Keeping rural facilities alive and well. Trustees must take action to ensure hospitals' future

To remain financially viable while providing high-quality primary care, rural healthcare facilities must deal with financial, human resource, technology, quality assurance, and community issues. Fewer qualified workers are available in rural communities as more career opportunities, better pay, and more attractive living conditions draw them to urban areas. Trustees must find ways to attract and keep employees. Trustees must carefully manage referral relationships with physicians to ensure that patients receive primary care in the rural facility. Quality of care issues arise as rural facilities experience limited debt capacity, fewer qualified physicians and workers, limited in-house technology, and a deteriorating plant. Facilities must develop processes to monitor quality and address clinical and nonclinical quality issues. Trustees can influence the community on the hospital's behalf by encouraging dialog with business, providing public relations, announcing new services, and enlisting support for hospital programs.