Beth Hopkins has lived in Patrick County her entire life.
She was even born at the Stuart hospital, which closed eight years ago and has sat vacant for most of the time since.
With two young boys who love climbing and leaping from high places, she finds that the absence of nearby emergency care is never far from her mind.
“It’s like, ‘Please don’t do that,’” she said of her sons. “We can’t afford that drive.”
Hopkins runs Gingerly Snapped, a homemade bath and skin care business. Her husband works as a carpenter, a trade that leaves him vulnerable to hand injuries. She remembers when he nearly lost two fingers in an accident. Their choices were to drive 45 minutes to the hospital in Martinsville, 55 minutes to Mount Airy, North Carolina, or two hours to the hospital in Radford, which is where they prefer to go for their care.
Now, as she watches renewed activity at the old hospital site, she hopes that its new owner, Tennessee-based Braden Health, will finally reopen the facility. Braden Health is a for-profit health care company that specializes in reviving small, critical-access and fee-for-service hospitals in rural areas, according to chief medical compliance officer Kyle Kopec.
Past disappointments are making some residents cautious.
Monica Hughes, a Stuart resident of about three years, remains skeptical. She owns Olivia’s Goodie Shop, a local bakery where Hopkins also sells her goods.
The bakery is named after her daughter, Olivia, who is 5 years old now. Olivia loves to run, jump and play. Living far from health care puts her mother on edge.
She remembers the promises made by the previous owners of the hospital property, including one “opening soon” sign that hung outside for more than a year past its promised date.
“We’ll see,” Hughes said. “They came in and started all this work, but that was almost a year ago. I’ll believe it when I see it.”
Two previous owners vowed to renovate and reopen the hospital but never followed through. The project was eventually abandoned and the property went up for auction. Braden acquired the site in November 2024.
Though an opening date hasn’t been set yet, the trucks pulling in and out have given some residents a tentative sense of optimism that emergency care will be available in their town again.
Work continues
Larry Henson, site manager for the project and revenue cycle director for Braden Health, has been overseeing work on the property since the company acquired it late last year. Since then, crews have filled at least half a dozen industrial-sized dumpsters with debris, he said.
The 25-bed hospital will include emergency services and two operating rooms on the lower level. The site encompasses nearly 63,000 square feet, Henson said.
Braden Health owns six critical-access hospitals, primarily in Tennessee, and its Virginia acquisition marks the company’s first in the state. Dr. Beau Braden, the company’s CEO, has also consulted on dozens of other financially struggling hospitals.
The Stuart hospital, built in 1962, still holds traces of its past. In a basement conference room, an old switchboard used to view X-rays still glows in its wall mount. In the IT room, hundreds of thin, overlapping phone lines climb the wall in a tangled web. Crews plan to remove them, but for now, they serve as a small homage to the building’s history.
The facility closed in 2017 after Pioneer Community Hospital declared bankruptcy and has sat mostly vacant ever since.
The damage was less severe than expected, Henson said. A leaky roof and old wallpaper contributed to some mold growth, but remediation is now complete. Asbestos remediation is still underway, though approaching completion.
Installing a new HVAC system included one of the more expensive changes. Braden Health hired a local HVAC company to do the work, which is nearly complete. The new system will allow patients to control the temperature in their own room.
Workers replaced the original tar-and-gravel roof with white PVC material layered over six inches of insulation. It took about 50 workers to strip off the old roofing, Henson said. Crews also tore out yards of old carpet, installed vinyl hardwood in the administrative wing and are planning on laying linoleum for the lab and pharmacy.
“One thing people don’t see is, obviously, what’s going on on the roof and what’s going on under your feet,” Henson said, pointing to a patch of new linoleum in what will be the pharmacy space.
The sewage system required urgent repairs. Crews descaled the cast iron pipes and will eventually line them with an epoxy coating. In one section, they found an empty gap around the pipe, leaving it unsupported and at risk of developing into a catastrophe.
Issues like this can cause a backup of sewage, or, in a worst-case scenario, a sinkhole could develop. Workers dug 6 feet down to make repairs.
“When a hospital is open, you don’t want to have to close the pharmacy. So when I told my support team, I told them this was a crisis averted,” Henson said.
The company also plans to expand the ambulance entrance to make it easier for emergency vehicles to maneuver and to accommodate multiple vehicles if needed, Henson said. This change was added to their plans after working closely with the local emergency medical services team.
So far, Braden Health has spent about $3 million on repairs, Kopec said. The company typically spends between $2 million and $10 million on revitalization efforts. This project was budgeted for up to $9 million.
“I wouldn’t be surprised if we get close to that,” Kopec said.
All equipment will be brand-new — an expense already built into the budget.
Because Braden Health operates as a for-profit company, it isn’t required to file publicly available tax documents like nonprofit hospitals do. As a result, there’s little financial information accessible to the public.
Braden Health’s leadership has not set a public opening date, saying they want to be certain before making any promises to the community.
Life Safety surveyors, who assess safety features such as fire suppression systems, have started their review and will return next month. Inspections will continue until all safety requirements are met.
Once those inspections are complete, the company’s application to open the critical-access hospital will move to clinical reviews. At that stage, Kopec said, Braden Health will likely announce an opening date.
Rural hospital sustainability
Nationwide, hospital closures in rural areas outpaced openings in recent years. From 2017 to 2023, more closed than opened, according to data from KFF, a nonprofit, nonpartisan health policy research organization. From 2005 to 2025, 193 rural hospitals shut their doors.
Stuart was one of three rural hospitals that closed in Virginia during that 20-year period, according to the Sheps Center for Health Services Research; the others were in Norton and Pennington Gap. The latter later reopened with financial backing from Ballad Health.
Delivering care in rural areas is more expensive because of the smaller markets. Even with fewer patients to treat, rural emergency rooms must maintain the same 24-hour staffing as their urban counterparts.
After studying other struggling hospitals, Kopec said instability can also stem from low staff morale, which drives turnover, along with outdated equipment and unfavorable insurance contracts.
“When all those things are brought together, along with, you know, maybe some poor inventory controls or a bad contract signed here or there, that leads to unsustainability,” Kopec said.
Braden Health leaders say these fragile operations are exactly where they thrive. The company aggressively negotiates contracts with private insurers, Kopec said, and makes employee satisfaction a top priority to reduce turnover. During the height of the pandemic, when many health systems relied heavily on traveling health care workers, Kopec said Braden Health had none.
“A lot of these hospitals that paid for these travel nursing contracts could have just paid their nurses more and kept them,” Kopec said.
Federal changes brought by the One Big Beautiful Bill have raised alarms among Virginia legislators and health care leaders, but Kopec said he and his team aren’t worried. They’re optimistic about the Rural Health Transformation Fund, a provision in the federal spending bill passed in July that allocates $50 billion over five years to help states offset potential harm to rural hospitals from budget changes. States will apply for the funding, then individual health systems will apply through their state for grants.
Kopec said this approach to distributing grant money is an improvement.
“What we were seeing before was that a lot of rural health grants would come out and companies that had nothing to do with rural health care or were not rural hospitals ended up with a lot of the rural health grants,” he said.
Braden Health leaders are also unconcerned about the federal changes that could make it harder for people to maintain their Medicaid expansion health coverage.
Coming from Tennessee, which never expanded Medicaid, Braden Health is accustomed to treating patients without insurance. The increase in uncompensated care that many in Virginia fear is already factored into the company’s budget for the Patrick County facility, according to Kopec.
“As far as our internal metrics go for financial stability, a Medicaid expansion state like Virginia is already a huge increase in Medicaid revenues. So those changes coming down the pike, we’re not very concerned,” Kopec said.
Rebuilding trust
In mid-2022, Chicago-based Foresight Health acquired the long-shuttered hospital, promising to renovate and reopen the site as a critical-access hospital. Originally, leadership at the company said they planned to reopen by late 2022, but they pushed the timeline back in 2023, citing supply-chain issues.
Despite assurances, tangible progress never materialized.
In early 2024, Patrick County officials confirmed that the critical-care hospital plan had officially been abandoned, sparking backlash from Foresight Health. However, few specifics followed.
By March 2024, Foresight sold the property to Wolf of Wabash LLC for $1.6 million, agreeing to lease it back to develop a behavioral health and substance use program. The deal continued to deteriorate until the property was put up for auction and Braden Health bought it for about $600,000.
Since then, Henson said he has worked hard to build trust with the community. He invites the public to stop by the site to see progress firsthand. Some locals have become “frequent flyers,” walking through the building regularly.
Henson says the community’s pride in the hospital runs deep. When the hospital was first built, residents contributed funds, and their names are still recorded in a big brass book.
For residents like Amber Huffman, whose family has lived in the area for generations, that history feels personal. She wonders if her own family members helped fund the original hospital.
Huffman now owns a small business on Main Street in Stuart. She remembers visiting the hospital on the outskirts of town when her sister needed treatment for kidney stones.
“I was just a little girl back then,” she said. “It would be nice to see it open again.”
She’s also a mother to young children, one of whom has special needs. She hasn’t needed an emergency department yet, but the peace of mind of having one in town would be priceless.