By Sarah Jane Tribble for KFF Health News.
Broadcast version by Kathleen Shannon for Wyoming News Service reporting for the KFF Health News-Public News Service Collaboration

There’s a new morning ritual in Pinedale, Wyoming, a town of about 2,000 nestled against the Wind River Mountains.

Friends and neighbors in the oil- and gas-rich community “take their morning coffee and pull up” to watch workers building the county’s first hospital, said Kari DeWitt, the project’s public relations director.

“I think it’s just gratitude,” DeWitt said.

Sublette County is the only one in Wyoming — where counties span thousands of square miles — without a hospital. The 10-bed, 40,000-square-foot hospital, with a similarly sized attached long-term care facility, is slated to open by the summer of 2025.

DeWitt, who also is executive director of the Sublette County Health Foundation, has an office at the town’s health clinic with a window view of the construction.

Pinedale’s residents have good reason to be excited. New full-service hospitals with inpatient beds are rare in rural America, where declining population has spurred decades of downsizing and closures. Yet, a few communities in Wyoming and others in Kansas and Georgia are defying the trend.

“To be honest with you, it even seems strange to me,” said Wyoming Hospital Association President Eric Boley. Small rural “hospitals are really struggling all across the country,” he said.

There is no official tally of new hospitals being built in rural America, but industry experts such as Boley said they’re rare. Typically, health-related construction projects in rural areas are for smaller urgent care centers or stand-alone emergency facilities or are replacements for old hospitals.

About half of rural hospitals lost money in the prior year, according to Chartis, a health analytics and consulting firm. And nearly 150 rural hospitals have closed or converted to smaller operations since 2010, according to data collected by the University of North Carolina’s Cecil G. Sheps Center for Health Services Research.

To stem the tide of closures, Congress created a new rural emergency hospital designation that allowed struggling hospitals to close their inpatient units and provide only outpatient and emergency services. Since January 2023, when the program took effect, 32 of the more than 1,700 eligible rural hospitals — from Georgia to New Mexico — have joined the program, according to data from the Centers for Medicare & Medicaid Services.

Tony Breitlow is health care studio director for EUA, which has extensive experience working for rural health care systems. Breitlow said his national architecture and engineering firm’s work expands, replaces, or revamps older buildings, many of which were constructed during the middle of the last century.

The work, Breitlow said, is part of health care “systems figuring out how to remain robust and viable.”

Freeman Health System, based in Joplin, Missouri, announced plans last year to build a new 50-bed hospital across the state line in Kansas. Paula Baker, Freeman’s president and chief executive, said the system is building for patients in the southeastern corner of the state who travel 45 minutes or more to its bigger Joplin facilities for care.

Freeman’s new hospital, with construction on the building expected to begin in the spring, will be less than 10 miles away from an older, 64-bed hospital that has existed for decades. Kansas is one of more than a dozen states with no “certificate of need” law that would require health providers to obtain approval from the state before offering new services or building or expanding facilities.

Baker also said Freeman plans to operate emergency services and a small 10-bed outpost in Fort Scott, Kansas, opening early next year in a corner of a hospital that closed in late 2018. Residents there “cried, they cheered, they hugged me,” Baker said, adding that the “level of appreciation and gratitude that they felt and they displayed was overwhelming to me.”

Michael Topchik, executive director of the Chartis Center for Rural Health, said regional health care systems in the Upper Midwest have been particularly active in competing for patients by, among other things, building new hospitals.

And while private corporate money can drive construction, many rural hospital projects tap government programs, especially those supported by the U.S. Department of Agriculture, Topchik said. That, he said, “surprises a lot of people.”

Since 2021, the USDA’s rural Community Facilities Programs have awarded $2.24 billion in loans and grants to 68 rural hospitals for work that was not related to an emergency or disaster, according to data analyzed by KFF Health News and confirmed by the agency. The federal program is funded through what is often known as the farm bill, which faces a September congressional renewal deadline.

Nearly all the projects are replacements or expansions and updates of older facilities.

The USDA confirmed that three new or planned Wyoming hospitals received federal funding. Hospital projects in Riverton and Saratoga received loans of $37.2 million and $18.3 million, respectively. Pinedale’s hospital received a $29.2 million loan from the agency.

Wyoming’s new construction is rare in a state where more than 80% of rural hospitals reported losses in the third quarter of 2023, according to Chartis. The state association’s Boley said he worriies about several hospitals that have less than 10 days’ cash on hand “day and night.”

Pinedale’s project loan was approved after the community submitted a feasibility study to the USDA that included local clinics and a long-term care facility. “It’s pretty remote and right up in the mountains,” Boley said.

Pinedale’s DeWitt said the community was missing key services, such as blood transfusions, which are often necessary when there is a trauma like a car crash or if a pregnant woman faces severe complications. Local ambulances drove 94,000 miles last year, she said.

DeWitt began working to raise support for the new hospital after her own pregnancy-related trauma in 2014. She was bleeding heavily and arrived at the local health clinic believing it operated like a hospital.

“It was shocking to hear, ‘No, we’re not a hospital. We can’t do blood transfusions. We’re just going to have to pray you live for the next 45 minutes,’” DeWitt said.

DeWitt had to be airlifted to Idaho, where she delivered a few minutes after landing. When the hospital financing went on the ballot in 2020, DeWitt — fully recovered, with healthy grade-schoolers at home — began making five calls a night to rally support for a county tax increase to help fund the hospital.

“By improving health care, I think we improve everybody’s chances of survival. You know, it’s pretty basic,” DeWitt said.


Sarah Jane Tribble wrote this story for KFF Health News.


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A new report on lung cancer by the American Lung Association showed Maryland has quite a bit of room to improve diagnoses and treatment but experts said the state has taken some big steps in tackling it.

The report showed almost 17% of Marylanders at high risk for lung cancer were screened, a little less than the national average. Maryland fared better in other metrics, including lower rates of adult smokers and people unable to access treatment.

Aleks Casper, Maryland director of advocacy for the American Lung Association, said to improve the state's standing, Marylanders at risk of lung cancer need to be screened at higher rates.

"If we can get people screened, our chances of impacting all the other metrics improve," Casper explained. "If we get people screened and we can find it early, then we can connect them to treatment and we can connect them to surgery, which impacts outcomes."

The report also noted Latinos in Maryland are the least likely group to be diagnosed early.

Casper pointed out certain policies in Maryland have removed barriers to diagnosis and treatment. Just this year, Maryland became one of 15 states to require insurance to cover biomarker testing, including for lung cancer. The National Cancer Institute described biomarker testing as using a sample of tissue, blood or other fluid to look for genes or chromosomes which could increase a person's likelihood of developing certain cancers, which Casper emphasized is critical.

"Being able to test and determine what the best type of treatment for that person's disease, that kind of really individualized care and giving people access to that, is really important," Casper added.

Those who want to find out if they're eligible to be screened for lung cancer can take a quick test at savedbythescan.org.


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By Kyla Russell for WISH-TV.
Broadcast version by Joe Ulery for Indiana News Service reporting for the WISH-TV-Free Press Indiana-Public News Service Collaboration

Walking pneumonia cases in central Indiana have seen a steep increase in recent weeks, local physicians say.

"But what we've seen this summer, starting in July and August, was an explosion in the number of cases," said Dr. John Christenson, associate medical director of infection prevention at Riley Hospital for Children. "Some require admissions to intensive care units. Children die, adults die .. sometimes it invades the brain and it can cause an infection there."

Walking pneumonia is generally considered less severe than pneumonia, but can have lasting impacts if not caught early on. The disease is caused by mycoplasma pneumoniae, which can damage the lining of the respiratory tract, according to the CDC.

It is spread through droplets released when someone coughs or sneezes.

"Symptoms can begin mildly with sore throat, cough, or chest pain," Christenson said.

About two million people are diagnosed with the disease each year. This year is different, though.

While it's common for young children and adolescents to be impacted, small children born during the Covid-19 lockdown are seeing a surge in cases.

The CDC said diagnoses in kids between two and four years old jumped from 1% to 7.2% over a six-month time span this year.

"We saw a rebound after Covid," Christenson said.

During lockdown, people were wearing masks, staying home, and were not at school and work.

"What happened was a lot of people who could acquire an infection around that time, didn't," Christenson said. "So, now they're all susceptible. You bring in a new germ or an old germ into an environment and it spreads like wildfire."

Several local schools have seen an increase in students, asking parents to be on the lookout for symptoms and to take their child to a physician if needed.

As holiday gatherings begin, Christenson is heeding a similar call, especially in severe cases.

"That's when you need to take them to their healthcare professional to have them seen, and in some cases, get X-rays," Christenson said.

Additionally, Christenson said it is important to make sure families are up-to-date on all vaccinations.


Kyla Russell wrote this article for WISH-TV.


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More than one in three children is now overweight or obese, according to new research published in the Lancet medical journal.

The study found while Kentucky and other southern states are forecast to continue seeing rising levels of childhood obesity, some other states, such as Utah, will experience even higher spikes.

Ben Chandler, CEO of the Foundation for a Healthy Kentucky, said the Commonwealth is struggling to address health care and quality of life for kids.

"I think we're 45th in being overweight," Chandler observed. "It leads to a shorter life expectancy. It leads to tremendous spikes in the odds of getting any number of diseases and it has a huge cost attributed to it. "

Almost half of teens and young adults now are either overweight or obese, compared with 29% in 1990. The number is expected to jump by between 31% and 50% for adolescents, and by 29% to 33% for kids ages 6-11.

Chandler argued the state should increase funding for physical activity programs in schools and address the persistent lack of access to healthy and affordable fresh food. He added the issue cannot be tackled solely through individual behavior changes.

"There are a lot of environmental factors that are involved here," Chandler pointed out. "There's a lot of money, quite frankly, being spent in advertising for things that are bad for you."

The study also found among U.S. adults, if the current pattern continues, more than 250 million people will be overweight or obese by 2050.