It had been a while since Jeanine Ing pricked a finger in Haywood County Community Hospital. She started her medical career here 40 years ago.

Now, on this day in August, the first day it reopened since the facility closed in 2014, she calibrated her equipment before any patients arrived.

“Who’da thought … I’d be back here?” she told the new owner, Dr. Beau Braden, while drawing a few drops of his blood.

Braden’s company, which has acquired four hospitals in West Tennessee, has been hiring as many people as he can find who were here when the hospital closed eight years ago.

“They know this building better than I do,” he said.

The former owners, Community Health Systems, were struggling nationwide and shut down the hospital, which sat empty until Braden took over.

Residents of the farming community of Brownsville have had to travel about an hour to the closest hospital — either to Jackson or Memphis. Those who needed a hospital job also had to travel to another Tennessee city.

A lot of rural communities have lost their hospitals in recent years, with closures accelerating during the pandemic. One of the big challenges with reopening is that people with any experience scatter to find work elsewhere. It’s a big reason that reviving a rural hospital is so rare, though Braden Health is trying to buck the trend.

Ing was commuting to a larger health system and said she grew tired of working overnight. Taking this job is a bit of a risk, she said, but she has become an evangelist trying to convince others to join.

“My sister worked here too as director of radiology. She stayed until the night they locked the doors,” she said. “I keep trying to get her to come back, but she’s teaching school, and she’s like, ‘Nah, I don’t think so.’”

It’s a tough time to be staffing a hospital from scratch. The job market is about as competitive as it’s ever been following the COVID-19-related exodus from the field, especially for experienced nurses.

According to data collected by Vivian Health, a job-posting platform for traveling nurse positions, the cost to backfill a nursing position has risen 60% from pre-pandemic levels. Rural hospitals — where money is already tight — often have to pay even more, said Tim Needham, Vivian Health senior vice president.

“It is largely a cost-driven marketplace and a benefit-driven marketplace,” Needham said. “Certainly, smaller rural hospitals, they’re going to be at a disadvantage, which means their cost of attracting talent is higher.”

So the Haywood hospital has been going after a very small pool of registered nurses — the few who live nearby.

“We interviewed a lot of the people who were here the actual day it closed,” said Chief Nursing Officer Kara Courtright.

Some in the area took lucrative travel nursing gigs during the pandemic but are ready to get off the road, Courtright said. And some local nurses are just weary of commutes; one was driving two hours each way to Mississippi.

“They realize what they miss. When you don’t have it, you miss it,” Courtright said. “And you don’t really realize it until it’s gone.”

Not that nostalgia has filled all the openings. As the Haywood hospital scales up to full operations, there are still open nurse slots, as well as in pharmacy, maintenance, nutrition services and billing.

Even a small hospital can employ a few hundred people, which is why losing one is such a blow to small communities. Often, hospitals are the biggest private employer with the highest-paying jobs around.

“And it’s not just a job. Seriously, it’s not just a job,” said Katrecia Miller, who resumed her position as an emergency room registration clerk a few weeks ago.

In taking the job, she said it felt like she was helping lift up her hometown. She had been watching the signs out front over the last two years that read “opening soon.”

“Then, the date was being changed. We were like, ‘Noooo.’ But now it’s open. We’re ready to roll,” she said. “We’re excited about meeting our new patients, to know that we’re serving our community. This is home. This is our community.”