Fitzgibbon Hospital, a central Missouri health care system, has announced it will be shuttering some services on Dec. 31, citing mounting financial pressures.
The nonprofit hospital said the closures will affect about 30 employees and hundreds of patients.
Fitzgibbon, in Marshall, operates several primary and specialty care clinics in central Missouri. Services that are closing include the Grand River Medical Clinic in Brunswick, Fitzgibbon Family Health in Fayette, the hospital’s inpatient behavioral health unit, a home health and hospice agency and a pain management clinic.
The decision comes after the hospital shuttered its intensive care unit in 2023 and reduced staff across the system.
With limited resources, health care providers strive not to duplicate services in each community. Not enough patients means limited revenue to keep doors open, Fitzgibbon CEO Angy Littrell said.
“We continually look at these things and really are trying to frame our decisions on services where we would not be leaving a huge deficit in the community, if at all possible,” Littrell said.
Both Brunswick and Fayette have other primary care clinics available with more on the way, Littrell said.
“We have to see a certain number of patients every day in order to be able to cover the costs,” Littrell said. “For us in those two particular clinics, it was very much volume-driven. We have primary care clinics in other areas that are doing much better.”
Competition in other arenas prompted Fitzgibbon officials to shutter the other services as well. Several hospice agencies serve the area and new behavioral health care is coming online.
Still, almost all of Missouri’s counties are now classified as health professional shortage areas, the latest data show. And vacancies in behavioral health positions are over 30%, according to the state’s application for the new federal one-time infusion of money under the Rural Health Transformation Fund.
By 2026, the application said, Missouri will have a shortage of more than 2,100 physicians.
And the financial pressures on hospitals only make those numbers more dire. About 70% of Fitzgibbon’s business is done in partnership with the federal government, through reimbursements for services under Medicaid and Medicare, among others.
“If you think about what inflation has done year over year over year over year, and then you consider the very modest increases that you might get out of Medicare or Medicaid, if any, year over year, there’s always a deficit,” Littrell said.
The hospital expects the closures will save more than $2 million a year. And in the face of Medicaid cuts, where hospitals are expected to take on more costs through uncompensated care, hospital leaders are concerned what that means for their future.
Missouri could lose an estimated $23 billion in federal funding over the next five years as cuts to health care materialize, according to the Missouri Foundation for Health.
“If you think about this, and then think now we have further billions of dollars of cuts coming to Missouri and the health care we provide,” Littrell said, “it is worrisome to all hospitals.”
Fitzgibbon is Saline County’s third-largest employer, according to its website. If the hospital were to close its doors, the next closest hospital for most of the county’s residents would be Bothwell Regional Health Center in Sedalia, which was identified by experts earlier this year as an at-risk hospital in the wake of cuts to Medicaid. In Missouri, 12 rural hospitals have closed since 2014.
