In the vestibule of Mercy hospital staff gathered, on Friday, to remember a facility that had been a key part of life in Independence, Kansas. A statue of the Virgin Mary stood in the entryway, to welcome patients, to comfort family members waiting on loved ones. On Friday, the only comfort to be offered was to staff, who walked throughout the entry way, looking through photobooks of patients who had been touched by their work.
Two tables were laid out with photos and news clippings. Mothers holding newborns and friendly notes from patients who had written back to the hospital and staff to commend staff on their care. The hospital hadn’t been home to newborns in some time, as the wind down had been coming along for months, but nurses had fond memories of smiling parents and anxious fathers.
Phillip Chappuie, an Independence native, walked with me through the hospital and pointed out memories of the hospital. “My father was a doctor here. My kids were born here.”
The hospital itself wasn’t what most would expect from a hospital facing closure. Clean, pristine and well kept, for many the look of Independence Mercy Hospital would make you think of a building waiting for an opening day, a chance to greet and serve patients to signal that a small Kansas community had interest in offering residents access to good medical care, as a way to help attract new residents and businesses.
The well-kept look of Mercy Hospital and empty hallways mirrors too much of the daily life in Montgomery County. The industrial park, about 14 miles outside of town, is full of new construction buildings that lay dormant, waiting on new owners and jobs.
An Amazon Warehouse which at one point brought 1,500 jobs into Montgomery County now waits for new industry. Southwire, another partner in the industrial park and an employer of 200 lays dormant nearby.
Micky Webb, City Manager of Independence, candidly evaluated the issues. “We’ve had county meetings on prospects for businesses to help come back into Independence, to bring some jobs here. Right now, though they are prospects; they aren’t jobs right now, just prospects, just talk. I think there are prospects for more jobs in the city as well. I think there will be some expansion from small businesses. So we’ve got some job prospects, but not enough to make up for the jobs we’ve lost.”
For the city of Independence, the closure of Mercy Hospital creates an added burden. While the state legislature and governor are disinterested in Medicaid expansion, citing concerns over cost, the City of Independence is beginning to feel the immediate impact of taking community tax revenues and spending on emergency services, while concerns of a shrinking tax base grow.
Committed to maintaining a way of life in Independence, the city government invested resources in their own emergency services, adding another ambulance and more paramedics. The reasoning was simple. “We have to be able to cover an emergency at peak here” contended Webb, “and if an Ambulance is out on a call, it may take more time.”
How much more time? Jonathan Booe, a paramedic for the city, told me the loss of the hospital creates new logistical problems. “Getting an ambulance isn’t driving an ambulance from our loading bay to a hospital. An ambulance has to go to the scene, then load up, then take a patient to the hospital. If the patient is aware, yeah they can make the choice (as to which hospital they wish to seek service), but now we need extra training in a lot of things – so we know which hospital to take them to in case of emergencies.” Booe noted that he thought the city had been working “really hard” to help paramedics with good training and new tools, like an extra vehicle to make this possible. “Still, you look at the time. If a patient needs critical care that requires us to go to Bartlesville (Oklahoma), you’re taking an Ambulance out of service for 3 hours, minimum. Even Coffeyville means an ambulance is out for 90 minutes or more because of the travel back and forth on top of handling patient care.”
Micky Webb had another concern, “we want to provide quality emergency care so people aren’t taking to the highway themselves and racing to the hospital elsewhere”. The paramedics agreed with that assessment. “I live in Cherryvale,” said Booe, “so people there are more used to preventive care because they don’t have a hospital that close. Here, people are used to a hospital so they just go to the emergency room when they feel sick. That’s going to change now, driving yourself to the hospital won’t be as close.”
Local businesses worried too about the closure of the hospital. Walgreens, the nearby pharmacy, is only a few blocks away from Mercy Hospital. Patients who left the emergency room and needed antibiotics for simple ailments or quick treatment often came to Walgreens to have their needs met. “I think we handle a lot of prescriptions from there. It’ll be different, that’s for sure,” said a Walgreens cashier.
Most of the community viewed the hospital as such a staple for their daily life that they found it hard to imagine a community without it. The existence of a hospital was one of the amenities that helped draw businesses and allowed Independence to market itself as a “full service community.”
The growth in paramedics and emergency services will help with that, Webb contends, but “the real question is always about money.” Governor Brownback had promised that the sun is shining in Kansas, but in Independence, Webb notes, the struggle has been ongoing, preceding his term with city government. Upon his arrival services in Independence had already been “cut significantly”, but now he contends “we’re going to have to look at how we can cut budgets. Public safety has to come first. We just don’t have a choice, you have to have it, but we will probably have to look at what we can do.”
Independence believes their children are the key to sustaining their way of life. City workers were proud to point that unlike other small communities, kids who graduate Independence High School and attend Independence Community College plan to stay in Independence. Despite that desire to stay, some Independence natives worry about loss of jobs and services pushing more students to reconsider and move to nearby cities.
The bucket truck had arrived on the scene and was prepared to cover the sign on the emergency room, to make sure that even during the daytime people would clearly know the hospital wasn’t open. “It’s instinct. I think everyone knows, but in an emergency, someone might still try to come here.” Turning off the lights that showed “EMERGENCY” on the entry way would be a part of it, and at 9:00pm, the sign would be covered.
The paramedics for city services still had work to do, by 7pm, they had 6 calls in a shift, not that abnormal, said Booe, “we have ups and downs, we had more than 2000 calls last year”. By 8pm, though, Paramedics too had time to come to the Hospital entrance and walk through the emergency room doors one last time. The hospital was quiet tonight, two intakes with a last minute walk-in. Simple illnesses that still gave some comfort to patients who sought care. Strep Throat marked what would likely be the last of the labwork and the last patient served many figured.
Sitting on the steps in front of the emergency sign, lab workers, nurses and staff told stories of how their life was impacted, and the politics of it at all. “Have you seen Jeff King since this all happened?” I asked lab workers, “Not a peep from anyone. I’m pretty unhappy with Brownback right now, I’ll tell you that.” While the Brownback stickers in nearby areas and voting patterns tell me there are likely a lot of Brownback supporters present, on the steps people wondered why the state had seemingly forgotten to help, to bring some of that “Kansas Sunshine” governor Brownback had promised to the streets of Independence. The hospital, a private, Catholic institution withered a series of cuts it couldn’t overcome. The loss of industry, jobs, residents who could pay and the lack of Medicaid expansion were all the small daggers that make it difficult for a small hospital to survive.
“A Catholic hospital has more than just the requirement to serve the sick, it’s a moral obligation.” Said a lab worker, “you know those urgent care centers they can turn you away if you can’t pay but an emergency room can’t, especially a good Catholic one.”
As they shared hugs and some laughs, I asked how long many had worked at the hospital. “I’ve been here 38 years”, “34 years”, “21 years”, even newcomers had time to remember “6 years”.
“What do you do next?” I asked, wondering if many who had served their community so long had plans. “Look for jobs. Still have a mortgage to pay, that’s for sure.”
Their Senator, Jeff King, and Governor Sam Brownback had run on a campaign of prioritizing anti-abortion and pro-growth economies, and had succeeded in winning votes in Montgomery county. Now, a hospital that had never practiced abortion as a religious institution was being put to rest, and the community labored to rehabilitate the job base after the promised Kansas Sunshine failed to materialize.
At 8:43pm, the lights on the emergency room sign were turned off for the last time. It had been turned off earlier as crews worked to begin the shutdown, but for the sake of employees a few more minutes were provided so they could have a final memory.
At 9:06pm, the signage that rest above the entrance way to Mercy Hospital was covered and all blinds were drawn on the 2nd floor. “We lost something big here,” said an older gentleman as he hugged an RN, “my wife passed away here, and you were so good to her."
For Micky Webb, the show must go on, and as city manager, he has to find a new way to help his city succeed. “Now is the ideal time for a strategy meeting about where do we go next. I’m ready for that meeting. I think we now have a chance to step back and say: what can we do, what should we do for the good of our residents of Independence and Montgomery County.”
No matter what the city leadership decides, though, the lack of leadership in the statehouse to consider Medicaid expansion makes it significantly unlikely that Independence can foster their own hospital again anytime soon.
Exiting town, the flags and signs for Neewollah flap in the wind, a town celebration designed to encourage kids to come to the town and celebrate rather than play tricks. The celebration which has gone on since 1919 will feel different this year; the tricks that Neewollah was formed to stop may not happen – no burning hay bales in Independence future – but for many, the loss of employment and a way of life will weigh heavy on many attendees, and that reality for them is unfortunately not a trick they can easily solve.
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