Lee County is the westernmost corner of Virginia, terminating at the Cumberland Gap and the Kentucky and Tennessee borders.
No matter what path you take to Lee County Community Hospital, you will do some slow driving on two-lane roads.
Monday morning, Democratic candidate for governor Abigail Spanberger visited the hospital in Pennington Gap — one of six in Virginia that are considered vulnerable to closure because of looming federal changes to Medicaid. Another one in far Southwest Virginia is Carilion Tazewell Community Hospital in Tazewell County.
President Donald Trump’s so-called “One Big Beautiful Bill” budget legislation will remove $26 billion from health care in Virginia, Spanberger said following a tour of the Lee County hospital. “The harm hasn’t hit yet.”
If she is elected governor Nov. 4, Spanberger said, “It will be on me to contend with those challenges.”
Following a community breakfast event in Pennington Gap, Spanberger — a former U.S. representative, Central Intelligence Agency officer and federal law enforcement officer — toured the hospital to highlight the threat to rural community health care facilities and “make sure Congress understands the real-world implications” of its health care cuts, she said.
Lee County Community Hospital is one of four “critical access” hospitals in the Ballad Health system, which serves far Southwest Virginia and northeast Tennessee.
To qualify as a critical access hospital under federal rules, a facility must have 25 or fewer acute care beds, be more than 35 miles from another hospital or be more than 15 miles from another hospital “with mountain terrain or only secondary roads.”
The nearest other hospitals are Lonesome Pine Hospital, a 30-minute drive away in Big Stone Gap, and Hancock Community Hospital, a nearly 45-minute drive away in Sneedville, Tenn.
According to hospital Administrator Cindy Elkins, 75% of its patients depend on Medicaid or Medicare.
The Lee County facility had to shut down in 2013 following insurance reimbursement cuts and a lack of consistent physician coverage, according to Ballad Health. The community refused to let the facility die and obtained General Assembly legislation to establish a hospital authority that acquired the building. Ballad Health reopened the hospital in 2021.
Elkins and internal medicine Dr. Jill Couch gave Spanberger a tour, including a view of one of the 10-bed hospital patient rooms, the radiology department and the emergency room.
ER physician Dr. Josh Puhr and Couch explained that while the hospital lacks an obstetrics department, 14 babies have been delivered there after mothers arrived at the emergency department.
The ER gets a lot of traffic, in part because so many low-income patients don’t have regular access to preventive care and wait until the last minute to seek help, hospital officials told Spanberger.
The addition of a helicopter landing pad after the reopening has been tremendously helpful for rapidly transporting patients to the facility or from the facility to higher-level hospital care elsewhere in the Ballad Health system, they said.
“People here understand what it is to do without this hospital after it closed,” Spanberger said after the tour.
The candidate has said she will work with the General Assembly to address the federal health care cuts’ impact on the state budget, work with the attorney general to defend critical health programs, invest in modernizing and building digital infrastructure, and build out additional administrative support to help people navigate the new requirements for Medicaid eligibility.
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