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The upcoming closure of a hospital in the southeast Kansas community of Independence has highlighted the problems faced by rural medical providers in states that have refused to expand their Medicaid programs. "The climate of health care these days is very challenging, and particularly for small rural hospitals like ourselves," said Joanne Smith, spokeswoman for Mercy Hospital in Independence. "We are facing decreased reimbursement; the fact that Kansas did not expand Medicaid has been a significant factor in our reimbursement, and declining population here in our corner of Kansas, as well as a lot of outmigration of patients to other communities for their health care." According to the National Rural Health Association, at least 55 rural hospitals across the nation have closed since 2010, and 283 more are at risk of closure. (9/13)

A small-town mayor who's already walked more than 550 miles to bring attention to the closure of the town's hospital is putting more mileage on his sneakers in hopes of getting a certificate that would allow the facility to reopen. Mayor Adam O'Neal left his coastal town of Belhaven on Sept. 8 and plans to finish the 130-mile walk to the state's Capitol on Wednesday, when he hopes to meet with Gov. Pat McCrory. (Waggoner, 9/12)

In a 300-page report released Friday evening, the Centers for Medicare and Medicaid Services, or CMS, detailed dozens of violations in the lab at Cleveland Clinic's Marymount Hospital in Garfield Heights. The CMS report cites wide-ranging violations of federal standards. These include numerous failures to follow established procedures with regard to testing blood samples, maintaining and checking the temperature of blood products, calibrating machinery, labeling supplies, and using expired materials to perform tests. (Zeltner, 9/11)

Sheila Rush has been fighting for an adult trauma center on the South Side for five years. In August 2010, her 19-year-old son Damian Turner was shot in the back just blocks from the University of Chicago Medical Center — which doesn’t have an adult trauma center. He died after paramedics drove him nine miles away to a downtown hospital. On Friday, she stood outside the Hyde Park hospital surrounded by members of the group she helped form — the Trauma Care Coalition — who held signs that read “Trauma Care Won.” The “Won” used to read “Now” on the group’s posterboards. On Friday, the word was flipped as a sign of victory. (Sfondeles, 9/11)

If a child were to build a hospital out of Legos it might look like the new Children's Hospital of Michigan Specialty Center, an irregularly shaped, multicolored facility slated to open in February in the Detroit suburb of Troy, Mich. “Everybody drives by it and says, 'I know that's for kids, but I'm not sure what it is,'” said Ron Henry, chief facilities engineering and construction officer at Tenet Healthcare's Detroit Medical Center, which is building the facility. The look is appropriate because the facility is indeed for children. But the Lego analogy—building in pieces with the ability to easily convert the structure into something else—is apt for another reason. (Royse, 9/12)