LINCOLN, Neb. (Flatwater Free Press) - Every day, Laura Gamble sees the importance of Pender Community Hospital in the lives of her neighbors. The woman who drove an hour to deliver her first baby. The man in a mental health crisis.

They rely on her northeast Nebraska hospital. “It’s like an oasis on the hill,” said Gamble, who grew up in the area and practiced as a nurse before becoming the hospital’s CEO.

The hospital is one of the largest employers in the 1,115-person town of Pender, Gamble said. It delivers more than 120 babies a year — the most per capita of any hospital in the state, according to its own analysis.

Across the state and country, it has become increasingly difficult for hospitals like the one in Pender to keep their doors open. Reimbursement rates for Medicaid have l

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