Story by Cole del Charco
TAYLORSVILLE, NC — Outside the brick walls, the old Taylorsville Memorial Hospital looks like any other building with its small windows and neat, trimmed grass. But inside, it’s not like any other building at all.
Sinks sit outside a dozen rooms. Incoherent graffiti smears the walls. Used condoms lie on the floor. Glass is shattered, and shards sit untouched. An overhead light hangs inches from the ground. All the results of looting and vandalism in the hospital that closed 13 years ago.
Town Manager David Odom remembers better times. Before he found the body of a deceased vagrant in a bush. Before thieves ripped out all the copper they could find. Before he had to carry a gun to feel safe beyond this wing of the hospital. Before 2004.
The hospital had never been on the cutting edge of technology, but for a time it did deliver babies and save lives. It had 60 beds, two surgical suites, equipment for advanced arthroscopic surgery and even a cafeteria.
Now, the hospital won’t treat another patient.
Alexander County has a population of 37,000, but no hospital.
“We’re surrounded by quality medical facilities,” Town Manager David Odom said. “But, we’re 30 minutes from everywhere.”
‘Humble beginnings’
Taylorsville Memorial Hospital was built in 1951 as the Alexander County Hospital. It was started with help from the Hill-Burton Act — a government policy that funded hospitals in rural towns.
“These people live a wholesome, simple, god-fearing life,” journalist Grady Cole said in an NBC broadcast at the time of the hospital’s construction.
“Our county had no public health matters: no school health programs, no sanitary inspectors, no health program of any kind,” Elsie Connelly of Taylorsville said in the same 66-year-old broadcast. “We were convinced that we needed all these things.”
Fulfilling health care needs wasn’t all it meant to Taylorsville. Because it was a small town, many of the 100-plus hospital employees were active members of the community. Odom can still rattle off the names of a dozen or so doctors he knew well who worked at the hospital.
Taylorsville Memorial Hospital would treat anyone who walked through its doors, including those who couldn’t pay. Eventually, that led to financial problems.
“In the late 90s, the hospital was struggling with cash flow and outstanding debt and their fixed costs were creeping up on them as well,” Odom said. “A series of public hearings were held at the courthouse, and of course everybody in the community, or most in the community, wanted to do something to save the hospital, but your average citizen didn’t know just how far in debt they were.”
For a while, the hospital was run by a larger hospital in Hickory, Frye Regional Medical Center, but it continued to lose departments, patients and funding.
Even after efforts by the board of the hospital, and most people in town, it couldn’t make up its debt. They tried everything to keep the hospital open, including pouring in more than a million dollars in tax money. But it was too late.
The building and its contents were bought by Charlie Track, who owns nursing facilities across the southeast. Track took sole ownership in 2013 and put it on sale three months ago.
The fears about lack of adequate health care voiced in the old NBC broadcast still echo in 2017: a lack of immediate health care in emergencies and a feeling that their town is incomplete.
‘Thirty minutes away’
Now, citizens have to drive across county lines to get emergency, or even immediate, health care.
The list of facilities about 30 minutes away is long: Iredell Memorial Hospital, Catawba Valley Medical Center, Caldwell Hospital, Frye Regional Medical Center and Davis Regional Medical Center.
The Taylorsville Memorial Hospital used to stabilize patients before moving them into larger hospitals where they could receive more specialized care. But now, Alexander County EMS has to take on that task — often in an ambulance while transporting the patient to a hospital.
Dale Killian knows. He’s been working at Alexander County EMS for 35 years.
“We hope that they will be fine, we strive to give that patient the best quality care that they would get in a hospital, so,” Killian pauses. “We strive hard to do that.”
The hospitals are about 30 minutes away in normal traffic. When Taylorsville Memorial Hospital was open, it didn’t always have a surgeon who could operate 24/7. It couldn’t afford to.
Even though an ambulance could shorten the drive from 30 minutes, it’s hard to count the number of emergencies that would’ve ended differently with a fully-staffed hospital in the county.
Killian remembers driving the ambulance to a patient’s house and finding a heavy-set man in his recliner, his face ashen.
Just a glance told Killian the man was in a state of shock, and during the exam he found an aortic aneurysm about to rupture. He felt the palpitation with his hand.
Killian and the EMS team had to get the patient to a hospital. Immediately. But going to Taylorsville Memorial, even though it was closest, wouldn’t get the patient on a surgeon’s table quickest. Instead, they drove to Iredell.
Driving flat-out with lights and sirens to Iredell Memorial Hospital took 15 minutes. On the drive, Killian called ahead so the surgeons could prepare.
They arrived at the ER and moved the patient from the stretcher to the hospital bed. The aneurism burst and he died.
In emergency health care, there’s a window of care called “The Golden Hour,” a 60-minute time frame after traumatic injury where medical attention has a better chance of preventing death.
But the EMS isn’t the only hope for people who are traumatically injured. There are also the eight local fire departments, some part time and volunteer, the Alexander County rescue squad, and, with the advent of helicopter transport, airlifts, such as Duke Life Flight.
Emergency airlifts occur about once a month in the county and can normally get a patient into a class-A medical facility close to that golden hour. The most recent use was an airlift for a car accident in late October.
‘Bearing the burden’
Killian said Alexander County EMS has been called on to provide more care since the hospital has closed.
“When it first closed we were really concerned about the impact it would have as for as our providing services to the county, but as time has gone on, we have been able to overcome a lot of those concerns,” Killian said.
Since the hospital closed, the group has added two full-time ambulance trucks to handle increased number of calls and the added distance.
“I think the biggest impact that it had with us was that we’re transporting, every patient that we transport, we’re transporting out of the county,” Killian said.
The decision to close the hospital wasn’t a surprise. Department after department was outsourced, then abandoned completely. In 2004, it was gone.
After 5 p.m. there wasn’t even an open doctor’s office for 10 years. Finally, in 2014 relief came to the county. An urgent care facility.
It has helped, but even the urgent care gets patients it isn’t qualified to handle. Lisa Tomlin, a nurse at the Urgent Care of Mountain View in Taylorsville, said they care for more types of injuries than most urgent care centers.
“We have people come here with heart attacks and cut off limbs and things that should go to a hospital, and we have to call EMS to have them transported because it’s beyond our means,” Tomlin said.
Tomlin said she’s never sure what she’s going to see in a day, and it’s not always something they can handle.
“We probably see tougher stuff than other urgent cares because people think we are an emergency room here, they think we’ve taken the place of the hospital, and they just know come here,” Tomlin said. “We’re the closest help — especially after 5 o’clock.”
The state of emergency health care in the town isn’t ideal. Even with the urgent care, there are times when there’s no immediate health care available outside the EMS.
Pharmacist Phil Icard works at People’s Pharmacy, and has since 1975. He remembers health care in town at its height.
“We had one physician in the county and he would drive home at night with one window down in case he heard an ambulance he’d just turn home and head to the hospital,” Icard said. “That’s the kind of close-knit community we had.”
Icard now knows what it’s like to live in town without the benefit of a hospital. He fears that the town couldn’t provide care in the case of a catastrophic emergency for the thousands of students driving and being bused in from the surrounding area.
“At one time I was disappointed that the hospital closed, and I still am, I wish we could’ve supported it, but the thing that has amazed the most is, our EMS has stepped up so much they can do so much in the back of that truck that they’re actually quicker than trying to get someone to the Iredell hospital,” Icard said.
“Our EMS has filled a big void because they can stabilize that patient that the hospitals and nursing rooms can’t until they get them to a place where they can do an MRI or a CT-scan or whatever it may be.”
‘Not the only ones’
Taylorsville isn’t alone. Six of the more than 80 rural hospitals in the U.S. that have closed since 2010 are in North Carolina.
“Our story is not just Taylorsville, because there are many rural communities in North Carolina that have gone through this, so we’re certainly not alone, but it’s a status and title, a moniker that we would rather not have,” David Odom said.
The town manager attributes the closures mainly to finances.
It is tough to compete with larger hospitals who can offer more services and have more full-time staff. The trend is similar in other rural areas of the U.S.
Hospital finances were a challenge for Taylorsville from the beginning. When it was proposed, townspeople had to raise money to receive a matching grant from the government through the Hill-Burton Act of 1946. Eventually, they raised enough.
Chris Fensterle, the chief operating officer at Frye Regional Medical Center, has worked for large hospital systems, a for-profit in Tampa and non-profit in northern Virginia. Fensterle said it’s normal for smaller, rural hospitals to have a hard time financially.
The key to a financially successful health system, he said, is to attract services, build them out and find physicians to work them.
“If you can do that, regardless of your location, urban or rural, you can keep growing it,” Fensterle said. “But if you lose a key service or you need to develop or go in a different direction, sometimes it can be difficult to get back.”
Once Taylorsville Memorial Hospital started losing services, like the OB-GYN and ER, they never got them back.
‘Taylorsville’s mobile mall’
For now, the old Taylorsville hospital is getting some use. The one condition: the city must mow the lawn.
“It’s a grand bargain to lease this building and the land for a dollar, a dollar is what we pay to Mr. Charlie Track,” Odom said. “And in turn, he gets free yard-care.”
On Saturdays, the upper parking lot at the hospital becomes a farmer’s market. Throughout the year it hosts food trucks and the annual Apple Festival. The grass is growing, and people are using the abandoned building as a community space.
While the second floor of the hospital is in shambles, the first is cleaned up. If only for a season.
The Taylorsville Fire Department has taken it over for a Halloween fundraiser. The hospital is indirectly paying for some of its medical equipment.
‘The Intensive Scare Unit.’ It’s filled with fake blood, jumpy animatronics and a pervasive darkness that heightens the senses.
It’s the first time a large group of people have been inside the hospital legally since it closed. It wasn’t an easy decision, for Odom at least, to host a haunted house in a hospital where people had died. But it was the necessary one.
“So far, there hasn’t been any negative response,” Odom said. “People are just glad it’s being used for something.”
The haunted attraction had more than 3,000 visitors and raised $30,000 during its month of operation.
Chris Brown, captain at the Alexander Central Fire Department, helped start the haunted hospital wing. When the hospital closed, Brown was distraught.
“What county (doesn’t) want a hospital?” Brown said. “What upset me the most is that people were able to get in and damage the place.”
The damage he’s talking about is obvious from the inside. The broken windows, the stolen machinery and wiring. Worse is that it’s unlikely to be replaced.
But Brown has hope.
“If we can help bring something positive to the community and help them out, which actually helps us out… it’s a win-win situation for everybody,” Brown said.
The freaky head and torso that pop up to scare children in the hospital get a jolt of fear, but only for a moment.
The fear of the long drive to the nearest emergency room lingers.
Good Article- At 85 can remember when the Hospital opened. Had a close friend (now Deceased) who was the 3rd. patient there. We had a minor auto accident & my Dad took her to the new Hospital.. She always remarked about being the third patient there.