DE QUEEN, Ark. – The state’s first rural hospital since Medicaid expansion will officially close its doors Tuesday.

In 2013, Arkansas became the first state in the country to receive approval to expand Medicaid under the Affordable Care Act through a waiver.

Since then, a West Memphis hospital closed due to a fire, but De Queen Medical Center will become the first to shut down because of financial troubles.

“The community needs a hospital or we don’t have anything,” Amy Wolcott, a human resources assistant at the hospital, told KARK’s sister station, KTAL.

Without the hospital, ambulances have to transport patients at least 35 miles away for help.

“We have to have a place to save lives,” said De Queen Mayor Jeff Brown.

During the last decade, nearly 40 rural hospitals in surrounding states that did not expand Medicaid closed. However, according to a Little Rock-based health policy center, De Queen could be just one on a list of rural hospitals in Arkansas not immune to closure moving forward. 

“Our expansion of Medicaid in the state helped secure the viability of rural hospitals in particular for a period of time. I think we’re coming to an end of that period of time,” said Dr. Joe Thompson, the president of the Arkansas Center for Health Improvement (ACHI). “There are some other complicating factors with De Queen, but I think it is the first of several that are going to have more financial strain on them in the coming years.”

Dr. Thompson also anticipates an end to the Critical Access Hospital (CAH) designation, which nearly 30 rural hospitals across the state, including De Queen, have depended on for funding.

“We need to rethink what and how we support rural hospitals and rural health care across the state,” he said.

Under current state licensing requirements, local communities must have a full-service, acute care medical center, which Thompson said could start a conversation ahead of the next legislative session in 2021. 

“The overhead and operating costs are making it where that’s more and more difficult,” he said. “We may need to rethink: can a hospital exist if they have a daytime treatment center and a 24-hour emergency room and not be a full-bore, acute medical care center for our rural communities across the state.”  

De Queen’s county leadership plans to build a new hospital from the ground up, but the question remains how to pay for it.