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Twice as many Texas hospitals at risk of closure than before the pandemic, report says

Patricia Lim

Staff burnout and loss of revenue has put added strain on hospitals since the pandemic started – and that strain weighs heaviest on the already vulnerable rural Texas hospitals.

Now, a new report shows that about 1 in 10 hospitals across the state – about twice as many since before the pandemic – are in danger of closure. Nicole Cobler, a reporter for Axios, joined Texas Standard to break down the numbers of the report from the Texas Hospital Association.

This transcript has been edited lightly for clarity:

Texas Standard: Tell us a little bit more about this report. It comes from the Texas Hospital Association, right? 

Nicole Cobler: Yeah, that’s right. And it’s interesting – the association says that despite this increase of federal funding from the CARES Act, hospitals remain at even more risk for closure because of increased expenses and delayed care that has led to sicker patients. You’ll remember that non-emergency care was halted; that led to patients pushing back preventive procedures and even cancer care. Now they’re seeing patients that are sicker and need longer stays.

I’m trying to understand how that translates, economically speaking, for these hospitals, because if you have the beds full, the hospitals are still making money, right? 

Yeah. Well, during the pandemic, when they halted these preventive care procedures, especially in rural areas, they weren’t seeing as many COVID patients as bigger urban facilities. So they weren’t earning any revenue from preventive care that they normally would see.

Is it clear which hospitals are more in danger than others, and what parts of Texas we’re really talking about here? 

The hospital association didn’t give specific names and didn’t drill down into regions, but it just was this rural and urban divide in the report. Rural facilities are usually independently owned, while larger facilities in these urban areas are part of bigger healthcare systems that see much more money.

Back during the height of the pandemic, there was a lot of conversation about burnout among hospital workers. I wonder if that’s a factor here and whether hospitals are actually able to meet the demand from patients. 

Yeah, that was a really big issue in Texas. Texas really relied on travel nurses during the pandemic because of all of those worker shortages, and travel nurses are expensive. The association says that Texas hospitals are working to lessen their reliance on contract staff, but that workforce shortage means that there’s still this dependence on staffing agencies to fill those positions.

You mentioned that these hospitals were receiving money from the CARES Act, which was a pandemic relief act. One would think that hospitals would not be struggling as they are here in Texas. And I wonder if the report outlines any possible relief or solutions to this crisis. 

They do, and it’s really about more funding, especially regarding workforce issues. The hospital association says more state funding for these medical professionals would help them. And it’s also worth noting that the industry as a whole is pressing for more federal relief, citing inflation, labor [and] supply cost pressures.

Are they talking about specific dollar amounts here, or are they just saying we need more money to make ends meet? 

You know, I’m not sure about specific dollar amounts, but, right – they need more money.

What comes next? We obviously have the Texas Legislature about to reconvene. Do you sense that they are listening or paying attention to these red flags? 

I have the feeling we’ll see medical groups like the Texas Hospital Association pushing the Legislature for more funding. So far, there’s been no signs that lawmakers are thinking about that yet.

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Kristen Cabrera is a graduate of the Salt Institute for Documentary Studies in Portland, Maine, where she saw snow for the first time and walked a mile through a blizzard. A native of the Rio Grande Valley, she graduated from the University of Texas-Pan American (now UTRGV) and is a former KUT News intern. She has been working as a freelance audio producer, writer and podcaster. Email her: