Congressman Mark Alford visited Bothwell Regional Health Center last week for a firsthand look at the hospital’s operations, its role in the community, and the financial pressures that threaten rural health care sustainability.
Bothwell is more than a hospital. For 95 years, it has been a trusted part of west-central Missouri, caring for people in their most important moments. The hospital is deeply rooted in the community and grounded in the values of community, purpose, integrity, and joy. As a city-chartered, nonprofit, independent health center, it has never received local tax support. Everything built over the decades has come from hard work, strong partnerships, and a lasting commitment to the people it serves.
Every dollar invested in Bothwell strengthens the regional economy. With more than 1,000 employees, it is Sedalia’s largest employer and a pillar of economic vitality. The hospital operates 24 outpatient clinics in communities including Cole Camp, Lincoln, and Warsaw; handles more than 318,000 patient visits annually; and provides 24,000 Emergency Department visits each year. It has brought on more than 25 new physicians and providers in the past two years and employs or contracts directly with 150 physicians and advanced practice providers. As home to Missouri’s first rural family medicine residency program, it currently trains six resident physicians, two of whom have already graduated, creating a pipeline for future care providers in the region.
During the visit, Mayor Andrew Dawson underscored that Bothwell’s independence is one of its greatest strengths — and also one of its biggest challenges. As a community-owned hospital that receives no local tax subsidy, every decision about its operations, investments, and services is community-led, guided by people who know and understand Sedalia. This approach allows Bothwell to be more responsive to patient needs and community priorities. However, Dawson also noted that the hospital receives no local tax, and the hospital must generate every dollar it spends in an increasingly difficult health care environment, making financial stability a constant balancing act. 
State Representative Brad Pollitt emphasized the direct link between a strong hospital and economic development and pointed to the recent passage of the Farm Bureau Health Care bill as a win for rural communities. The new law is expected to give farm families and small business owners another option when searching for health care plans that best fit their needs and budgets — expanding access to coverage while helping support hospitals that serve rural Missouri.
CEO Lori Wightman outlined the financial landscape. Despite recording its first positive operating margin since 2018 in FY2024, the hospital still provided more than $21.6 million in uncompensated care last year. Bothwell operates without local tax support, receives less from Medicare and Medicaid than the cost of providing care, and competes for resources with larger health systems. New federal policies — including the CMS Transforming Episode Accountability Model (TEAM), expanded quality reporting requirements, and a proposed 340B rebate pilot program — could add millions in costs and further strain the hospital’s already limited financial cushion.
Alford’s tour included the Intensive Care Unit, where he met Dr. ShiAnne Farris, a family medicine resident who chose Sedalia for its broad training opportunities and plans to remain in the region. In the Emergency Department, Emergency Director Mike Shipp and Dr. George discussed patient volume, high-acuity cases, and ongoing construction aimed at improving patient flow.
The visit concluded with a discussion of capital priorities, including expanded surgical capabilities, infrastructure upgrades, and partial replacement of the aging hospital facility. Hospital leaders expressed hope that the meeting will help open the door to federal support, ensuring Bothwell remains a lifeline for west-central Missouri for generations to come.
