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The exam rooms from inside the new St. Vincent Health hospital on September 8, 2021, in Leadville, Colorado. (Hugh Carey, The Colorado Sun)

When the only hospital in Leadville started to close down seven years ago, officials in the highest-altitude city in the country worried they would lose their “heart and soul.”

There were layoffs in the nursing department. Extended care patients were moved to nursing homes. A city council member feared retirees would flee to other areas with more accessible medical care. 

“To lose people who can’t live here anymore because they don’t have health care that they can rely on, that would have been a big blow to us,” said Greg Labbe, the council member who is now Leadville’s mayor.

But instead of closing, the once-booming mining town has seen the historic St. Vincent hospital in Leadville come back from the brink of financial ruin with the opening this month of a new facility where ailing patients can have surgery and access specialists they used to drive an hour to see. 

It’s nothing short of a “stunning accomplishment” for a struggling hospital started by Kansas nuns in the 1870s, Labbe said. And it’s a boon for the mountain city, which saw the decline of a mine empty its commercial district decades ago, only to claw its way back through outdoor recreation, heritage tourism and pandemic-fueled population growth.

Now called St. Vincent Health, the new hospital replaces an old building that had fallen into disrepair and will bring more robust services to the 8,000 or so residents of Lake County, where 16.5% of people live at or below the federal poverty line and nearly half have reported difficulty affording medical care.

But local officials and health care advocates hope the hospital can also be an economic engine and an anchor for a rural community in the midst of economic transition. Once home to gold rush prospectors and a silver boom, Leadville is close to a molybdenum mine that is projected to close for good in 2038, potentially taking with it a substantial portion of the county’s property tax revenue. 

People tour the new St. Vincent Health hospital during its grand opening on September 8, 2021, in Leadville, Colorado. (Hugh Carey, The Colorado Sun)

Though many rural hospitals have shuttered nationwide, experts say they can play a pivotal role in attracting businesses and workers, and are often one of the largest and top-paying employers in remote regions. Nationally, one-fifth of rural county residents worked in education, health care or other social service programs between 2011 and 2015.

Fewer than 10% of workers in Lake County worked in health care and social assistance last year, about half as many as were employed in mining, quarrying and other extractive industries.

“Hospitals are one of those institutions that a community organizes around,” said Dr. Dylan Luyten, a part-time Leadville resident and St. Vincent’s chief of staff. “St. Vincent in Leadville has served that role in the past and I think was in turmoil for a while. … I very much see that coming back and being a building block for jobs.” 

Aleta Bezzic, board chair of the tax-collecting St. Vincent General Hospital District, said the hospital is vital to her family’s life in Leadville — the place where three generations have “lived, been born and died.” Her great-grandparents moved from Slovenia when Leadville was a bustling mining community and she saw it become a near-ghost town in the 1980s and recently come back to life as younger families and hipsters move in.  

The hospital was there through the booms and busts. 

But one day in 2014, Bezzic’s father called her in a panic. The hospital might be closing down, he said. Without access to care, he’d have to sell his house and move. 

 “I don’t think they believed we were going to do it”

Constructed in the 1950s, the St. Vincent hospital was deteriorating by the time local voters rejected a tax increase in 2014 that would have funded improvements. The heating system was decrepit, with poorly functioning boilers and pipes like Swiss cheese. There had not been a mill levy increase since 1988.

On the verge of financial failure, the board of the hospital said it would close in 2015. 

But Centura Health — a hospital and health care network in Colorado and western Kansas — agreed to a plan to keep the hospital open and, later that year, voters approved two mill levy increases to help stabilize the hospital and fund an ambulance service. Centura stepped away from the project around 2017.

Officials decided to build a new hospital that was slated to open at the end of 2020. The opening was held up by supply chain delays and construction crews having to quarantine, on top of extreme weather that limits construction activity. The eight-bed facility unveiled in September is next to the old hospital, which now houses various administrative offices and specialty clinics. 

“The community, of course, because of our history, were a little skeptical. And so until they saw it with their own eyes, I don’t think they believed we were going to do it,” Bezzic said.

 Specialists in orthopedics, cardiology, ophthalmology and other areas from nearby cities will come out once a month to see patients in Leadville and perform surgeries. A dermatologist has already begun seeing patients and is there weekly due to demand, said Brett Antczak, St. Vincent’s chief executive officer.

Empty hallways inside the new St. Vincent Health hospital on September 8, 2021, in Leadville, Colorado. (Hugh Carey, The Colorado Sun)

Before, residents often drove 45 minutes to two hours for care on treacherous winter roads — which sometimes required them to take time off work and find child care and transportation for procedures that required sedation.

“Obviously here in the mountains, we’re not going to do brain surgery per se, but they could do easier, simpler cases,” Antczak said. “The main goal of bringing specialists up here to Leadville is to provide care where people live. It’s easier to bring one person up here than it is to have 20 folks traveling out of the county for the day.” 

For emergencies, a heated helipad has been added to quickly transport patients who need critical care out of the region. Before, the helicopter would land in a parking lot that might be frozen with snow and ice — Leadville experiences freezing temperatures on more days a year than not.

Crucial minutes could be wasted shoveling the area clear and moving cars so it could land. (​​When Bezzic’s grandmother was growing up, town residents used to dig tunnels to go to the grocery store in winter months and let their cars get buried in the snow, she said.)

A Denver-based physician group — which Luyten is a part of — staffs the hospital’s emergency room. Hospital officials said the setup brings in highly trained physicians and frees up local primary care doctors to focus on more common ailments and see more patients.

Before, “when our one doctor in town had to go to the emergency room, all of his patients had to sit there and wait until he was finished in the ER,” Bezzic said. 

The hospital is financed with a low-interest $17 million loan from the U.S. Department of Agriculture and $4 million in private lending. It also received a $535,000 grant from the Colorado Department of Local Affairs. Taxpayer dollars raised through mill levies make up less than 8% of the hospital’s $13.5 million annual operating budget. 

Local officials hope the new hospital will encourage residents to get preventative care, and that having an ambulance and hospital close by will assuage the worries of seniors who live or want to retire in the region. The new facilities — complete with nicer linens, soothing music and 55-inch televisions on which patients can watch Netflix — could attract health care workers as well, officials said.

A medical service helicopter sits on the helipad at the new St. Vincent Health hospital on September 8, 2021, in Leadville, Colorado. (Hugh Carey, The Colorado Sun)

Tom McConaghy, with the Upper Arkansas Area Agency on Aging, said seniors tend to need more regular access to testing and having to commute for those visits “impacts those who can afford it least.” 

He expects people will still need to travel for certain procedures or will choose to seek out renowned specialists — for example, to see orthopedic doctors in Summit County to have hips or knees replaced. His agency, which serves Lake County, helps reimburse transportation expenses for those over age 60 traveling for care.

“It’s not an end all, be all,” he said. “It’s a small hospital, of course, but they do offer a lot of things that haven’t been offered in that area for quite some time.”

The hospital won’t offer all services. 

St. Vincent will provide prenatal care up to 36 weeks, but will only deliver babies in the emergency room — by an ER doctor, not a midwife or obstetrician. Hospital officials said St. Vincent’s small size leaves them unable to perform surgeries and administer anesthetics 24-hours a day outside of emergencies, and babies born at high altitudes often take their first breaths on oxygen. 

There are maternal care deserts across the state and country. 

Alison Davis, director of the Center for Economic Analysis of Rural Health at the University of Kentucky, said changing demographics in rural areas — more elderly residents and fewer young families and expectant mothers — is one reason hospitals have cut obstetrics wards.

That can be self-fulfilling, she said, “because now it’ll be harder to attract young families because they don’t have the ability to give birth in their community.”

A hospital can serve as an economic engine for rural communities 

The hospital’s revival comes at a time when many rural hospitals are facing dire financial straits due to low patient volume and insufficient government reimbursement rates. More than 100 rural hospitals have closed in the last decade in other states, and about 22 of the state’s rural hospitals were operating in the red pre-pandemic, according to Michelle Mills, chief executive officer of the Colorado Rural Health Center. 

The hospital’s reopening also coincides with a shifting economic identity in Lake County, which had an estimated population between 15,000 to 40,000 during an 1880s silver boom. Its population plummeted to 5,400 residents after the temporary closure of the molybdenum mine outside Leadville a century later, but has since grown to around 8,000, fueled by tourism, the mine’s reopening and a recent influx of work-from-anywhere pandemic transplants. 

Four hundred new homes, a new county building and a second fire station are being built for a growing population and visitors who travel in to snowshoe, ski and climb the state’s highest peaks, local officials said.

The surgery room with a dummy for demonstration during the grand opening inside the new St. Vincent Health hospital on September 8, 2021, in Leadville, Colorado. (Hugh Carey, The Colorado Sun)

“It’s not just a mining community anymore — it is really starting to turn into more of a destination in itself,” said Michael Yerman, a planner with the Southern Colorado Economic Development District, who said the hospital could provide an “economic backbone” for the region. The district works with 13 counties including Lake County. 

Experts say health care infrastructure is a draw for businesses looking to set up shop in a community, and that a hospital itself can bring families to an area and provide an economic future for high school or college graduates who want to keep working nearby. Health care as a sector typically has a low unemployment rate, and hospitals can bring jobs for health care workers and those in related industries, like medical records management. 

“Communities that have regional care facilities — which (Leadville’s) hospital would be — tend to be the stronger, more populous communities,” Yerman said. “People relocating to communities, that’s one of the major things they look for.”

Davis, with the rural health economic analysis center, said hospital jobs pay well, have benefits, and “tend to attract individuals with higher levels of education, which is what a lot of our communities are searching for.” 

A hospital can also help maintain rural areas and their sense of community by offering seniors who need care a means to stay, said Katharina Papenbrock, a deputy director in Colorado’s Rural Opportunity Office.  When paired with local workforce training programs, it can do the same for recent graduates who need jobs.

“Having systems like local hospitals, health care facilities — those types of things really, really encourage that,” she said.

The hospital won’t be a perfect health care solution for every resident. About three-quarters of Lake County’s workers commute to places like Eagle and Summit counties, so it is easier for some to get care in the town where they work.

Residents have also raised concerns about medical cost and lack of options. 

A 2020 report from Lake County officials and St. Vincent found some residents would more readily seek health care if they could afford it, had health insurance or had more choices. The report said people of color and low-income communities are generally more likely to struggle with food and housing needs, putting them at greater risk for poor health. 

Lake County has a larger Latino population — 35% —  than the state overall, and a lower median income.  Latino residents reported more difficulty affording medical costs than white residents. 

Still, local officials believe the hospital will expand access to care and save residents the burden of having to travel miles over a mountain to go to an appointment. 

“As a community member and as a mom with two young children, there’s times when you just can’t wait,” said Lake County Commissioner Kayla Marcella. “We’ve come a long way from patients or community members not knowing where to turn for medical care.”  

Shannon Najmabadi covered rural affairs and the rural economy for The Colorado Sun from 2021-2023.