“It’s intense because we know what we’re dealing with is very serious,” said hospital CEO Mary Ellen Pratt. 

ST.  JAMES PARISH, La. — As hospital systems work tirelessly to care for folks battling complications from the coronavirus, it’s the smaller, rural hospitals playing a much bigger role then they were designed to do. 

With only 25 beds and a total staff of about 200 people, St. James Parish Hospital, like many small hospitals across the state, is operating a bit differently than normal. 

“It’s intense because we know what we’re dealing with is very serious,” said hospital CEO Mary Ellen Pratt. 

Pratt says smaller hospitals like hers are typically outpatient focused, but because elective surgeries and procedures aren’t happening right now, equipment and staff are being shifted to focus on inpatient care, especially when it comes to COVID-19 cases.  As of Monday afternoon, the state health department reports 167 positive cases in St. James Parish. 

“Our COVID unit as we’re calling it is running ten patients if not more, in terms of those isolation patients that we’re dealing with,” said Pratt. 

According to the U.S. Census Bureau, one in five Americans, or about 60 million of us, live in rural areas.  A big portion of that population includes people who are older and considered to be more at risk for COVID-19. 

“Critical access hospitals are vital to that portion of the community and without us, quite frankly, people die,” said Riverside Medical Center CEO Peter Sullivan. 

In Washington Parish, which as of Monday afternoon had 92 positive COVID-19 cases, Sullivan says it’s a constant balancing act at Riverside Medical Center. 

“The issue with rural hospitals is we work on such smaller margins that the larger facilities do,” said Sullivan. 

That means less resources while making sure care is the top priority.  With relief on the way for small hospitals from the state and federal governments, Sullivan says the concern is whether that relief gets to hospitals in time. 



“Most rural hospitals operate on a razor thin margin at all times anyway and it doesn’t take a lot to reach a tipping point as it related to their ability to remain viable in the community,” said Sullivan. 

Keeping supplies on hand is also challenge.  The need for things like masks, gowns and gloves is in high demand.  Sullivan and Pratt say they both worked to get out ahead of the need, but there’s a concern of running out. 

“We’re keeping a perpetual inventory.  Every day I come in, they tell me how many days on hand we have and we continuously work to try and get more of the things that become critical,” said Pratt. 

Smaller hospitals are also working on plans for when larger ones can’t accept patients being transferred.  At St. James Parish Hospital that means increasing the number of ventilators on hand, in hopes of buying time, for a transfer to happen. 

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