Copper Queen Community Hospital planning expansion, a boon for southern Arizona rural health care

Copper Queen Community Hospital in Bisbee is in the planning stages of a $10 million project to expand its surgical department.

The hospital's build-up comes at a time when some rural hospitals cannot stay open, like in the recent closure of a hospital in Green Valley. The pandemic has also magnified the desperate need for more medical professionals in rural areas, as reported by The Arizona Republic last year. 

Copper Queen CEO Robert Seamon said with the hospital's current size, it is limited in services it can offer due to a lack of space. However, the hospital has big plans for its expansion and increased services it will be able to provide to southern Arizona residents.

The main hospital is in Bisbee, and it has four rural health clinics throughout Cochise County located in Douglas, Palominas, Tombstone and Bisbee. The hospital serves communities stretching from southern Sierra Vista to Douglas and Tombstone.

Expansion will allow hospital to do more

With the expansion, the hospital will be able to add more surgeons and expand the specialties the hospital already has, said Seamon. 

“In orthopedics right now, we don’t do any total joint replacements: no hip replacements, knee replacements, etc.” Seamon said. “We don’t have the space and facilities for it, but with this new expansion we will be able to offer those services.”

The hospital also will be able to add an adjoining endoscopy unit, he said.

The surgical expansion, which should be completed over the next two and a half years, is not the only change the hospital has started implementing over the last couple years as part of its Master Facility Plan.

In mid-August, the hospital added a 3D state-of-the-art mammography unit allowing screening and diagnostic testing services, which previously would have been done in a bigger hospital in a larger area, like Tucson.

Additionally, Copper Queen Community Hospital opened a new outpatient physical therapy clinic in Bisbee, and a rural health clinic in Tombstone. The hospital also purchased a clinic in Hereford. 

Keeping patients closer to home

Every additional service a hospital provides means that patients can stay closer to home, a huge benefit when a barrier to health care access is often transportation, according to experts in the industry.

“Transportation is difficult even for us to provide local access to care,” Seamon said. “When you have to go to Sierra Vista, Tucson or Phoenix, that can be a real heavy burden on people.”

Tucson, which has the bigger hospital, is about an hour and a half drive from Bisbee and an additional half hour from Douglas. 

The Copper Queen Community Hospital is trying to keep care local, Seamon said.

This is exemplified not only through rural health clinics spread out through the county but also the hospital's visiting medical professionals.

Seamon said the hospital has physical therapists that visit patients in their homes, as well as a visiting nurse program based out of Douglas that allows nurses from the Douglas rural health clinic to also visit patients in their homes.

Funding for the surgery unit expansion comes from a USDA grant that the hospital’s foundation, the Copper Queen Community Hospital Foundation applied for. Previous expansion activities came from money the hospital already had available, according to the hospital. 

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The need for new hospital facilities was made clear a few years ago when the facility's aging buildings needed to be replaced, Seamon said, noting some buildings were constructed 30 years ago. 

The hospital also conducted a community health needs assessment to discover what the community requires in regard to health care. Mental health services and basic primary care services were at the top of that list.

Seamon also highlighted the high prevalence of diabetes in the community and a need for colon cancer screenings, cervical screenings and mammograms.

To address the mental health needs, Seamon said the hospital has a psychiatric nurse practitioner and the organization is searching for another mental health provider.

Bisbee hospital is bucking trends

Copper Queen Community Hospital seems to be bucking the national trend of rural hospital closures.

Dr. Daniel Derksen, a public health professor and the Walter H. Pearce Endowed chair and director of the Arizona Center for Rural Health at the University of Arizona, said states that have not expanded Medicaid eligibility tend to have higher rates of rural hospital closures.

While Arizona has expanded its Medicaid eligibility, Derksen said that Texas, which did not expand the eligibility, has one of the highest rates of rural hospital closures in the country.

When hospitals treat patients without health insurance, the medical institution must absorb that uncompensated care, he said.

Derksen noted that Arizona is lucky enough to have expanded access to Medicaid helping people who cannot afford private insurance. This has been helpful during the pandemic when many people lost their jobs and subsequently their job-sponsored health insurance. 

However, because Medicaid does not pay as much a private health insurance the hospitals with lot of patients that depend on public insurance programs “tend to be hospitals that struggle with having a positive fiscal margin,” Derksen said. 

Derksen noted that successful rural hospitals, like Copper Queen Community Hospital, tend to expand their revenue portfolio by including more outpatient or ambulatory services and having federally designated rural health clinics.

These clinics tend to be affiliated with critical access hospitals, like the Copper Queen Community Hospital. One benefit to being a critical access hospital, is access to better compensation from public payers like Medicare and Medicaid, Derksen said.

Retention, recruitment are the ‘biggest challenges’ to rural health care

According to Derksen, retention and recruitment are some of the biggest challenges in the field of rural health care.

When a rural hospital loses just one intensive care unit nurse, a physician or general surgeon, that can often make or break the ability of the hospital to stay open, he said.

In addition, he said with all the state’s medical schools based in Tucson or near Phoenix, as well as the location of “lucrative” medical positions also located in those cities, rural areas are often left underserved and with a lack of health care providers. 

Because the schools are located in these bigger cities, and schooling for health care professionals is long. This means that young medical professionals are often building community and building their lives in these places, making them less likely to leave and work in more rural areas of the state, “where they are needed most,” Derksen said

One solution, he said, is adding community-based experiential learning to the students' medical training.

Students would receive a portion of their training in rural communities “to better match where people get their health profession’s training with where they are needed,” Derksen said, adding that balancing training in the big cities with training in rural areas, increases the likelihood health professionals will stay in more rural communities.

To help put medical professionals where they are desperately needed, the state offers medical students at Arizona’s medical schools scholarships for promising to work in rural Arizona, as reported by The Republic in 2019. 

Coverage of southern Arizona on azcentral.com and in The Arizona Republic is funded by the nonprofit Report for America in association with The Republic.

Reach the reporter at sarah.lapidus@gannett.com.