Boxes were stacked as high as 6 feet in many of Hartselle Medical Center's administrative offices by 3 p.m. Tuesday, and the only work being done in the emergency room was inventory.
The medical facility, which has served this Morgan County city for more than 60 years, was down to its final hours when news came of a slight reprieve: Huntsville Hospital announced a tentative agreement with Tennessee-based Capella Healthcare to acquire the hospital's assets for $1.5 million.
The deal, expected to be finalized within 45 days, includes the 150-bed hospital site and its equipment, plus facilities Capella rents to doctors and Encore Rehabilitation on Pine Street.
The potential arrangement could keep the facility in place, at least for outpatient and ambulatory services. It remains unclear whether the transaction would save jobs or how many.
Huntsville Hospital Chief Executive Officer David Spillers said Huntsville will provide some level of medical services in the facility, but emphasized it will not keep the place open as an inpatient hospital.
"There may be an opportunity for us to provide some services on an outpatient basis," he said.
Spillers said Huntsville will work to keep physicians in Hartselle by providing them access to services their practices need, "such as lab and imaging."
Before stating exactly what it will do with the hospital, Spillers said, Huntsville will assess what services and technology the community can support.
"We would definitely want the community to be supportive of any plans we might develop, but whatever is proposed would have to make financial sense," he said.
Mona Jackson, longtime emergency room nurse manager for Hartselle Medical Center, was working Tuesday when Capella announced Huntsville's purchase.
A nurse for almost 30 years, Jackson has accepted a job at Parkway Medical Center in Decatur, which Huntsville Hospital purchased in December from Capella for $17.5 million.
She will be case manager of the emergency department at Parkway beginning March 12.
"At this point, I'm just ready for it to be over," Jackson said of the Hartselle closing.
She said she was devastated when Capella announced the closing, her emotions ranging from anger to sadness.
But she wasn't totally surprised.
"There had been talk (among employees) because the patient census was going down," she said. "I was the biggest one in denial. My heart wouldn't let me accept it."
The hardest part was accepting that she would no longer see her coworkers day after day.
"We have an excellent crew here," Jackson said. "That's what's so difficult. It took a while for us to build what we have here.
"Now it's gone."
She treated her last patient in the emergency room at 1 p.m. Tuesday.
"It was for minor injuries," she said.
The hospital dismissed its last admitted patient Thursday. Since it stopped admitting patients a week ago, the emergency room had seen 13 patients per day until Monday, when only three came for treatment.
Outside, a blue tarp covered the lighted hospital sign. Wooden barriers were in the entrances with signs saying the hospital was closed and those with emergencies should call 911.
"My job here is complete," CEO Tim McGill said. McGill will remain with Capella.
"It will be somewhere north of here," he said.
Capella officials said the company decided to close the hospital after Morgan County's Medicare reimbursement wage index dropped to the lowest in the nation this year.
That meant Hartselle Medical would be reimbursed for Medicare expenses at about half the rate for a procedure in a state with a high wage index, such as New Jersey.
About 40 percent of patients in Alabama hospitals are on Medicare.
Capella called the wage index change a multi-million dollar decision, and announced that it was closing the hospital after failing to reach agreement to keep it open with four different healthcare providers.
Spillers said Huntsville entered the picture after doctors in Hartselle called and expressed concern about access to equipment they needed to maintain their practices.
This tentative agreement and the Parkway acquisition give Huntsville Hospital a near monopoly on area health care. From 2008 through 2010, Decatur General, Athens-Limestone Hospital and Helen Keller Hospital in Sheffield formed affiliations with Huntsville. Helen Keller has a subsidiary in Red Bay.
The $71 million Madison Hospital to open in February is part of Huntsville Hospital's not-for-profit system.
Hartselle Mayor Dwight Tankersley said he was saddened about the change for 136 employees at Hartselle Medical Center, but encouraged by Huntsville's plan.
"I just want them to open some kind of medical facility there," he said.
