What happens to a community when it loses its only hospital?

Published on
March 22, 2023

What happens when more than 150,000 people lose the only acute care hospital in their county? The residents of Madera County in California’s San Joaquin Valley are currently grappling with that reality. 

Since hearing of Madera Community Hospital’s closure, we’ve heard and reported a few harrowing anecdotes about the county’s residents faced with extremely limited health care access. With the hospital shuttering, Maderans are now at least 20 miles away from the closest hospital emergency room — a 30-minute drive south to Fresno. 

One person we spoke to in January said she had to abruptly change the hospital at which she’d give birth, after learning the Madera hospital would close days before her due date. Luckily, she had the resources to travel a half hour, but many residents in Madera aren’t as fortunate. 

The hospital’s closure overwhelmed the local ambulance system in January, which in turn created a higher barrier to getting an ambulance ride to an emergency room. One doctor told me that although one of his patients was having chest pain, the operator wouldn’t dispatch an ambulance because she wasn’t going into cardiac arrest. 

The stories are many and through my reporting for the 2023 California Health Equity Fellowship, I’m looking to explore the human toll of Madera losing a critical piece of its health care infrastructure. I’m also looking to delve into how the hospital’s closure has strained other public systems that depended on it — that includes everything from 5150 holds that are now transported outside the county to strained county morgue and coroner resources. 

I’m also looking to also examine the policy implications of what happened. Did the absence of certain guardrails let this happen in the first place? The hospital’s closure has squarely put attention on Medicaid reimbursement rates, although it seems to be more complicated than just that. What does the state of Madera County’s health care resources tell us about health care in America? What solutions could keep this from happening again? 

As things stand now, it’s likely to take several months to establish a permanent solution and bridge the health care gap in Madera County. I’m looking to also explore what solutions possibly lie ahead and constructively inform the public about what that entails.