VAN ZANDT COUNTY, Texas — Nearly 55,000 people live in Van Zandt County. However, for decades there has been one hospital to provide emergency care services to the entire county. As of Monday, Van Zandt Regional Medical Center is no longer in operation. 

RELATED: Grand Saline hospital closes its doors citing Medicare cutbacks, low reimbursement

The closure was announced Sunday via a post on the hospital's Facebook page. According to the post made by Jerome Crane, physician assistant, Medicare cutbacks and low reimbursements from insurance companies forced the hospital to close. 

Van Zandt Regional Closes
Facebook: Van Zandt Regional Medical Center

Across the state, several small-town hospitals are struggling to stay open. Rural hospitals face many challenges including the recruitment and retention of qualified doctors and nursing staff. 

In this particular case, Van Zandt Regional Medical Center is the most recent name of the hospital located on Waldrip Street in Grand Saline. The name change happened in May following a transfer of management. 

While no one cared to speak on camera regarding the hospital's closure, Crane spoke with CBS19 off-camera regarding the hospital's current situation. He says the financial burden left behind from previous management proved to be too much to maintain for current management. 

Crane says due to the Medicare cutbacks and lack of reimbursements, the new management has covered the hospital's payroll, expenses and debt either out-of-pocket or through loans for the last three months. He could not say how much debt the hospital accrued or how much out-of-pocket funds the new managers have spent to sustain the hospital. 

Even though Van Zandt Regional remains licensed under Texas General Hospital, which gained ownership in 2016, Crane says the hospital is locally-operated by a board made up of volunteers. 

He says all hope may not be lost for the facility. Management is apparently in negotiations with a local physician group that has shown significant interest in assuming control of the hospital. If reopened, the hospital could continue as a full-service facility or become a standalone emergency room. Crane says the decision is expected to be made this week. 

Hospital Negotiations
Facebook: Jerome Crane

In response to the closure of Van Zandt Regional, Grand Saline Mayor Jeremy Gunnels sent the following statement to CBS19:

"I am saddened by the closing of Grand Saline’s Van Zandt Regional Medical Center.

I toured the hospital at its Grand Opening with the new owners and was very impressed with the cleanliness and upkeep that I saw. The hospital may have been mismanaged in the past with possible flawed billing strategies. Those issues were resolved but unfortunately, those negative connotations were associated with the current situation which drove people in need away.

The hospital is very important to our community and surrounding communities; therefore, I am hopeful that the doors will reopen, the community will see the improvements, and that the hospital will thrive again. In the meantime, we hope to continue to work with UT Health Systems to provide community access to a local clinic."

No matter what decision is made regarding the hospital's fate, Crane says he will continue to operate the Grand Saline ACO Medical Clinic. He says the clinic will no longer be under the same ownership or management as the hospital if it reopens. The clinic looks to add new services including cardiology, orthopedics, neurology, and pain management.   

While Van Zandt Regional Medical Center is closed, the nearest hospitals are in Quitman, Tyler, Dallas, and Athens.