Emergencies are inevitable.

Responding to this in rural areas already presents unique challenges: weather conditions, terrain and available resources.

Take away the region’s only hospital and the impact of lack of care will quickly spread across county lines.

Williamston Fire-Rescue-EMS Chief Michael Peaks has spent his career doing his best to prepare for the many unknowns of an impending 911 call.

“Our work, our activity, is: “What if?” “, Peaks said.

Peaks and his team must now navigate uncharted waters after the region’s only hospital closed last year.

Martin General Hospital abruptly closed its doors in August 2023.

Torn signs and chained-off entrances now inform people that care is not available. The hospital website points patients to ECU Beaufort, 22 miles to the south.

Williamston Mayor Dean McCall still remembers hearing the news while working as a physical therapist at the hospital at the time.

“Quorum Healthcare was operating the hospital at the time,” McCall said. “On August 3 at 8:30 a.m., they arrived, had a meeting with the staff and let us know that they were going to declare bankruptcy and close the hospital. They literally closed the entrances and emergency rooms at 10am. »

McCall said it was a rush to move doctors and patients while remaining staff worked to find new roles elsewhere.

The area is served by 5 fire and emergency services. Peaks said not having the option of Martin General is not only an inconvenience for his team, but also for first responders throughout the region.

“Without Martin General being an option, it has certainly increased our patient contact time. » said Peaks. “Before Martin General closed, our average commute time was 5 minutes 38 seconds. Today, our average transit time is 19 minutes 56 seconds.

The chief said he is grateful that increased travel time has not led to a significant increase in negative outcomes.

He also shared that the county provided additional funds that the department used to increase staffing from 18 to 25. He noted that his staff responded well to the challenge and said that calling in air support from the ECU Medical Center and UNC Health in Rocky Mount is another tool that may need to be used more often.

“Seconds matter in our job and our profession, so yes, it is a concern and it continues to be,” Peaks said.

When asked what the best-case scenario would be, he replied: “It’s a call to reopen.”

He also added: “And we have to think about our journey. We have Highway 64 and Highway 17 going through our area, people travel through the Outer Banks, etc. We want these travelers and visitors to have the same access to health care as our citizens.

The worst-case scenario is also the one that worries Yancey Warren.

“It makes you really sick because you have nowhere to go, you have no support,” Warren said.

Warren spotted a WRAL crew filming the exteriors of Martin General Hospital during one of his many trips to the stretch of road near the facility.

He told the crews he hoped they would be there to share the good news that the hospital was reopening.

“As a patient, it’s a little scary because your life-threatening problems could occur in a matter of minutes,” he said. “You then have to go to Greenville or Edgecombe or wherever you have to go, and every minute is a part of your life that you could lose.”

County Attorney Ben Eisner shared efforts to bring good news to residents like Warren.

The county and state are exploring the possibility of reopening Martin General as a rural emergency hospital (REH).

This designation would allow emergency departments to reopen and restore immediate care, provided the average length of patient stay does not exceed 24 hours.

“The question is how do we go from a closed facility to an open facility within that REH designation,” Eisner explained.

If Martin General reopens as REH, it would be the first of its kind in the state. This would also be a first in the country since no hospital has ever closed entirely before reopening as an REH.

“I see it as a real opportunity to reimagine what health care would look like in a rural area like Martin County over the next fifty years,” Eisner said. “This is both a formidable challenge and a real opportunity that we face.”

UNC Cecil G. Sheps Center follows hospital closures and REH conversions nationally. He says the model has been used more than 30 times across the country to help maintain a certain level of care in rural areas.

Eisner said there are still many questions to answer before knowing if the doors will actually reopen.

“The building has a long lifespan dating back to the 1970s and has been constructed in different ways,” he said. “Understand what state and federal regulators will allow, what requirements may be necessary in terms of development, retrofitting or just maintenance, and how much those things are going to cost.” This is kind of a first step in understanding, for potential providers and the county, what can fit into this space.

Eisner said it was unclear to what extent the building could reopen if Martin General received an REH designation.