The Chicago Tribune takes a look at the health care crisis lead by bad debts, unpaid bills, and rural hospital closures.

When Ryan Neville was brought on as the chief executive of Memorial Medical Center, the sole hospital serving Clark County, Wisconsin, it could not get a bank loan.

With few other options, it took the unusual step of seeking help from city hall, which helped the hospital get a $1.5 million loan.

“We are very thankful for that,” Neville told The Chicago Tribune. “I think without that loan that the city helped us get or backed us on, we potentially could’ve closed or been significantly downsized.”

Nationwide, 155 rural hospitals have closed in the past 15 years, according to the North Carolina Rural Health Research Program

Wisconsin has fared better than many states: Just one of its rural hospitals has closed in the past 10 years. Others have cut services or merged with larger systems to stay alive.

But as of 2017, 16 of Wisconsin’s 76 rural hospitals were operating in the red, according to a report from Chartis and iVantage Health Analytics.

And a report from the Wisconsin Hospital Association Information Center found unpaid medical bills continue to climb as 150 Wisconsin hospitals reported $1.2 billion in “bad debt” and charity care in fiscal year 2018 — an increase of nearly $90 million from fiscal year 2017.