Political drama involving a rural Georgia county reflects how state regulations that govern when and where hospitals can be built or expanded are evolving.

Rural hospitals sometimes look for lifelines through consolidation with big city hospitals. Now a couple of rural hospitals in Middle Georgia are trying a grassroots approach emphasizing local ownership. And, they say, it’s working. 

Recent publications point to differing estimates of how many hospitals are at risk, but consider ownership, profitability and debt as contributing factors.

A feasibility study underway will help decide the new model for the facility. Randolph County lost its only hospital in 2020 after decades in operation. 

By converting to a Rural Emergency Hospital, existing rural hospitals commit to changing their model of care, with a focus on emergency medicine, in exchange for subsidies from the federal government.

Georgia senators voted to allow new hospitals to be built in counties with fewer than 50,000 residents without state permission. The measure is particularly aimed at allowing an undisclosed entity to build a new hospital in the home county of Republican Lt. Gov. Burt Jones.

According to a Georgia Department of Public Health report, Georgia had the 12th-highest stroke death rate in the U.S. in 2020. With 4,821 deaths, it was the fourth-leading cause of death that year. And racial disparities are not the only issue making Georgians more vulnerable to stroke. A glance at the map of hospitals participating in the stroke registry shows wide gaps across parts of the state that are distant from big cities.