This rural hospital closed, putting lives at risk. Is it the start of a 'tidal wave'?

WILLOWS — As infirmary unit carted distant aesculapian instrumentality from abandoned diligent rooms, Theresa McNabb, 74, roused herself and painstakingly applied make-up for the archetypal clip successful weeks, finishing with a mauve lipstick that made her eyes pop.

“I consciousness a small anxiety,” McNabb said. She was inactive taking aggregate intravenous antibiotics for the monolithic corruption that had astir killed her, was unsteady connected her feet and was unsure however she was going to negociate buying and cooking nutrient for herself erstwhile she returned to her flat aft six weeks successful the hospital.

But she couldn’t enactment astatine Glenn Medical Center. It was closing.

The infirmary — which for much than 7 decades has treated residents of its tiny workplace municipality astir 75 miles northbound of Sacramento, on with countless victims of car crashes connected adjacent Interstate 5 and a astonishing fig of crop-duster pilots wounded successful accidents — unopen its doors connected October 21.

McNabb was the past patient.

Registered caregiver Ronald Loewen, 74, checks connected 1 of the past fewer patients. Loewen, a nonmigratory of Glenn County and a erstwhile Mennonite schoolhouse teacher, said the infirmary closing is “a portion of our past gone.”

Nurses and different infirmary workers gathered astatine her country to ceremonially propulsion her wheelchair extracurricular and into the doors of a aesculapian transport van. Then they stood connected the lawn, looking bereft.

They had each conscionable mislaid their jobs. Their municipality had conscionable mislaid 1 of its largest employers. And the residents — galore of whom are poor— had mislaid their entree to exigency aesculapian care. What would hap to each of them now? Would section residents’ wellness turn worse? Would immoderate of them dice preventable deaths?

These are questions that elected officials and policymakers whitethorn soon beryllium confronting successful agrarian communities crossed California and the nation. Cuts to Medicaid backing and the Affordable Care Act are apt rolling down from Washington D.C. and hitting tiny hospitals already teetering astatine the brink of fiscal collapse. Even earlier these cuts hit, a 2022 survey recovered that fractional of the hospitals successful California were operating successful the red. Already this fall: Palo Verde Hospital successful Blythe filed for bankruptcy and Southern Inyo Hospital successful Lone Pine sought exigency funds.

But things could get acold worse: A June investigation released by 4 Democrats successful the U.S. Senate recovered that galore much hospitals successful California could beryllium astatine hazard of closure successful the look of national healthcare cuts.

“It’s similar the opening of a tidal wave,” said Peggy Wheeler, vice president of argumentation of the California Hospital Association. “I’m acrophobic we volition suffer a fig of agrarian hospitals, and past the full strategy whitethorn beryllium astatine risk.”

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1. Medical adjunct Kylee Lutz, 26, right, hugs activities coordinator Rita Robledo connected closing day. Lutz, who volition proceed to enactment successful the session that remains open, said done tears, “It’s not going to beryllium the aforesaid without you ladies.” 2. Rose Mary Wampler, 88, sees doc adjunct Chris Pilaczynski astatine the clinic. Wampler, who lives unsocial crossed the thoroughfare from Glenn Medical Center, said, “Old radical can’t thrust acold away. I’m each by myself, I would conscionable dial 9-1-1.”

Glenn Medical’s financing did not illness due to the fact that of the caller national cuts. Rather, the infirmary was done successful by a national determination this twelvemonth to portion the hospital’s “Critical Access” designation, which enabled it to person accrued national reimbursement. The hospital, though it is the lone 1 successful Glenn County, is conscionable 32 miles from the nearest neighboring infirmary nether a way mapped by national officials — little than the 35 miles required nether the law. Though that region hasn’t changed, the national authorities has present decided to enforce its rules.

Local elected officials and infirmary administrators fought for months to person the national authorities to assistance them an exception. Now, with the doors closed, argumentation experts and residents of Willows said they are terrified by the imaginable consequences.

“People are going to die,” predicted Glenn County Supervisor Monica Rossman. She said she feared that older radical successful her assemblage without entree to proscription volition enactment disconnected seeking attraction until it is excessively late, portion radical of each ages facing exigency situations won’t beryllium capable to get assistance successful time.

Kellie Amaru, a licensed vocational caregiver who has worked astatine Glenn Medical Center for 4 years, reacts aft watching a co-worker permission aft moving their last displacement astatine the hospital.

But adjacent for radical who don’t look a beingness oregon decease consequence, the hospital’s closure is inactive a assemblage blow, said Willows Vice Mayor Rick Thomas. He and others predicted galore radical volition enactment disconnected regular aesculapian care, worsening their health. And past there’s the economical wellness of the town.

Willows, which sits conscionable eastbound of I-5 successful the halfway of the Sacramento Valley, has a arrogant past stretching backmost astir 150 years successful a workplace portion that present grows rice, almonds and walnuts. About 6,000 radical unrecorded successful the town, which has an economical improvement webpage featuring images of a tractor, a duck and a brace of hunters lasting successful the gangly grass.

“We’ve mislaid 150 jobs already from the infirmary [closing],” Thomas said. “I’m precise disquieted astir what it means. A infirmary is bully for caller business. And it’s been hard capable to pull caller concern to the town.”

Dismantling ‘a bequest of agrarian healthcare’

From the time it started taking patients connected Nov. 21,1950, Glenn General Hospital (as it was past called) was celebrated not conscionable for its relation successful bringing aesculapian attraction to the small workplace town, but besides for its relation successful helping Willows turn and prosper.

“It was rather state-of-the-art backmost successful 1950,” said Lauren Still, the hospital’s main administrative officer.

When the hospital’s archetypal babe was calved a fewer days aboriginal — small Glenda May Nieheus clocked successful astatine a robust 8 pounds, 11 ounces — the accomplishment was celebrated connected the beforehand leafage of the Willows Daily Journal.

But arsenic a tiny infirmary successful a tiny town, the instauration struggled astir immediately. Within a fewer years, according to a 1957 communicative successful the section newspaper, the infirmary was already grappling with the occupation of nurses leaving successful droves for higher-paying positions elsewhere. A communicative the pursuing twelvemonth revealed that infirmary administrators were forcing a attraction idiosyncratic to measurement successful arsenic an ambulance operator connected weekends — without the requisite chauffeur’s licence — to prevention money.

In a motion of however tiny the municipality is, that operator was Still’s boyfriend’s grandfather.

Still, the instauration endured, its grassy field and low-slung wings perched proudly connected the eastbound extremity of town. Generations of the town’s babies were calved there. As they grew up, they went into the exigency country for X-rays, stitches and attraction for fevers and infections. Their parents and grandparents convalesced determination and sometimes died there, cared for by nurses who were portion of the community.

“They saved my brother’s life. They saved my dad’s life,” said Keith Long, 34, who works astatine Red 88, an Asian fusion edifice successful downtown Willows that is simply a fashionable luncheon spot for infirmary staff.

Glenn Medical’s finances, however, often faltered. Experts successful healthcare economics accidental agrarian hospitals similar Glenn Medical mostly person less patients than suburban and municipality communities, and those patients thin to beryllium older and sicker, meaning they are much costly to treat. What’s more, a higher stock of those patients are low-income and enrolled successful Medi-Cal and Medicare, which mostly has little reimbursement rates than backstage insurance. Smaller hospitals besides cannot instrumentality vantage of economies of standard the mode bigger institutions can, nor tin they bring the aforesaid musculus to negotiations for higher rates with backstage security companies.

Across California, successful the archetypal decades of the 20th century, agrarian hospitals were moving retired of wealth and closing their doors.

T-Ann Pearce, who has worked astatine Glenn Medical Center for six years, sits successful the aesculapian surgical portion during 1 of her past shifts with lone a fewer remaining patients near to care.

In 2000, Glenn Medical went bankrupt, but was saved erstwhile it was awarded the “Critical Access” designation by the national authorities that allowed it to person higher reimbursement rates, Still said.

But by precocious 2017, the infirmary was successful occupation again.

A backstage for-profit company, American Advanced Management, swooped to the rescue of Glenn Medical and a adjacent infirmary successful Colusa County, buying them and keeping them open. The Modesto-based institution specializes successful buying distressed agrarian hospitals and present operates 14 hospitals successful California, Utah and Texas.

The infirmary acceptable astir gathering backmost its unit and improving its estimation for diligent attraction successful the community, which had been tarnished successful portion by the 2013 decease of a young parent and her unborn baby.

“We’ve been connected an upswing,” Still said, noting that indicators of prime of attraction and diligent restitution person risen dramatically successful caller years.

Then came the missive from the national Centers for Medicare & Medicaid Services. On April 23, the national bureau wrote Glenn Medical’s absorption institution with atrocious news: A caller reappraisal had recovered that Glenn Medical was “in noncompliance” with “distance requirements.” In plain English, national officials had looked astatine a representation and determined that Glenn Medical was not 35 miles from the nearest infirmary by alleged main roads arsenic required by instrumentality — it was conscionable 32. Nor was it 15 miles by secondary roads. The infirmary was going to suffer its Critical Access designation. The deed to the hospital’s fund would beryllium astir 40% of its $28 cardinal successful nett revenue. It could not past that cut.

At first, infirmary officials said they weren’t excessively worried.

“We thought, there’s nary mode they’re going to adjacent down hospitals” implicit a fewer miles of road, Still, the hospital’s main executive, said.

Especially, Still said, due to the fact that it appeared determination were galore California hospitals successful the aforesaid pickle. A 2013 national Inspector General Report recovered that a bulk of the 1,300 Critical Access hospitals successful the state bash not conscionable the region requirement. That includes dozens successful California.

Still and different infirmary officials flew to Washington D.C. to marque their case, definite that erstwhile they explained that 1 of the alleged main roads that connects Glenn Medical to its nearest infirmary wasn’t really 1 astatine all, and often flooded successful the winter, the occupation would beryllium solved. The way everyone really used, she said, was 35.7 miles.

“No roads person changed. No facilities person moved,” administrators wrote to national officials. “And yet this CMS determination present threatens to dismantle a bequest of agrarian wellness attraction stability.”

Without it, the head wrote, “lives volition beryllium mislaid for certain.”

But, Still said, their protestations fell connected deaf ears.

In August came the last blow: Glenn Medical would suffer its Critical Access backing by April 2026.

The quality acceptable disconnected a panic not conscionable successful Glenn County but astatine hospitals astir the state.

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1. A bicyclist passes by Glenn Medical Center. First opened to patients connected November 21, 1950, the halfway was called Glenn General Hospital then. 2. A subordinate of the unit signs a farewell committee connected closing time astatine Glenn Medical Center connected October 21, 2025.

At slightest 3 different hospitals got letters from the Centers for Medicare & Medicaid saying their Critical Access presumption was nether review, Wheeler said: Bear Valley Community Hospital successful Big Bear Lake, George L. Mee Memorial successful Monterey County and Santa Ynez Valley Cottage Hospital successful Solvang. The hospitals successful Monterey and Big Bear Lake provided information demonstrating they met the requirements for the status.

Cottage Hospital, however, did not, contempt showing that entree successful and retired of the country wherever the infirmary is located was sometimes blocked by wildfires oregon rockslides.

Cottage Hospital officials did not respond to questions astir what that mightiness mean for their facility.

Asked astir these situations, officials astatine the Centers for Medicare & Medicaid said the instrumentality does not springiness the bureau flexibility to see factors specified arsenic weather, for example, successful designating a captious measure hospital. They added the infirmary indispensable show determination is nary driving way that would marque it ineligible based connected driving distances included successful the statute.

Jeff Griffiths, a region supervisor successful Inyo County who is besides the president of the California Assn. of Counties, said helium has been pursuing the grim infirmary financing quality astir the authorities with mounting worry.

The infirmary successful his county, Southern Inyo, came adjacent to moving retired of wealth earlier this year, helium said, and with much national cuts looming, “I don’t cognize however you tin expect these hospitals to survive.”

“It’s terrifying for our area,” Griffiths said, noting that Inyo County, which sits connected the eastbound broadside of the Sierra, has nary casual entree to immoderate aesculapian attraction connected the different broadside of the elephantine upland peaks.

‘This is the last call’

In Willows, erstwhile connection got retired that the infirmary would suffer its funding, nurses began looking for caller jobs.

By precocious summer, truthful galore radical had near that administrators realized they had nary prime but to shutter the exigency room, which closed Sept. 30.

Helena Griffith, 62, 1 of the past patients, waves goodbye arsenic diligent transport Jolene Guerra pushes her wheelchair down the hallway connected October 20, 2025.

Through it all, McNabb, the 74-year-old diligent receiving intravenous antibiotics, remained successful her bed, getting to cognize the nurses who buzzed astir her.

She became alert that erstwhile they weren’t caring for her, galore of them were trying to fig retired what they would bash with their lives erstwhile they mislaid their jobs.

On the hospital’s past day, caregiver Amanda Shelton talented McNabb a caller sweater to deterioration home.

When McNabb gushed implicit the sweetness of the gesture, Shelton teared up. “It’s not each time that it volition beryllium the past diligent I’ll ever have,” she told her.

As McNabb continued to stitchery her things, Shelton retreated to the hospital’s recreation room, wherever patients utilized to stitchery for games oregon conversation.

With each the patients prevention McNabb gone, Shelton and immoderate different infirmary unit took up a crippled of dominoes, the trash speech of the crippled peppered with bittersweet remembrances of their clip moving successful the creaky aged building.

Registered caregiver Ronald Loewen, 74, looks retired the model connected closing time astatine Glenn Medical Center connected October 21, 2025. Loewen, who grew up and attended schoolhouse successful Willows, had 4 children delivered astatine Glenn Medical, 2 of them survived, and took attraction of erstwhile classmates astatine this hospital, says the infirmary closing is, “a portion of our past gone.”

Shelton said she is not definite what is adjacent for her. She loved Glenn Medical, she said, due to the fact that of its assemblage feel. Many radical came for agelong stays oregon were predominant patients, and the unit was capable to get to cognize them — and to consciousness similar they were healing them.

“You got to cognize people. You got to cognize their family, oregon if they didn’t person immoderate family,” you knew that too, she said. She added that successful galore hospitals, being a caregiver tin consciousness similar being an hold of a computer. But astatine Glenn Medical, she said, “you really got to look successful someone’s eyes.”

The gathering itself was successful dire shape, she noted. Nothing was up to modern code. It didn’t person cardinal aerial conditioning, and it was heated by an old-fashioned boiler. “I mean, I person ne'er adjacent heard of a boiler room” earlier coming to enactment there, she said.

And yet wrong the walls, she said, “It’s community.”

Bradley Ford, the exigency country manager, said helium felt the aforesaid mode and was determined to wage tribute to each the radical who had made it so.

At 7 p.m. connected the exigency room’s past nighttime of service, Ford picked up his microphone and beamed his dependable retired to the infirmary and to each the ambulances, occurrence trucks and others tuned to the signal.

He had practiced his code capable times that helium thought helium could get done it without crying — though during his rehearsals helium had ne'er yet managed it.

“This is the last call,” Ford said. “‘After 76 years of dedicated service, the doors are closing. Service is ending. On behalf of each the physicians, nurses and unit who person walked these halls, it is with dense hearts that we people the extremity of this chapter.”

Nurses and different unit members recorded a video of Ford making his announcement, and passed it among themselves, tearing up each clip they listened to it.

In an interrogation aft the infirmary had closed, Ford said helium was 1 of the fortunate ones: He had recovered a caller job.

It was adjacent capable to his location successful Willows that helium could commute — though Ford said helium wasn’t definite however agelong helium would stay successful his beloved small municipality without entree to exigency aesculapian attraction there.

Rose Mary Wampler, 88, waits to person humor drawn astatine the laboratory beside a cordoning off, signaling the closure of the infirmary broadside of Glenn Medical Center, connected October 22, 2025. Wampler lives unsocial crossed the thoroughfare from the hospital.

Rose Mary Wampler, 88, has lived successful Willows since 1954 and present resides successful a small location crossed the thoroughfare from the hospital. Her 3 children were calved astatine Glenn Medical, and Wampler herself was a diligent determination for 2 months past year, erstwhile she was stricken with pneumonia and interior bleeding. She said she was fearful of the thought of driving much than 30 miles for healthcare elsewhere.

She looked retired her model connected a caller day astatine the now-shuttered hospital.

“It looks similar idiosyncratic conscionable unopen disconnected the full city, there’s obscurity to spell get help,” she said.

Glenn Medical Center diligent Richard Putnam, 86, closes the model successful his infirmary room. A period shy of it’s 75th year, the infirmary closed connected Oct 21, 2025.

(Christina House/Los Angeles Times)

Times lensman Christina House contributed to this report.