Ecu Health’s Plan To Reopen Hospital Offers Hope To Martin County

By Jaymie Baxley

Dexter “Drew” Batts, nan authorities head for Martin County successful eastbound North Carolina, often thinks astir nan nighttime his adjacent puerility friend suffered a bosom onslaught successful 2025.

The friend, a 39-year-old female who was a personnel of Batts’ precocious schoolhouse graduating class, lived conscionable 9 miles distant from Martin General Hospital. Generations of section families successful this rural, economically distressed organization had relied connected nan infirmary for emergency attraction since its founding successful 1950.

But Martin General wasn’t an action that evening. The 43-bed installation had closed successful August 2023. Owner Quorum Health blamed nan shutdown connected “financial challenges related to declining organization and utilization trends.”

Batts’ friend was alternatively transported to an emergency section astir a half-hour northeast successful neighboring Bertie County. When nan doctors location couldn’t thief her, she was taken astir 40 miles southwest to ECU Health Medical Center successful Pitt County.

She died location aft spending 3 days connected life support.

“Who’s to opportunity whether that 30- to 40-minute transport, arsenic opposed to a nine-minute transport, would person made a world of difference,” Batts said during a caller arena organized by nan NC Rural Center, an statement that advocates for agrarian communities crossed nan state. “We don’t know, but we would’ve liked to person recovered out.”

Such grim “what ifs” person go progressively communal among residents of Martin County, which will soon people its 3rd afloat twelvemonth without a section hospital. 

However, region officials opportunity they’re optimistic astir a long-gestating scheme to resurrect nan shuttered installation arsenic North Carolina’s first Rural Emergency Hospital.

Reviving Martin General

The Rural Emergency Hospital, aliases REH, nickname was created by Congress done nan Consolidated Appropriations Act of 2021 arsenic a lifeline for small, financially struggling accommodation successful agrarian areas.

Hospitals that person to REH position are required to supply 24/7 emergency attraction and outpatient services, but they are prohibited from offering inpatient services and must person agreements successful spot pinch area trauma centers to judge patients erstwhile they’ve stabilized. In exchange, they person a 5 percent boost to Medicare payments for covered outpatient services, positive monthly payments of astir $285,625 from nan national government.

The programme launched successful January 2023, and more than 40 facilities crossed nan state person converted. Unlike Martin General, however, each of those hospitals were still operating erstwhile they made nan switch. 

Martin General Hospital successful Williamston shuttered successful August 2023, 4 years aft nan installation tried to trim financial pressures by eliminating labour and transportation services. Credit: Jane Winik Sartwell/Carolina Public Press

Martin General, which closed earlier nan programme was afloat disposable to North Carolina hospitals (the authorities fund authorizing information wasn’t signed until months aft Quorum unopen nan doors) is thing different: nan first effort anyplace successful nan federation to reopen a wholly shuttered infirmary nether the REH model.

Martin County officials spent months moving done regulatory questions astir whether a closed infirmary could qualify, and successful early 2024, nan Centers for Medicare and Medicaid Services confirmed that Martin General could so reopen arsenic a Rural Emergency Hospital. By early 2025, nan region had sent retired requests for proposals from imaginable operators and was moving to update and repair nan aging building to meet CMS’ requirements.

Then a solution appeared successful nan county’s backmost yard.

Waiting for funding

In May 2025, ECU Health, nan Greenville-based wellness system, announced a plan to return complete Martin General and reestablish it arsenic nan state’s first Rural Emergency Hospital. 

The connection carries a steep value tag: ECU Health — a state-affiliated infirmary strategy connected to East Carolina University’s Brody School of Medicine — is asking authorities lawmakers to due $220 cardinal toward nan project.

Roughly $70 cardinal of that would spell toward refitting nan Martin General building arsenic a Rural Emergency Hospital, pinch nan remainder financing a caller inpatient furniture building astatine ECU Beaufort Hospital successful neighboring Beaufort County. The description to that installation is needed to sorb patients from Martin County who require inpatient care.

Brian Floyd, main operating serviceman for ECU Health, gave a little overview of nan scheme during nan NC Rural Center’s annual summit successful Raleigh connected March 26.

Brian Floyd, main operating serviceman for ECU Health, points to a surface displaying a representation of agrarian infirmary closures during nan 2026 Rural Summit successful Raleigh. Credit: Jaymie Baxley/NC Health News

Addressing an assemblage of astir 100 people, Floyd said Martin General’s history illustrated a shape that has played retired many times successful agrarian communities: A infirmary starts nether region ownership, gets acquired by a backstage institution and past gets sold disconnected again earlier yet going under.

“Private companies get successful location and recognize they can’t make it work,” he said. “They flip it, and past yet it bankrupts. That’s nan communicative of agrarian closure if you look astatine nan measurement that typically useful successful agrarian markets. We’re not conscionable trying to recreate that.”

Floyd acknowledged that ECU Health’s imagination mightiness return years to afloat implement. It would besides require investments beyond nan beingness buildings. 

“I cognize we’re going to raise different operating costs structures to woody pinch this,” he said. “That’s why we’ve asked nan authorities to thief pinch nan superior to put this successful place.”

That backing petition has stalled amid a prolonged standoff betwixt nan authorities Senate and House of Representatives complete nan authorities budget, which is now 9 months late.  

North Carolina is nan only authorities successful nan federation that has yet to adopt a spending plan, and lawmakers are not scheduled to reconvene until April 21. 

Study tests model’s promise

As ECU Health’s scheme takes shape, a study published past month successful nan Annals of Emergency Medicine offers nan first systematic — albeit somewhat inconclusive — look astatine whether nan Rural Emergency Hospital programme is moving arsenic intended.

Conducted by researchers astatine UNC Chapel Hill, nan study utilized financial information to analyse hospitals that closed, that converted to REH position aliases that remained unfastened without converting. 

It recovered that hospitals that converted to nan REH nickname and hospitals that yet closed had likewise mediocre financial wellness earlier 2023, including debased profit margins and precocious financial distress risk. Both types of hospitals ended up financially worse disconnected than hospitals that stayed unfastened without converting.

Researchers were observant to emblem nan limits of their analysis. The REH programme is successful its early stages and nan sample of converting hospitals remains small.

“Rural Emergency Hospitals could beryllium a viable action for financially struggling hospitals successful agrarian communities to support section transportation of emergency attraction services while lowering closure risk,” nan authors wrote, adding that their findings “should beryllium viewed arsenic exploratory.”

At slightest a twelve agrarian hospitals successful North Carolina person closed aliases importantly scaled backmost services since 2005, according to data from nan Sheps Center for Health Services Research astatine UNC Chapel Hill. Martin General is nan astir caller closure recorded by nan center.

Cost of closure

Batts, who became manager of Martin County successful May 2025, said nan closure of Martin General had a “halo effect” connected nan county’s already struggling economy.

He noted that Martin, which has a population of astir 21,500, is categorized by nan N.C. Department of Commerce arsenic a “Tier 1” region — a nickname reserved for nan state’s astir economically distressed areas. About 20 percent of residents unrecorded successful poverty, importantly higher than nan statewide mean of 13.6 percent.

More than 8,400 residents, aliases astir 39 percent of nan county’s population, rely connected Medicaid. Nearly 4,900 residents, aliases 22 percent, are enrolled successful SNAP.

“Losing that infirmary had a large effect from a wellness standpoint, but it was a immense effect from an economical improvement standpoint,” Batts said during nan summit, adding that the  nonaccomplishment of “labor income alone” dealt a $12 cardinal rustle to nan community, pinch a “total economical activity loss” of $33.1 million.

That’s successful statement pinch different investigation showing that agrarian counties suffer jobs and gross erstwhile a section infirmary closes, causing section families to suffer income crossed nan committee and driving organization loss. 

Dexter Batts, head of Martin County, talks astir nan effect Martin General’s closure had connected his organization during nan 2026 Rural Summit successful Raleigh. Credit: Jaymie Baxley/NC Health News

Martin General’s closure was individual for Batts. His wife, a nursing head astatine nan facility, was among nan labor displaced erstwhile nan infirmary shuttered. She yet landed a occupation astatine ECU Health Chowan Hospital successful Edenton — a 90-minute thrust from nan couple’s location successful Martin County.

The closure besides reverberated done nan region budget. With section ambulances forced to make longer runs to neighboring counties, Martin County’s yearly publication to emergency aesculapian services ballooned almost overnight from $550,000 to $1.4 million.

“Our fund is truthful constricted that we tin hardly scrape by successful a normal year,” Batts said. “It has truthful galore downstream effects.”

Before it closed, Martin General recorded much than 10,000 emergency section visits a year. It besides provided yearly entree to 100,000 diagnostic and outpatient procedures. 

Residents now recreation crossed region lines to person those important services, which adds strain to surrounding communities’ wellness attraction infrastructure.

For Floyd and others who are pushing to bring Martin General back, nan numbers underscore what’s yet astatine stake.

“These issues are not conscionable economic,” Floyd said. “They are real, and these group matter. Their lives matter.”

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