BRIDGEPORT, Ala. (AP) - It seems everyone around here knows someone who owes his or her life to North Jackson Hospital in the foothills of northeast Alabama.

Joyce Cooper's mother was treated for congestive heart failure at the one-story hospital. Shirley Woodall's aunt was there for chronic pneumonia, and her pastor drove himself to the emergency room for a snake bite suffered while turkey hunting.

The red-brick hospital, built in 1959, has a familiarity as comfortable as the two green rocking chairs on its shady front porch.

But the publicly owned hospital has accumulated $1.03 million of debt since October and is itself in need of life-support. The Jackson County Hospital Authority plans to vote in August whether to close it.

"The older people who have always used this hospital will not go anywhere else," said Andrea Phillips, who works at a doctor's office next door. "It's their hospital."

The problems plaguing North Jackson are being played out at small, rural hospitals across the country.

The Department of Health and Human Services reported that 64 hospitals closed nationwide in 1999, the last year for which statistics are complete.

The 21 rural hospitals that shut down that year had an average occupancy rate of 31 percent, according to a government report. North Jackson's occupancy rate in 1999 was only 18 percent, state figures showed.

Rural hospitals have trouble hiring workers and competing with larger hospitals, says the American Hospital Association.

Compounding the problem, according to the AHA, is the fact that rural hospitals receive more than 40 percent of their revenue from Medicare, yet they are reimbursed at a lower rate than urban hospitals.

Bills have been introduced in Congress to improve Medicare payments for some 2,600 rural hospitals nationwide, but any aid might come too late for North Jackson.

The 64-bed hospital admitted only four patients a day on average last month. The emergency room treated about 15 people a day.

Without North Jackson, residents of the nearby towns would have to drive about 15 miles to a hospital in Jasper, Tenn., or 30 minutes to Scottsboro.

The thought of losing North Jackson has spurred supporters to action. Last month, about 250 people attended a community meeting about saving the hospital, where six doctors practice, and Gov. Don Siegelman has toured the facility.

"I don't know that I can help," Siegelman said. "I can only promise you that I'll try."

Teacher Becky McCoy is leading a community drive to keep the hospital open. Options include more government money, new management or maintaining only the emergency room.

McCoy's two children were born at North Jackson, and her grandparents died there. "It's the only hospital I've used for 20 years," she said.

North Jackson Hospital sits on old U.S. 72, a two-lane blacktop replaced long ago by a divided highway several miles away.

That isolation is at the heart of the hospital's problems. Jackson County has only 54,000 residents, and many of them live in or around Scottsboro, site of the much larger Jackson County Hospital, also run by the county authority.

North Jackson's work force has dwindled from about 90 employees to about 60 as fewer patients showed up. Employees are being reassigned or leaving on their own.

After 13 years at North Jackson, Sharon Grider is being forced to become a roving nurse who will move between North Jackson, the adjoining county nursing home and the hospital in Scottsboro.

"I don't want to be a jumping bean," she said, bidding a tearful farewell to co-workers. "This is where my heart is."

The hospital's two operating rooms are used only on Tuesdays, and the obstetrics unit sits idle. Some of its most recent babies are old enough to be in elementary school.

It saddens Joyce Cooper, whose mother, Elsie Gilley, was admitted to North Jackson five times over the last year.

"If it hadn't been for this hospital yesterday my mama would be dead today," Cooper said.

Taking a break during a visit to aunt Ruby Burton, Shirley Woodall looked out over the nearly empty parking lot.

"I don't know what the solution is," Woodall said. "But I know it's a much-needed facility."

Excite

-- Anonymous, July 30, 2001