CELINA, Tenn. (WTVF/WJHL) – When Maria Ramirez stopped breathing back in August, her son John rushed her to the emergency room. The only problem was, it was closed. John had taken his mom to one of the 12 rural hospitals now-shuttered across Tennessee.

That is when time mattered the most for John Ramirez’s 94-year-old mother.

“If the hospital had still been open? She would’ve survived a little longer, and she would’ve had a little more time,” John Ramirez said.

With no time left, John drove to a small family clinic across the street where, in the parking lot, family physician Dr. Richard Clark started performing CPR.

“In my car… it’s crazy but it’s reality,” John Ramirez said. “She was in the car, we laid the seat back and had to do it in the car, in the parking lot.”

This is the reality of rural healthcare in Tennessee. With emergency rooms closing, people like John Ramirez don’t know where to go in an emergency.

“I feel more responsibility, you can say that’s pressure, Fentress County is in danger,” John Ramirez said.

By the time Maria Ramirez made it to the hospital, most of the damage from the stroke was done.

A few days later she was gone.

“If the hospital had been open, would she still be alive? Oh, yea,” John Ramirez said.

A life or death situation in Tennessee’s rural counties.

Ballad Health says recent changes to hospitals in our region is a way to continue to provide suitable care for the Tri-Cities. This comes after concerns continue to rise across Tennessee about the future of rural hospitals.

According to a report from the Tennessean, the State Department of Health highlighted more than 10 hospitals losing money over the span of three years. That report included hospitals in Greeneville, Kingsport and Unicoi County.