ARI SHAPIRO, HOST:
In recent years, dozens of smaller cities and towns across the U.S. have seen their local hospitals shuttered. And once a rural hospital closes, it's usually gone for good, which is why a hospital reopening in Brownsville, Tenn., is such a big deal. Here's Blake Farmer of member station WPLN.
BLAKE FARMER, BYLINE: The sun is rising over the Haywood County Community Hospital, and Michael Banks stands out front in a seersucker suit, welcoming back employees in the dim light.
JEANINE ING: There's no backing out now.
MICHAEL BANKS: All right. Go get your stuff set up. Let's get ready to rock and roll.
FARMER: Banks is a local attorney who was chair of the hospital board. Now he's CEO.
BANKS: So I remember getting called into that office right there by the CEO at the time and him telling me that they were closing. And that was in 2014.
FARMER: This hospital was part of a wave of closures that hit states that have refused to expand Medicaid to cover the working poor. In all, 16 rural hospitals closed in Tennessee - more than anywhere but Texas.
BARRY DUNAGAN: This building had sat here for six or seven years with no air circulation, no water in the lines. Everything just deteriorates.
FARMER: Barry Dunagan is back as head of maintenance after eight years. The mothballed hospital was handed to the local government, and Dunagan assumed it would be bulldozed.
DUNAGAN: It takes a world of work to ever get it back.
FARMER: But it's really happening.
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FARMER: They're down to installing the doorstops for the first phase of renovations. A new company out of Florida called Braden Health acquired this and three other hospitals between Nashville and Memphis. It's one of a handful of companies trying to resuscitate closed rural hospitals now that communities are practically giving them away. But it takes millions of dollars to get them going, even if everything goes right. Braden Health's Terry Stewart says the Haywood hospital was supposed to open in January.
TERRY STEWART: And we started seeing some spots of mold come back up. So we gutted the building out again.
FARMER: That mold severely complicated Stewart's pet project - preserving hundreds of ceramic tiles that local kindergartners painted and put on the walls in the late 1990s. Saving them has become a sort of symbol of the new owner's commitment to the community.
STEWART: If they just had one crack, I glued them back together and put them back on the wall just so I could say I saved everything I could possibly save.
FARMER: Manager Tyeshia Allen, who grew up here, is still looking for hers.
TYESHIA ALLEN: I'm going to find it. I got plenty of time to find it, so yeah. When I came here the first time, I was like, oh, my God, they still have the handprints.
FARMER: Allen moved to Illinois after the hospital closed, but the reopening reeled her home to Tennessee. She's back managing the supply room, where she's still getting the bedpans and bandages in order.
UNIDENTIFIED PERSON: How about we just put them right there? Will it fit? Perfect.
FARMER: Allen says she's trying to bring other co-workers back, too. Several nurses are driving an hour or more to work at other hospitals. Then there are the patients who've gotten used to driving to the cities for care, but not her mom, who's ready for an excuse to be admitted.
ALLEN: My mom said - she was like, well, I'm just going to come next week. I'm like, what is going to be wrong with you next week to just come to (laughter), you know, a doctor's office? Everybody's excited.
FARMER: The excitement is real, but it will take time to change habits and rebuild trust. It took until the afternoon for the first patient to show up. But Amy Spotts, who came in with abdominal pain, left a satisfied customer.
AMY SPOTTS: My husband drove by this morning and saw the sign out that said it was open. And I called him earlier, and I said, I need to go somewhere.
FARMER: She and her husband didn't realize they'd be making history - the first patients in Tennessee's first rural hospital to successfully reopen. For NPR News, I'm Blake Farmer in Brownsville, Tenn.
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SHAPIRO: And that story was produced in partnership with Nashville Public Radio and Kaiser Health News.
(SOUNDBITE OF JOAN JEANRENAUD'S "AXIS") Transcript provided by NPR, Copyright NPR.
