Health & Wealth Desk

It was a scheduling mishap that led Kourtnaye Sturgeon to help save someone’s life. About four months ago, Sturgeon drove to downtown Indianapolis for a meeting. She was a week early.

“I wasn’t supposed to be there,” she said.

As he fights to retain control of Putnam County Memorial Hospital in Unionville, Missouri, Jorge Perez’s woes continue to pile up at other rural hospitals where he was once hailed as a hero.

Last month, in the second of a three-part series, CBS News aired a piece about Empower, a Perez-run company whose affiliates have been involved in many of the rural hospital takeovers orchestrated by Perez and his associates.

A battle royale has erupted in tiny Unionville, Missouri, over the town’s endangered community hospital.

Trustees of Putnam County Memorial Hospital in the north central community are trying to get rid of the company that took over the ailing institution in 2016 and then ran more than $90 million in questionable lab billings through the hospital.

This story was originally published February 6. It has been updated as of February 9 at 1 pm.

The Atchison-Holt Ambulance District spans two counties and 1,100 square miles in the far northwest corner of Missouri. The EMTs who drive these ambulances cover nearly 10 times more land area than their counterparts in Omaha, the nearest major city. 

Though the shops along Sullivant Avenue in Columbus, Ohio had all closed their doors one cold November night, a young woman walked alone down the alley behind the Seventh Day Adventist Church. She was petite and wore lipstick, a tweed coat and blue jeans torn at the knee.

When the hospital closed in rural Ellington, Missouri, a town of about 1,000, the community lost its only emergency room, too. 

That was 2016. That same year, a local farmer had a heart attack.

When President Trump declared the opioid epidemic a public health emergency in late October, it triggered a regulatory change intended to make it easier for people to get care in places with provider shortages. This declaration allows for the prescribing  of addiction medicine virtually, without doctors ever seeing the patient in person. (The regulatory change is not fully implemented until the DEA issues further rules.)

It’s a familiar story in rural America. Four years ago the Pemiscot County hospital, the lone public hospital in Missouri’s poorest county, nearly closed. What’s keeping it in business today has also become increasingly common in rural healthcare: relationships with a handful of local pharmacies.

In 2011, Maureen Sweeney was working as a registered nurse in labor and delivery at a Cleveland-area hospital. She helped hundreds of women, many minors in their early teens, deliver their children.

No one at the hospital in Fulton, Missouri (population 12,790) had ever heard of a management consultant named Jorge Perez until he showed up at its potluck in September.

Officer Ron Meyers drove down a dirt road 20 minutes outside the small city of Chillicothe, Ohio. As he passed each home, he slowed down and squinted, searching for an address. Out here, the house numbers are written on the front of homes in marker or in faded numbers clinging to old mailboxes. There’s no GPS.

After 20 years of selling and using meth, 38-year-old Andy Moss turned his life around. He got off drugs and got a good job. Next step: he wanted to fix his teeth, which had disintegrated, leaving nerves exposed.

When Sarah Scantling went into labor this summer, she had to drive 30 miles and across state lines.

Three years earlier, the only maternity ward where she lives in Pemiscot County, Missouri closed down. Scantling had to choose between a handful of other hospitals in the region between 20 and 70 miles away. She chose to give birth in the hospital in Dyersburg, Tennessee.

For five years now, the Missouri legislature has considered legislation to create a prescription drug monitoring database that would allow pharmacists and physicians to look at their patient's prescription history for signs of misuse of narcotics. And for five years, Missouri pharmacists like Erica Hopkins have watched those efforts fail with disappointment.

Nurse Catherine “Bizz” Grimes moves like her name sounds: at a frenetic pace. She darts across the hall from the prenatal diagnosis clinic at Indiana University Health University Hospital in Indianapolis, sits down at her cubicle, puts on her headset over curly white blonde hair and starts dialing.

$1.25 million.

That’s the size of the bill that could have shuttered the only public hospital in rural Pemiscot County, Missouri in August 2013.

Next year, Blue Cross Blue Shield of Kansas City will leave the individual health care marketplace in Missouri that was set up under the Affordable Care Act. And when it does, about 18,000 patients in 25 western Missouri counties will lose their health insurance. If those enrollees sign on to Healthcare.gov this fall to buy a replacement plan, they may have no options to choose from.

That's because those 25 counties could become "bare."

For the hundreds of rural hospitals struggling to stay in business, health policy decisions made in Washington D.C. this summer could make survival a lot tougher.

Blue Cross Blue Shield of Kansas City announced on Wednesday that it will not offer individual plans on the Affordable Care Act insurance exchanges next year The move will affect about 67,000 people across 30 counties in Missouri and two counties in Kansas

“Through 2016 we have lost more than  $100 million [on ACA plans],” the company’s CEO Danette Wilson said in a release. “This is unsustainable for our company.”

The Affordable Care Act did a lot to expand HIV/AIDS treatment and prevention for people at highest risk for the disease. Many gay men and other men who have sex with men gained health insurance and new infections went down. The estimated number of annual HIV infections in the United States declined 18 percent among gay and bisexual men between 2008 and 2014, according to the Centers for Disease Control and Prevention.

In the current debates over health care, one topic rarely gets mentioned: dental health benefits. That’s because dental health has historically been separated from the rest of medicine. But today, that separation leaves many Americans with no way to prevent or treat debilitating dental health problems.

Author Mary Otto tells the story of the rampant disparities in dental health in the United States and how those play into other disparities of race, class and income in her new book, Teeth: The Story of Beauty, Inequality, and the Struggle for Oral Health in America.

As the outreach counselor for Battle High School in Columbia, Missouri. Dana Harris’s job is connecting students with services when they have mental and emotional troubles such as ADHD, anxiety or depression.

Six years ago, 53-year-old Corla Morgan noticed blisters forming on her neck and back.

“I couldn’t sleep because when I took my shirt off, if my shirt touched my skin, the skin just peeled off,” Morgan says. “I was in really horrible pain.”

Darvin Bentlage says his health insurance plan used to be the same as all the other cattle farmers in Barton County, Mo.: stay healthy until he turned 65, then get on Medicare. But when he turned 50, things did not go according to plan.

“Well, I had a couple issues,” he says.

He’s putting it mildly.