Nebraska Dialysis Unit Shuts Down Despite $219M Rural Health Funding Boost

HAY SPRINGS, Neb.— On a crisp February morning, Mark Pieper left his home near his cattle ranch before sunrise. For the past three and a half years, he had made the same early-morning commute three days a week to Chadron Hospital for dialysis. That day would be one of his last sessions before the hospital ended the service in late March.

Pieper, who lives outside Hay Springs—a town of 599 residents, according to a town sign—always remembered his chocolate-brown cowboy hat before driving his pickup truck for a half-hour to Chadron. When he learned the center was closing, he recalled thinking, “I guess I’ll just bloat up and die in a month.”

Pieper relies on dialysis to survive after cancer treatment damaged his kidneys. He was one of 17 patients who depended on Chadron Hospital for the life-sustaining therapy that filters waste and fluid from their blood—a job their failing kidneys could no longer do. Each treatment lasts about four hours.

The closure highlights the long decline of health care services in rural America, where residents face higher rates of chronic conditions but have less access to care than elsewhere. The Trump administration had pledged to address the issue with the $50 billion federal Rural Health Transformation Program, launched in September 2018. However, experts question whether the funding is enough to reverse the trend.

“[President Donald] Trump says he is going to help the rural health care,” Pieper said. “Dialysis is one thing that we really need here.”

Patients Forced to Relocate or Travel Long Distances

Some patients have moved closer to care, including several nursing home residents who now live farther from their families. Others endure lengthy drives to dialysis centers. Pieper eventually found treatment in Scottsbluff, the largest city in western Nebraska’s rural Panhandle region, with about 14,000 residents. His new commute will triple his travel time, adding more than nine hours on the road each week.

Jim Wright and his wife reduced their drive time—but increased their expenses—by renting a small home near Rapid City, South Dakota. They live there on weekdays so Wright can receive dialysis. “I understand that rural hospitals face financial challenges,” Wright said. “But we’re talking about something that’s lifesaving. It’s not a matter of, ‘Oh, I would like to be there.’ It’s a case that if you don’t, you die.”

Hospital CEO Struggled with Closure Amid State Funding Announcement

Jon Reiners, CEO of the independent, nonprofit Chadron Hospital, faced a difficult decision to end dialysis services. The closure was announced as Nebraska officials celebrated the state’s receipt of $219 million in first-year funding from the Rural Health Transformation Program.