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Health care in America, particularly the landscape for hospitals, continues to change. In Orangeburg, the community watches closely as the Regional Medical Center deals with realities that have threatened facilities around the country.

In its latest report, the hospital owned by Orangeburg and Calhoun counties, reported it was $3.2 million in the black through the end of January. At the same time a year ago, the hospital system was posting a $3.7 million loss for the fiscal year, which begins Oct. 1.

The turnaround has not been without changes. Some have been difficult.

"We had about $1 million more in operational revenue but our biggest impact was in our operating expenses of about $4.3 million less," RMC Chief Financial Officer Liza Porterfield told trustees.

The hospital has saved about $3.4 million this year by reducing its use of contract labor. It’s also saved $900,000 by reducing the use of physicians that fill in for other physicians on a temporary basis.

The good news from RMC comes as a new analysis by Navigant of data from the U.S. Centers for Medicare & Medicaid Services concludes times are not good for other hospitals. More than a fifth of the nation's rural hospitals are near insolvency.

Twenty-one percent of rural hospitals are at high risk of closing, according to the Navigant analysis of data on 2,045 rural hospitals. That equates to 430 hospitals across 43 states that employ about 150,000 people and generate about $21.2 billion in total patient revenue a year.

As rural populations decline, inpatient admissions fall, more beds sit vacant and the number of people covered by government-sponsored plans rises, these communities are left to grapple with the ramifications of losing a hospital, said Dr. Daniel DeBehnke, a Navigant managing director, co-author of the report and former CEO of the Omaha-based Nebraska Medicine system.

A loss of acute-care beds and ultimately hospitals, particularly in smaller, rural communities, is inevitable. And in the words of Alex Kacik, writing for, that begs a thorny question: “How many hospitals does the U.S. health care system need?”

Navigant set out to define "essential" by weighing trauma status, proportion of Medicaid days or uncompensated care to net revenue, geographic isolation, and hospital employee-to-county population. More than a third, or 153, of 430 hospitals designated financially unstable are not "essential," according to Navigant's data. This is not to say these hospitals aren't important to their communities, DeBehnke said.

RMC is “essential” – and for many reasons. In serves people in multiple counties that do not have hospitals. Its regional role is further highlighted by the reality of RMC being the only hospital of proximity along the major Interstate 26 route from Columbia and Charleston.

In uncertain times for hospitals and health care as a whole, Orangeburg can continue to be thankful that it has a lot to offer in terms of modern medical care. The Regional Medical Center and its affiliates are the heart of the system.

If Orangeburg County and its neighbors are to reach the development objectives to which they aspire, the prosperity of RMC is vital. Direct community support through use of services and indirect support via word of mouth are important.

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