More than a country doctor – The Tryon Daily Bulletin


More than a country doctor

Posted at 3:30 a.m. on Wednesday, September 14, 2022

RRemember the country doctor back then who made house calls with a black medical kit? Seventy-five percent of all home visits were for the flu or cold. Of course, there was little the doctor could do to treat these ailments, but often it was not a cure that the mother was looking for but confirmation that her child was not suffering from poliomyelitis, tuberculosis or smallpox.

Much has changed in rural health over the years.

Today we promote “World Class Intake in Rural Polk County”. It is much more than a slogan that we find in our advertisements. “Bringing world-class” describes the transformation that has taken place at St. Luke’s over the past three years – bringing world-class urology, oncology, orthopedics and now cardiology – and bringing technology, talent and world-class patient care.

It’s no secret that our hospital has struggled in the past to attract patients. But thanks to a lot of hard work, the ship is turning around. Our teammates and community are embracing vision casting. World-class talent finds Polk County a pleasant and peaceful place to live. And just like that, the word is spreading. We’ve been more successful at securing grants from the community and beyond, which has allowed us to purchase world-class equipment and give our vendors the tools they need to keep you healthier. And it is vital for the community that we continue this trend.


Nationwide, most rural health facilities are losing money and struggling to survive. Over the past ten years, more than one hundred and thirty rural hospitals have closed, resulting in the loss of emergency department and essential outpatient services in rural America. These closures increase the risk of death and disability in the event of a serious medical emergency. But the closures also increase health risks from undiagnosed conditions and mistreatment due to limited access to care.

In the United States, more than 1,600 rural hospitals (including St. Luke’s) average fewer than 15 acute care inpatients per day. Most of these hospitals are small because the communities they serve are small. The preponderance of counties in the United States has a population of less than 26,000. A third of all short-term general hospitals are small rural hospitals that provide most health care to the small communities they serve. Yet rural hospitals receive only 5% of all national hospital expenditure. At the same time, most urban hospitals make more than 5% profit for services rendered, receiving almost all the profits from hospitals in the country.


St. Luke’s is a small Critical Access Hospital (CAH). CAH is a designation given to eligible rural hospitals by the Centers for Medicare & Medicaid Services (CMS). Congress created the CAH designation through the Balanced Budget Act of 1997 (Public Law 105-33) after more than 400 rural hospitals closed between 1980 and the early 1990s.

To be eligible for the CAH designation, hospitals must:

  • have 25 or fewer acute care inpatient beds
  • be located more than 35 miles from another hospital (exceptions apply)
  • have an average annual length of stay of 96 hours or less for acute care patients
  • provide 24/7 emergency service

St. Luke’s has twenty-five acute care beds and a 24/7 emergency department. In addition to the services listed above, we have the best rehabilitation center in the area, a radiology department , a pain center and Steps to Home (a swing bed rehabilitation program).

Steps home

Over the past forty years, Medicare has changed the way they reimburse hospitals for care, resulting in shorter hospital stays. However, frequently fired patients have yet to regain the strength to perform the most basic tasks. Rehabilitation in a nursing home is an alternative, but many patients are reluctant, fearing they will never get out once they enter.

Our Steps to Home program is a great alternative that meets the need well and is another fundamental difference from other regional hospitals. Through the Social Security Act, St. Luke’s provides swing bed services, under which we can use our inpatient beds as needed, to provide acute or post-hospital skilled nursing care (“tilting” l use of this hospital bed to qualified nursing care for this period). Medicare Part A (the hospital insurance program) covers swivel bed care.

Rural health clinics

In 1977, Congress passed the Rural Health Clinic Services Act, creating rural health clinics. The programs aim to increase the practice of healthcare providers in rural America. To qualify as a certified CHR, the clinic must be located in a “non-urbanized” area with a shortage of healthcare professionals. St. Luke’s also has two federally certified CHRs, Foothills Medical Associates and Saluda Family Medicine. Our clinics are outpatient facilities that provide primary family health services and routine laboratory services to communities in Polk County.

If you have a topic of healthcare interest or a question, send me a note at [email protected] Also, please follow us on Facebook, Twitter and LinkedIn, or visit to learn more about St. Luke’s Hospital and our new world-class services.

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