Retirement ironically proved short-lived for 69-year-old Ted Matthews. Just eight months into retirement, he received a call from Pete Klein, an Anson General board member and good friend, asking whether he would come back to help the struggling hospital. Matthews said he didn’t think twice, answering, “How could I say no to my home community?”

Like most other rural hospitals in Texas, Anson General has struggled with financial problems, jeopardizing its survival, in an ongoing battle that has lasted for years. From staffing shortages to a lack of patient volume and the financial situation of most of its patients, Anson was at the crossroads of closing its doors not just for the day, but for good. This again led Matthews to stand in the same position where he had entered rural health care back in 2003, with a mission to save the hospital all over again, in part by converting it to an emergency rural hospital. 

Across America, word has come back of rural hospitals closing at a frightening rate. A whopping nearly half of all rural hospitals operate with deficits ranging from 20% to 100%, according to the Chartis Center for Rural Health. 

Texas bore the majority of these cases, with multiple hospital closures over recent years, 27 of which were just like Anson’s.

“Pay for an inpatient unit, staff it, though sometimes not used at all, are gigantic costs that hospitals are losing money on,” said Craig Hunnicutt, Hendrick Health Director, Regional Services.

Limited populations and demographics, covered in large part by federal health care programs that generally don’t pay the full cost of care, present a financial strain for many rural hospitals. In fact, according to Hendrick’s president and chief executive officer, Brad Holland, hospitals often get less than 85 cents on the dollar for the federally insured patients they serve.

In Anson’s case, this would apply to well over half of the community members they provide care to.

To assist with this, the federal government under the Biden-Harris administration developed the Emergency Rural Hospital designation, allowing hospitals to shut down inpatient areas while maintaining emergency and outpatient services in exchange for federal subsidies.

These subsidies average about $385,000 a month, providing critical financial aid regardless of patient volume. Such assistance is important since closing a hospital affects more than just health care access; economic security, employment stability, and the health of a community are also at stake.

“Rural health care is a three-legged stool,” Matthews said. “You have to have industry, an excellent school system, and medicine. If you lose one of those, all of that just tips over.”

And he is right, Anson General is a valuable asset to the community, employing over 60 people whose families depend on their jobs, as well as giving fellow residents access to medical care. The hospital closure would have been a huge blow to the city in both of those factors.

So, closing the hospital down was not a possible solution, but keeping it alive wasn’t an easy decision either. However, it was a necessary one, to maintain the hospital staying in its community due to the closest other hospital being 25 miles away. 

“It doesn’t seem like a long distance when you’re healthy, but it’s a long way when you’re in the back of an ambulance,” said John Henderson, chief operating officer of TORCH.

Although everyone can get behind the decision to keep Anson in the community does not solve the money issue, and with millions of dollars in debt, Anson General was looking for strong leadership. That’s when Ted Matthews stepped in as interim CEO.

“When I arrived in February 2023, I walked through the front door and proceeded straight to Ms. Gonzalez’s office,” Matthews said. “I asked her, ‘How bad is it?’ and she said, ‘Really bad.'”

The hospital had accounts payable of credit holds at $800,000, a loan of $1.8 million, and more. Basic equipment was also overdue for maintenance, and there was no money to fix it.

“We were operating a duct tape around here,” Matthews said. “We just kept a roll in our pocket.”

While trying to reverse the hole that the hospital was in, some changes had to be made.

“Every month, we targeted reducing costs by 2% to 3%,” Matthews said. “We had an 18% reduction in staff. And I’ll tell you, those were really trying times for us because everyone that worked here basically lives within our community, and when you have to make those decisions, it affects individuals personally.”

But despite the difficult decisions, the hospital did indeed survive.

“We became extremely aggressive identifying grants and supplemental payments that could fund our hospital and help us offset that debt,” Matthews said. “By October, we had paid all the debt off.”

These decisions played a huge role in the survival of the hospital. 

“I just don’t think there would be healthcare in Anson if it weren’t for Ted,” Henderson said.

And it is probably because, to Matthews, Anson General was not just a business, but a personal tribute to helping his community and hoping to make a lasting change.

“I hope I’m remembered for making a difference in rural healthcare,” Matthews said. “For making things better.”

And about the whole retirement thing?

The plan was to retire again in a few months for Matthews because the hospital brought on Chief Operating Officer Justa Clark, who is in training and recently has taken over as CEO.

Matthews conceded he doesn’t envision going completely cold turkey, however, saying he can’t completely run away from helping people.

“I imagine I’ll stay connected to rural healthcare in some capacity,” he said with a smile. “And my wife is okay with that.”