Representatives for the Fulton Medical Center have had meetings with local government about obtaining public financing.
"They're looking for help, and we're looking to see if we can help," Fulton Mayor LeRoy Benton said. "We're very restricted about how we can help them."
Fulton Medical Center is faced with losses due to patients who can't pay for their health care, Callaway County Presiding Commissioner Gary Jungermann said.
One meeting last week drew Jungermann, Fulton Mayor LeRoy Benton, Callaway Chamber of Commerce Executive Director Tamara Fitzpatrick, Fulton Director of Administration Bill Johnson, Fulton Medical Center CEO Mike Powell and a NueHealth representative.
"We did meet with them about three months ago," Benton added. "They said things were not looking good, but they were making some positive headway. It is a tough business."
NueHealth LLC, a private, for-profit company, and the University of Missouri Health Care purchased the Fulton Medical Center - then known as the Callaway Community Hospital - in December 2014.
At the time, then-chairman of Nueterra Dan Tasset said, "Nueterra has a strong record of improving access, affordability and quality of care in communities similar to Fulton."
Since then, company officials have said unpaid medical expenses from the indigent have impacted the company's finances, according to Jungermann
"They're just worried that they're not ever going to break even," he added. "On an average, they're losing close to $200,000 a month. They're trying to figure out ways to supplement their losses."
By law, emergency rooms are required to treat anyone who walks through the door.
MU Health has made large contributions to the hospital since its formation, MU spokesperson Mary Jenkins said.
"As a non-controlling minority member of the limited liability company, the university has made approximately $1.6 million in capital contributions to help fund Fulton Medical Center since it was formed," she said.
One possible remedy is to create a "hospital district."
"It's real similar to like the ambulance district," Jungermann said. "They're their own separate entity, and they collect tax dollars to run."
People living within the district would pay additional property tax. He said the city, county and a newly formed hospital district board likely would work together to determine the amount of tax to levy.
However, it wouldn't happen soon, officials said.
"Nothing's going to happen in 2017," Jungermann said. "The potential of something being on the 2018 ballot is there, but it's not a great potential."
The city and county would have to review the hospital's financial records, then determine what area the hospital district would cover and whether the property owners within it could make a dent in the hospital's losses.
Jungermann pointed out people on the west, south and north sides of the county are likely to head toward hospitals in Columbia, Jefferson City or Mexico instead of Fulton. The district would likely encompass just Fulton and areas east of the city, he said.
"When we run the numbers, the county and the city might say there's no way we could run this," Jungermann said.
Then the issue would have to be voted on by residents, a board formed and a levy determined, which might require yet another vote.
If the hospital district or another solution don't come to pass, the hospital's prognosis might be grim.
"That potential is there (for them to leave)," Jungermann said.
Nueterra Capital spokesperson Dolores Kitchin said her company wants to do what's best for the community. NueHealth is the parent company of Nueterra Capital.
"We continue to assess the sustainability of Fulton Medical Center, alongside NueHealth," she said.
Kitchin said studies show one in three rural hospitals is at risk of closing.
Jungermann believes having a hospital in the county protects public health and is attractive to large businesses.
"Our whole goal is to keep the doors open," Benton added. "There's over 150 jobs - well-paid positions."
When asked why Fulton Medical Center was seeking public funding, Kitchin said that's not the right question.
"The real question is, 'How can we meet the health care needs of our community?'" she said.
"One idea on the table is turning to our community to look for the best solution, but no decisions have been made yet, and the discussion is continuing to evolve."
Jungermann has reservations about potentially using taxpayer dollars to support a hospital largely controlled by a for-profit company. (NueHealth has a 65 percent stake in the hospital, he said.)
"But when you look at it from the public safety avenue, that's a whole 'nother question now," Jungermann said. "You're not trying to make a company profitable; you're trying to make sure the needs for public safety are met."
He and other officials are seeking counsel and advice from experts on the matter, along with community feedback, he said.