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Putnam County Memorial was ailing from the same conditions squeezing the finances of many of the nation's rural hospitals. At least 55 have closed since 2010 across the U.S., with another 1 in 10 at risk of going under, by one talley. Only about 5,000 people live in Putnam County, and they tend to be older, poorer, sicker and less insured than the rest of the state. Health care analysts says Medicare and Medicaid's relatively low reimbursements, combined with dwindling populations in rural regions, are forcing many hospitals like Putnam to operate with tighter profit margins than suburban institutions — and sometimes even at a loss. (Sable-Smith, 7/21)

A year ago there were almost 3,500 Kansans with physical disabilities awaiting Medicaid coverage for services to help them live in their homes and communities. Much has changed in 12 months. The physical disability (PD) waiting list is down to fewer than 1,500 people, and Kari Bruffett, secretary of the Kansas Department for Aging and Disability Services, told members of the National Council on Disability who visited Topeka earlier this month that more reductions are coming. [But] even as the number of Kansans waiting for PD services shrinks, the number of Kansans enrolled and actually receiving the services is also dropping. (Marso, 7/20)

Just 12 percent of Georgia home health agencies received a superior 4-star or 5-star rating in a new Medicare quality ranking system for that industry. The only states worse than Georgia in percentage of top-rated home health agencies were Alaska, with 0 percent, Washington state, with 3 percent, Wyoming, with 4 percent, and Oregon, with 9 percent. (Miller, 7/20)

California may be in the vanguard of a movement of parents who resist vaccinating their children against measles and other communicable diseases, but they’re going to have a tougher time avoiding the immunizations starting next summer. On June 30, California Gov. Jerry Brown signed a bill that will eliminate both personal and religious exemptions for the inoculations starting on July 1, 2016. The state joined West Virginia and Mississippi as the only ones not allowing religious or personal exemptions for the vaccine. (Evans, 6/20)

Baltimore County plans to begin charging fees for ambulance rides — reversing a policy that for years has set the county apart from nearly every other jurisdiction in Maryland and many across the country. The fees, $700 or $750, depending on the type of care provided, plus $10 per mile, will be charged to a patient's health insurance company, Medicaid or Medicare. The plan, announced Monday, is expected to add up to $26 million annually to county coffers. (Wood, 7/20)

Parents of children insured by Medicaid, the U.S. health program for the poor, are more likely to incorrectly assume antibiotics can treat colds and flu and seek these drugs when kids don’t actually need them, a study suggests. Parents surveyed in Massachusetts reported using antibiotics for their kids on average less than once a year, the study found. But when asked if antibiotics should be used for colds or flu, only 44 percent of the Medicaid parents correctly said “no,” compared with 78 percent of parents with private coverage. (Rapaport, 6/20)

Indiana's Labor of Love public health initiative to reduce the state's infant mortality rate appears to be working, according to a new report. With 7.6 deaths for every 1,000 live births in Indiana in 2012 — one of the country's worst rates, according to the KIDS Count Data Book report from the Annie E. Casey Foundation — the number of babies with low birth weight is decreasing significantly statewide and locally. Short gestation and low birth weight — less than 5.5 pounds — is the leading cause of death for infants under 1 year old among all races. (Lazerus, 6/20)

After Ashley Anderson gave birth to her daughter, Jade Marie, the nurses placed the little girl on her mom’s chest. She says she remembers her newborn looking serene, with delicate lashes, her eyes gently closed. The heartbreaking truth — as Anderson had learned during the delivery — was that Jade had died in the womb. Jade would have been a year old in May, but Anderson is far from the only mom in Wyandotte County who must celebrate filial milestones with only their memories. Wyandotte is one of just three Kansas counties where infant deaths reached triple digits combined between the years 2009 and 2013, according to statistics from the Kansas Department of Health and Environment. (Sherry, 6/20)

But for years state government here has been dominated by Republicans. Most of them are white, and deeply skeptical about the power of government to solve South Carolina’s problems. In the midst of the recession, the state’s previous governor, Mark Sanford, refused to take $700 million in federal stimulus money to help the state’s struggling schools, and did so only after the State Supreme Court forced his hand in 2009. And Mr. Sanford’s successor, Nikki R. Haley, is among a number of Republican governors who have declined to use the Affordable Care Act to expand Medicaid eligibility to the working poor in their states. Some Democrats here interpret such stands in the context of the state’s troubled racial history. (Blinder and Fausset, 7/20)

The N.C. Ethics Commission has dismissed a complaint filed against Rep. Donny Lambeth by a whistleblower who contends the lawmaker betrayed his trust. Joe Vincoli, a former hospital official who spurred a federal investigation into Carolinas HealthCare System, says that he sent emails to Lambeth in confidence in 2013 and 2014. But later, Vincoli said, he was troubled to learn that Lambeth had forwarded those emails to officials with CHS and MedCost, a for-profit health benefits company that the Charlotte-based hospital system co-owns. (Alexander, 7/20)