Sen. Grassley Hears Rural Health Care Concerns During Visit To Mahaska Health

U.S. Sen. Chuck Grassley visited Mahaska Health in Oskaloosa to meet with hospital leaders, physicians, and local business representatives to discuss the future of rural health care in Iowa. Topics during the meeting included staffing shortages, emergency room transfer delays, maternity care, critical access hospital regulations, physician recruitment and the growing role Mahaska Health plays in providing care for patients across southeast Iowa.

Oskaloosa, Iowa — Doctors and hospital leaders at Mahaska Health told U.S. Sen. Chuck Grassley on Wednesday that rural hospitals are being pushed harder than ever as more small-town health care services disappear across Iowa.

Grassley met with physicians, administrators, and business leaders at Mahaska Health to talk about the problems facing rural hospitals, including staffing shortages, insurance delays, maternity care and the limits placed on critical access hospitals.

One of the biggest concerns discussed during the meeting was how many smaller hospitals no longer deliver babies or provide full surgical services.

Those changes has shifted where many rural patients now go for care.

Mahaska Health leaders said Oskaloosa has become a hospital that many surrounding communities now depend on because medical services available in other towns have slowly gone away.

Doctors said patients who once doctored closer to home are now traveling to Mahaska Health for surgeries, emergency care and labor and delivery services.

Hospital officials said that growth has been good for the community, but it has also created pressure on the hospital’s staff and the available space to provide those services.

Mahaska Health is classified as a critical access hospital, which means there are federal rules that limit the hospital to 25 inpatient beds.

Doctors told Grassley that limit becomes difficult when nearby hospitals stop offering many of those medical services previously talked about, and more patients come to Oskaloosa instead.

Several physicians said Mahaska Health has continued to expand services while other rural hospitals have cut back.
The hospital has added specialties and continues offering medical services that many communities have lost, including obstetrics and surgery.

Hospital staff said one possible solution would be removing labor and delivery patients from the 25-bed limit. Other ideas discussed would allow rural hospitals in the same region to share bed space instead of each hospital operating under separate limits.

Emergency room doctors also described how difficult patient transfers have become since the COVID-19 pandemic.

Before COVID, doctors said patients needing advanced treatment would often be transferred to larger hospitals fairly quickly. Now, patients can sometimes wait several hours or longer because hospitals in larger cities are already full.

Those challenges have forced Mahaska Health to handle more complicated cases locally and keep patients longer.

Staffing shortages was also discussed, as the issue is being faced across rural Iowa.

The recruiting of physicians, nurses and specialists remains one of the biggest challenges facing small-town hospitals.
Insurance prior authorizations were also discussed during the meeting. Hospital officials said delays from insurance companies often slow down patient care and create extra paperwork for medical staff.

Grassley listened as hospital leaders explained how federal rules affect rural hospitals differently than larger urban facilities.

Local business leaders in attendance at the meeting explained Mahaska Health plays a major role in economic growth in Mahaska County.

When businesses are trying to hire workers, they need strong local health care services in order to attract families and employees to the area.

Grassley spoke about several federal programs connected to rural hospitals and encouraged hospital officials to continue sharing concerns with his office.

The meeting showed how much rural health care has changed over the past several years, especially for communities trying to keep medical services close to home.

For Mahaska Health, hospital leaders said the goal is continuing to grow while making sure patients in Oskaloosa and nearby communities can still receive care locally instead of driving long distances for treatment.