’t work’
Perhaps the most substantial hurdle Jellico faces is the fact that a 2,000-person community just doesn’t provide enough business to sustain a regional hospital.
Local newspaper editor Robby O’Daniel says this is ironic, because there’s plenty of local demand for a hospital.
“Practically everybody in Jellico wants the Jellico hospital to be back, but there’s just not enough people to sustain a hospital like that,” he said.
O’Daniel has been covering the hospital’s troubles for the LaFollette Press since 2021, when it briefly closed for the first time under Rennova Health’s leadership. Boa Vida Healthcare took over later that year, reopening the emergency room for a few years until they shut down for good. O’Daniel says it’s all about the money.
“It seems purely as a capitalistic endeavor, it just doesn’t work,” O’Daniel said “There’s just not enough people in Jellico.”
In 2024, the hospital posted a loss of roughly $14 million in the first quarter under Boa Vida. Local minister Benji Johnson says he remembers those days, when supplies stopped showing up to the hospital because it was losing so much money. He worked in a variety of roles there beginning in 2011, from chaplain to supply manager.
“They did try to keep the hospital going, they did try to keep jobs going,” Johnson said. “I think their back was up against the wall so they just turned around and decided to shut this place down.”
In 2022, the Biden administration had attempted to address the deepening crisis of rural hospital closures in the United States by introducing new benefits for providers through the federal medicare and medicaid programs.
If hospitals met certain criteria they would net an extra 5% from the federally-subsidized health insurance, which could make a huge difference in a hospital’s bottom line.
Jellico meets all but one criteria: the federal government doesn’t consider the town to be rural. Instead, O’Daniel says, the small town and several surrounding communities get lumped into the Knoxville Metropolitan Area, making them ineligible for the benefit.
“And I think that boggles everybody’s minds,” O’Daniel said. “A big aspect of everybody’s issues with getting the hospital situation to work has been being able to get that rural emergency health designation, and that way they would get federal funding to be able to make the finances work.”
A building in need of repair
In addition to the federal bureaucracy, the hospital is becoming less attractive to operators the more time passes. The 52-year-old building is going to need a lot of work before it can be used again, eating into a potential operator’s profits. Plus, the city wants to charge operators about $10,000 per month in rent for the privilege of running the hospital, despite the repairs it needs.
The sprawling, single-story brick building hulks near the center of town, largely untouched from the day it closed. Wheelchairs are scattered haphazardly in the lobby. The hospital’s 25 beds remain in place, ready for patients. The only signs that something is off here is a single strip of caution tape blocking the entrance to the parking lot, and the sign still taped to the door announcing its closure.
Johnson says he drives by from time to time, reminiscing about his years working there.
“I loved helping people, being able to talk to them, praying with them,” Johnson said. “If you really needed an ER, right here was the place where they could get help.”
When Boa Vida Healthcare shut down the hospital in 2024, Johnson was briefly kept on as a groundskeeper. He trimmed the trees and hedges and kept an eye on the building to make sure it wasn’t falling into disrepair. But after they pulled out of the community for good a few months later, he says there’s nobody left to take care of the place.
“When I was here, I kept everything checked on,” Johnson said. “Now, water pipes is busted, ceiling tiles are falling down … you got wallpaper that’s peeling off the walls.”
That’s because the city isn’t keeping the building heated in the winter or cooled in the summer, Johnson says.
“If you don’t take care of a hospital or a building, that’s what happens.”
‘Distinct challenges’
Locals say Jellico Mayor Sandy Terry doesn’t want to talk about the details of the hospital’s ongoing closure. The mayor used the hospital as a major talking point during her 2022 campaign, telling the LaFollette Press she wanted to improve Jellico’s ambulance service and “work toward the hospital.”
“I really, honestly had high hopes for the mayor,” said Debbie Stanaford. “I really did, about opening the hospital and just doing different things for our town. … It’s let me down a little bit.”
For this story, WUOT News reached out to Terry several times by phone, email and social media beginning in March. An unsuccessful attempt was made to reach her in-person at the Jellico Municipal Building, where city employees said the mayor was part-time and only worked one day a week.
At a town planning meeting, Terry told WUOT News she was interested in being interviewed about the hospital, but she still did not return phone calls or emails.
“I’ll return calls that I get here, but news people I don’t call,” Terry said.
The mayor did add that she is working with U.S. Senator Marsha Blackburn’s office to re-cast Jellico as rural in the federal government’s eyes so that its hospital will be eligible for the Biden-era subsidies.
In response to a request for an interview about Jellico’s hospital, Blackburn’s office emailed a statement boasting of the Republican gubernatorial candidate’s bills aimed at making rural healthcare more accessible.
“Every rural hospital serves a unique patient population with distinct challenges, which is why I have supported investments in infrastructure …,” the statement reads. “Additionally, this last year I led passage of the $50 billion Rural Health Transformation Program, which will yield more than $1 billion for health care providers across Tennessee over the next five years.”
The Stanafords say they’re frustrated with the lack of attention the federal government is giving their community.
The faded paper sign still clings to their abandoned hospital’s doors, pointing them to the nearest emergency rooms: a Tennova hospital in LaFollette or Baptist Health in Corbin, Kentucky. Each is about 30 minutes away by interstate. But if people need the care of a specialist, many face an hour drive to Knoxville.
“When you have somebody really sick and you realize that calling an ambulance or putting them in a car is still going to result in an hour one way before a medical professional can even look at them,” Beldon said. “That’s a scary thing.”
On Air - 90.3 WPLN-FM