Community health systems are coming under increasing financial pressure and that’s creating uncertainty for rural patients.

A case in point: less than two years after it acquired three Mississippi hospitals and doubled its size, Curae Health has filed for Chapter 11 bankruptcy, stating it owes more than $96 million, and placed itself up for sale.

“We hit our targets in terms of expense reductions and savings that we had anticipated when we took over,” explained the Clinton, Tennessee-based health system’s CEO, Steve Clapp. Revenues fell after the acquisition, he said, which ultimately proved “too problematic.”

“Physician turnover contributed a little bit. There were delays in the Medicare extender programs in Congress. Those had ceased in October 2017 and didn’t get reinstated until the spring, and it was just within the last 60 days that we’ve been paid on our low-volume adjustment,” Clapp noted.

“We had some challenges obtaining financing on our information systems,” he told HealthLeaders‘ John Commins. “It was just a series of things.”

Although five other rural Mississippi hospitals have closed since 2013, Curae has assured the public that its three troubled facilities will remain open as the group seeks a buyer.

Read Clapp’s full interview with HealthLeaders here.