Beth Kelley spent most of her life working at Sturgis Hospital. For 32 years, the nurse said it was "unusual to walk down the hall and not recognize somebody." The independently owned hospital had served its community in rural St. Joseph County for more than a century. This was reported by Qazaqyia.kz citing Associated Press.
"I like the small hospital atmosphere," Kelley, 56, told Bridge Michigan. "I know this is maybe a little cliché, but it's like family."
When administrators held a town hall last month to tell staff the hospital would close about 70 hours later, Kelley said the room filled with "shock" and "devastation." The decision left many long-serving employees like herself "scrambled trying to find a job" while they worked their remaining shift hours.
Sturgis Hospital shuttered its doors June 19, citing "years of ongoing financial challenges" facing rural health care providers. The facility had 84 licensed beds and about 300 associates working, according to the hospital.
There were warning signs. The facility had been winding down services in recent years, even as it obtained a city-issued pandemic relief loan, a state lifeline and new federal status — Sturgis Hospital became Michigan's first designated rural emergency hospital in 2023, which allows for increased support from the US Centers for Medicare & Medicaid Services.
It's not the only rural hospital in Michigan to be impacted by a shifting health care landscape. These health care facilities, sometimes the only medical care providers available for miles, have been navigating several problems, including declining payer reimbursements, rising operating costs, and a federal reworking of Medicaid and Medicare — programs used by the bulk of patients in rural hospital settings.
For Kelley and others, the Sturgis Hospital closure is part of a bigger trend and serves as a wake-up call for her and others in the field.
"As a nurse, we took care of patients, and that's all we did. It's all we cared about. We didn't care about the financial end of it," Kelley said. "Those days are gone."
Rural hospital closures, reductions, restructuring and consolidation dominate the contemporary health care landscape in Michigan, according to researchers, physicians and policy advocates working in the field.
For one thing, Michigan's population is aging, which puts strain on the state's health care system. In addition, many point to problematic payment models that don't offset costs for service, and federal program reductions outlined in HR 1 — the "One Big Beautiful Bill."
Five rural hospitals have closed in Michigan since 2005, according to the Cecil G. Sheps Center for Health Services Research at the University of North Carolina at Chapel Hill.
As Congress debated the One Big Beautiful Bill last year, the Sheps Center estimated four of 63 rural hospitals in Michigan could be at risk for closure, highlighting facilities that had run a three-year deficit or existed as one of the top Medicaid revenue earners in the country. Sturgis Hospital was not included.
Even if a hospital does manage to remain open, many have to drop major parts of their operation to survive. Last year, the labor and delivery unit at Aspirus Ironwood Hospital and the obstetrics unit at MyMichigan Medical Center in Tawas City closed.
Rural birthing hospitals are costly and difficult to staff, according to Michael Shepherd, an assistant professor at the University of Michigan School of Public Health focused on rural health disparities and health policy in the US.
"Half of births in rural communities are being paid for by Medicaid at the moment," Shepherd told Bridge following passage of President Donald Trump's One Big Beautiful Bill, which calls for slashing Medicaid. "So what you're talking about is a not very profitable service line — it's very expensive and one that's about to face massive financial shortfalls."
Sturgis Hospital had closed its birthing center in 2018. Last month, it ended the remaining services.