Issue Summary

As COVID-19 spread throughout the U.S., Missouri’s rural hospitals responded by ensuring their communities had access to COVID-19 testing and treatment, while establishing new practices to ensure the safety of patients, visitors and employees. To support rural hospitals, MHA worked to simultaneously shape the state’s response and provide assistance through member communication, and connection to policy- and decision-makers. As Missouri continues to move through the pandemic, MHA remains committed to understanding the challenges that rural hospitals face and providing solutions that meet the discrete needs of rural hospitals.

Issue Spotlight

Advocacy and Financial Support

The operational and financial challenges posed by the COVID-19 pandemic are profound for many rural hospitals. To help hospitals address these challenges, MHA focused on securing regulatory relief through waivers of federal and state standards, while promoting financial assistance to offset the enormous financial losses incurred by Missouri hospitals. The state and national funding sources have proven vital for many rural hospitals.

Lessons Learned Speaker Series

The COVID-19 Lessons Learned from Missouri Hospitals is a speaker series that reflects on COVID-19 and its impact on Missouri hospitals, while looking forward to help prepare for what may yet come. A list of upcoming events and past recordings are available.

access the speaker series

Regulatory and Legal

MHA is actively working with the Centers for Medicare & Medicaid Services and the State of Missouri to provide regulatory flexibility during the pandemic response. With COVID-19 response and recovery evolving, MHA remains in touch with hospitals to evaluate the existing regulatory framework, understand the urgency for existing and future waiver needs, and monitor how regulations will influence emerging best practices. A regularly updated waiver tracking document is available online.

Telehealth

As the COVID-19 pandemic surged — and state and nationwide shelter-in-place orders were announced — rural Missourians’ already-limited access to care was further curtailed by the pause in outpatient services and community-based fear of COVID-19 exposure. COVID-19 has underscored the great potential of telehealth to increase access and decrease barriers for effective and efficient delivery of health care services. MHA maintains a COVID-19 telehealth FAQs document with links to multiple resources.

In June 2020, MHA released a COVID-19 Rural Hospital Compendium to assist rural hospitals with responding to the pandemic in their communities.

Read the compendium

Emerging Missouri Practices

As a health care system serving rural populations, Ozarks Medical Center experienced both positive and negative consequences during the early stages of the COVID-19 pandemic. Closing nonessential services in anticipation of a surge limited access to care for a population that typically has higher incidences of comorbidities resulting in many patients becoming acute and requiring hospitalization.

On the other hand, the rural community did afford OMC some advantages. With a naturally socially distanced population who were compliant with CDC-suggested safety practices, the hospital avoided a major surge and had very low incidences of infection. Unfortunately, this lack of an early surge also left some community members jaded to the effectiveness of masking and prevention measures.

Despite the ups and downs the hospital experienced, in the end, the size and commitment of OMC were such that they were able to quickly and significantly implement elevated precautions, screening and visitor policies, as well as alter facilities to accommodate COVID-19 positive patients with a new VICU. The organization’s goal is to continue to preserve the ability of OMC to care for the communities they serve during this unprecedented time.

COVID-19 Rural Health Care Fact Sheet