Mt. Vernon hospital assures viability with long-term respiratory care, expanding at a time when many rural hospitals are in trouble

The scheduled expansion of Rockcastle Regional Hospital Respiratory Care Center is a prime example of how one rural hospital is evolving to not only meet the needs of its community, but to also survive the many changes in health care that have been particularly hard on rural hospitals, Kristy Robinson Horine reports for The Bridge, Kentucky’s Connection to Rural Health Issues.


“Rockcastle Regional is one of the very few rural hospitals anywhere that has expanded in recent years,” President and CEO Stephen Estes told Horine. “In fact, a turbulent health care industry has resulted in some closing their doors. Rockcastle Regional has positioned itself to be viable for the long-term.”

Map from Office of the State Auditor

State Auditor Adam Edelen released a report in March that said one-third of rural Kentucky hospitals are in poor financial shape and said the survival of some will likely depend on their willingness to adopt new business models.

Since the release of the report, several rural hospitals have merged with larger hospital groups to make ends meet and rural hospitals in Nicholas and Fulton counties have closed.

The Respiratory Care Center is an example of how rural hospitals can adapt new business models by finding a health-care niche that hasn’t been served.

Within the next few months, the center, located in Mount Vernon, will add 67,000 square feet offering 28 more beds for ventilator-dependent patients and will include on-site dialysis.

Rockcastle Regional discovered the need for long-term care for ventilator patients after they opened just one bed in their nursing home to a 17-year-old long-term ventilator patient in 1978 because no other facility could handle his needs. “This decision opened a floodgate of need that no one had noticed before,” Horine writes, and 30 years later it is expanding to further meet this need.

Nearly half of the patients who spend time in the Respiratory Care Center leave the care center without a ventilator, some go home with a ventilator, but others make the center their home, Horine reports.

Meggin Nunamaker

Meggin Nunamaker, a professional speech pathologist, is one of the residents who calls the center home. She made the decision to live there after her condition shifted and she started falling down frequently. Nunamaker was diagnosed with cerebral palsy at birth, which was later re-diagnosed as muscular myopathy, a disease where the muscles of a patient are weakened.

“I have good days and bad days,” Nunamaker, who is the president of the Resident Council and involved in a weekly Bible study, told Horine. “It’s important to remember that life isn’t over when you are on a vent.”

The hospital also offers a wellness center, diagnostic imaging, nutritional services, emergency care services, home health services, an Outpatient Infusion Center, lab services, cardiac and pulmonary rehabilitation services, a retail pharmacy, a surgical suite and speech, physical and occupational therapies in addition to certain specialized medical care through partnerships with University of Kentucky units: the Kentucky Children’s Hospital, Markey Cancer Center and Gill Heart Institute, Horine reports.

Our board has had the foresight to continually be proactive and seek ways to grow rather than just survive,” Estes said. “That growth has enabled us to provide award-winning care while maintaining financial stability.”

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