By John Zippert, Co-Publisher and Editor

In a special meeting on October 23, 2025, the Greene County Commission approved a loan/grant combination of $240,000 in financial assistance to the Greene County Health System (GCHS), which includes the hospital, nursing home and physician’s clinic.
The healthcare system has been challenged by many financial problems over the past decade. The monthly revenues have not been sufficient to cover all expenses of the GCHS, for the past three years. “We have had to juggle bills for a while to keep operating and we have come to the end of the line. An IRS lien at the beginning of September took all our reserves and some funds we were holding to pay other bills. Last week, Blue Cross-Blue Shield, which provides health insurance for our employees cancelled our policy saying we owed $60,000 for two months – September and October,” said Dr. Marcia Pugh, GCHS Administrator.
The income of the GCHS has been also affected by low reimbursement rates from Medicaid, Medicare and private insurance. The failure of the State of Alabama to expand Medicaid to persons making less that 135% of poverty level income, has resulted in 40% of the people in Greene County, most who are working at low wages, not to have any health insurance coverage. This has meant that the facilities of GCHS giving increasing “uncompensated care”, which adds to the facilities operating deficits. The uncertainty of the impact of future cuts in Medicaid, Medicare and other health care benefits casts a shadow over the future financial progress of the organization.
John Zippert, Board Chair of the GCHS requested that Garria Spencer, Chair of the Greene County Commission consider advancing to the healthcare system $100,000 from the 4 mil advalorem, property tax funds , that the county collects for the hospital. Taxpayers are starting to pay their 2025 property taxes as of October 1, 2025, and will pay over the next four months. Spencer checked with the County’s Legal Counsel and called the special meeting for the Commission to discuss and act on the request.
The Commission approved the $100,000 advance to be used to pay Blue Cross-Blue Shield to reinstate the employee health insurance and to pay other bills, including payroll. The Commission also approved transferring $40,000 of Opioid Lawsuit Settlement funds to the GCHS. At the suggestion of Commissioner Tennyson Smith, the Commission also approved granting $100,000 to GCHS from the Commission’s Bingo Funds. That resolution was amended by Commissioner Roshanda Summerville for $50,000 to be used for an audit and the remaining $50,000 to pay other bills, when the GCHS presents a list of bills owed. Commissioner Allen Turner urged the GCHS Board of Directors to seek funding from the sheriff, municipalities, and other groups receiving funds from gaming.
John Zippert, GCHS Board Chair thanked the Commission for its support and said that the healthcare system might have to come back for additional help depending on the finances of the organization. Zippert explained that GCHS has a short-range financial plan and a longer-range plan that it was working to implement.
The GCHS currently has a loan/bond financing arrangement with Citizens Trust Bank to pay off bills and debts that accumulated over a dozen years ago. This bond issue matures in 2027 but should have accumulated reserves to pay off the bonds early. The healthcare system looks to make a new loan/bond issue, with the support of the County Commission, to pay off over $2million of current debts. The bonds are backed by a one cent of the 3 cents sales tax that the County Commission receives each month. The County Commission pays the sales tax funds to the bank to service the secure bridge loans to keep operating until supplied the assurance necessary to the bank and the bondholders that they will be paid.
Along with a new bond issue, the GCHS Board is looking to find other sources of new revenue for the health system. This includes a new Alabama Rural Hospital Investment Fund (RHIF), which can make grants for operational costs to qualified rural hospitals. The grant will be contingent on hospitals raising money from individuals and corporations willing to pay into the RHIF, in lieu of paying state income taxes. Another source will be the five-year, $50 billion fund for rural hospitals, in Trump’s ‘Big Beautiful Bill’. Federal regulations are still being developed for the dispersal of these funds. The GCHS also proposes to increase usage of the facilities which will increase revenues. Currently there are 38 residents in the Greene County Nursing Home, and they have 72 beds which potentially could be filled.
The GCHS plans call for securing the new bond issue by the end of this calendar year. In the meantime, the short-range plan calls for bridge loans to help the facility remain open and operating to serve county residents. The plan also includes asking creditors for patience until the longer-range plan goes into effect to receive the funds they are owed.
The GCHS Board of Directors, which is appointed by the County Commission, has vowed to keep the hospital, nursing home and clinic open and operating, no matter what it takes.