By THOMAS P. WEAVER
HORIZON Editor
CELINA-When the announcement of the pending March 1 closure of Cumberland River Hospital (CRH) was made 10 days ago, immediate shock was quickly transformed into uncertainty, not just for the future of the healthcare facility with a legacy of over 50 years of service to the community, but also for its many dependents—including the local ambulance service.

Multiple questions were addressed by CRH parent company CEO and Celina native Paul Korth in a press conference the same day news of the looming hospital shutdown broke (visit dalehollowhorizon.com for the full story), but Cookeville Regional Medical Center’s (CRMC) top brass had no answer when asked about the continued existence of local emergency medical service (EMS)—an entity not affiliated with either of the hospitals and operated by the Clay County Emergency Management Agency (EMA) and the City of Celina.

“This was basically the first stop for the majority of the stuff, so it will be a big blow to the ambulance service,” Korth said of CRH’s closure, before addressing the future existence of local EMS. “I don’t know. I can’t answer that question.”

The answer came emphatically from local EMA director Natalie Boone, when she was posed the same question over the weekend.
“The ambulance service will absolutely continue to exist and operate as business as usual,” she said. “(EMS) will remain ready to respond to calls within the county, however, we will be facing new challenges ahead without (CRH).
“(There are) a lot of unknowns at this point.”

Boone explained local EMS currently has two staffed units, which transported over 60% of their patients to CRH last year.

If the local hospital closes at month’s end, she explained EMS patients would be transported to “the closest appropriate facility” determined by state guidelines, unless another destination request can be met.

“We try to always honor patient wishes on a transportation destination, but we have to take into consideration destination guidelines set forth by the state,” Boone said. “Most of the time we are able to honor the patient request, but there are critical situations where the patient must be transported to the nearest facility for stabilization, before being transferred on to another facility.

“There are also times when the patient may be transported to the nearest facility in a non-critical situation, such as when both of our scheduled staffed units are on calls or out of the county. In those instances, the patient is transported to the nearest hospital in an effort to retain a unit in the county.”

Without the services of the local hospital, Boone’s concerns moving forward include increased response and turnaround times, larger operating costs, and the potential loss of both a helipad and a central location in the event of a disaster or other major event.

“Obviously, all our patients will be transported outside the county, which means our turnaround times will certainly increase, which translates to increased time Clay County will possibly be without an EMS unit available,” she said. “It will mean increased costs associated with operations of the service—such as increased fuel costs, increased maintenance costs, increased staffing costs to try and keep EMS coverage in the county, and it may also mean longer response times to get to calls if crews receive another call while headed back from a previous call.

“I wish I could tell you we have more than enough ambulances to cover the gaps that are about to be created, but unfortunately that just isn’t true.”
Boone revealed average turnaround times in 2018 as 24 minutes to CRH, 39 minutes to Livingston Regional Hospital (LRH), and greater than 40 minutes to all other facilities in surrounding counties, but explained those figures would rise if the local hospital closes.
“These numbers will without a doubt increase,” she said. “Especially when you eliminate the 60% of our total calls for the year that were transported to the local hospital.

“We continue to support (CRH) and it’ staff and are extremely hopeful a solution can be found to prevent this hospital from closing. There will undeniably be a negative impact on patient survival and outcomes without this facility and the amazing staff they employ.”

She said access to helicopter flights will continue to play a vital role for local EMS, but was unsure about the future availability of the helipad at the hospital.

“Helicopter flights are something we will continue doing and it’s hard to say at this point if those numbers will increase,” Boone explained. “It has not been made clear whether we will have access to the helipad or not, (but) it’s definitely a concern and question we will have to get clarification on.”
She called CRH “the lead agency tasked with treating patients in the event of a mass casualty or disaster,” said they were “very active and supportive” of the local EMA, and listed multiple examples of their dedication to the cause.
“The hospital was heavily relied on when it comes to EMA,” Boone said. “It’s always been a comfort to know you had the local hospital in case you ever faced a disaster or major event.”

Boone detailed other instances where CRH staff traveled to the site of a bus accident to assist, supplied an offsite emergency evacuation shelter, and offered an onsite impromptu storm shelter, among other extra services.
“This hospital meant so much to EMA and EMS, as well as the entire county,” she said. “Just knowing that it was here, I think makes you feel just a little safer.

“It will be a tremendous blow to both EMS and EMA. Those few things that jumped into my head about ways (CRH) has helped EMA out over the years are just a few examples of how important they have been.
“They are absolutely one of the largest pieces of the puzzle when it comes to emergency planning and response.”
See a future HORIZON for continuing coverage of the pending hospital closure.