ST. FRANCISVILLE - West Feliciana Parish Hospital receives 150 to 200 emergency calls a month. It's emergency room sees 6,000 people a year. If its doors were to close, 200 emergency phone calls would go unanswered, about 6,000 patients unseen. That's the importance of a rural hospital.

A new report by healthcare consulting firm Chartis identified more than 25% of Louisiana's rural hospitals as "vulnerable to closure." The analysis was based on indicators such as decreasing reimbursements, declining operating margins and staffing shortages.

Since Chartis' initial report four years ago, 30 hospitals once identified as vulnerable to close have since shut their doors. The repercussions of closing rural hospital doors are catastrophic for two reasons: putting rural residents' health at risk and creating economic ramifications.

"It's a lot when you consider that hospitals are critical to those 30 environments," said Lee Chastant, CEO at West Feliciana Parish Hospital, on the impact of the recent closures.

Rural hospitals are known as "safety nets," hospitals that provide healthcare to individuals regardless of their insurance status.

"People don't realize that in many counties and parishes, in our case, the hospital may be the biggest employer and one of the biggest generators of economics in the community," Chastant said. "Additional physicians in the community that service our community, they would have nowhere to send their patients. We wouldn't have an emergency room. We wouldn't have an ambulance service. All the specialists would have to go away."

West Feliciana is considered a critical access hospital. To qualify for that status, hospitals must have fewer than 25 beds and be located in a rural community. West Feliciana Parish Hospital also has the parish's sole ambulance.

"We’re the only ambulance service in the community, and if they’re not contracting with the hospital, then those patients don't have routine ambulance services or routine physician services," Chastant said. "So, we see this as a big problem, and in fact, if it continues, it may be that final nail in the coffin for rural health."

Dr. Ewell Bickham is the staff emergency physician at West Feliciana Parish Hospital, a first responder, a former coroner and a sheriff's deputy in East Feliciana. He said he has worked at almost every rural hospital in the state and firmly believes in the vitality of rural hospitals.

"They're just necessary," Bickham said. "They're needed. You've got to have them. You've got to have them, you just got to have them."

The Rural Hospital Coalition of Louisiana was created in 1994 to advocate for its now 48-member rural hospitals. In 1996, the coalition helped push through the state Legislature the Rural Hospital Preservation Act, which acknowledges the poor financial conditions of rural hospitals and works to give them a chance to survive.

The executive director of the coalition told WBRZ that he was alarmed and concerned about the report's findings — since the quarter of identified vulnerable hospitals in Louisiana are members of the coalition — but he believes that the Rural Hospital Preservation Act will be the lifeline to continued rural hospitals.