There was a network of ERs covering West Tennessee where each small town had one and many had inpatient facilities that were busy also. One by one the smaller facilities were either sold off or shut down. The latest is the one in Ripley Tennessee which leaves Lauderdale county residents 20 minutes highway time to either Covington or Dyersburg. You can die in less than 20 minutes without acute care.
A lot of people blame this on the ACA which is totally not true. I believe it is, in large part, due to the lack of expansion of Medicaid. Several ( mostly red ) states have refused the federal dollars and on what point of contention I do not understand. Now the big city hubs are not able to handle the patient load coming to THEM, so transfers from a rural setting can be tricky. The hospital in Ducktown near the Ocoee River is gone now with patients having to travel to either Cleveland or Chattanooga. Don't get hurt on the river. They'll have to airlift you out of the raft!
I spent a quite entertaining day with the family of friends and their two dogs. A change of activity is always good. The water is going down and it's cold again. That's all I know for sure at this point. Keep the faith kids ^j^