GRAND COUNTY – Healthcare in small communities has always been tough, according to Grand County Rural Health Network Executive Director Jen Fanning.

"Access to care isn't as great as in an urban community," Fanning said.

And in her small community, it just got tougher.

Two days ago, Grand County's only hospice program, Heart of the Mountains, closed due to lack of funds.

It opened in 2001, but Executive Director Mikee Tennant says keeping it open has been a struggle ever since.

"Rural America doesn't have the resources or volume of patients in order to make it work more successfully," Tennant said. "So it's been a struggle financially."

About 40 percent of their money comes from Medicare and private insurance. The other 60 percent comes from private donations – which have gotten smaller over the years.

"It's very difficult if you're talking about $180,000 to $190,000 a year," Tennant said.

Mix that with the rising cost of health care, and Grand County is without a hospice.

"Now medicine is about making money, and there are shareholders and so the profit margin is much more important than it ever was before," Tennant said.

The program typically cared for 25 patients a year. Two were under its care when the doors closed. They had to find facilities outside of Grand County.

Tennant is hoping a donation will get the program up and running again.

"We would love a miracle at this point and time," Tennant said. "It would be great."

But for now, terminally ill patients in Grand County will have to go somewhere else.

"This is a huge impact on our community," Fanning said. "There will be no hospice care, there will be no death with dignity at your house."

She says this will make life and death harder in her rural community.

"Dignity in death, that's what we all really want," she said.

Along with the county's hospice program, the Grand County Commissioners voted Wednesday to close the their home health care program, which sends nurses to homes to help with rehabilitation or other long term medical issues.

The effective closure date is Feb. 12. 

(© 2016 KUSA)