STOKES COUNTY -- Four years ago, Pioneer Health Services, based in Mississippi, began operating a hospital equipped with an ER in Danbury and a satellite location in King. Leaders in King made a request to have a 24-hour ER within the city.

"That's something we would work towards,” said Pioneer Community Hospital of Stokes CEO Pam Tillman. “We have studied it, and it was just becoming evident that was less of an option."

Instead, hospital operators found an urgent care facility would be more viable in the rural community.

"We are disappointed that the hospital has made the decision to close the emergency room and open an urgent care,” said King City Manager Homer Dearmin. “That is contrary to what they told us over the years; however, I do understand that it's a business decision."

Leaders said the decision was based on the fact the facility was losing money.

"The cuts that they have been hit with and other financial factors were very important to their decision," said Dearmin.

According to University of North Carolina research, over the last five years 57 rural hospitals have been forced to shut their doors. Some, like the one in nearby Yadkin County, which closed in May, are working to reopen. 

"I certainly had peers there who I was concerned with, and I worked with a lot of the folks there that lost their job,” Tillman said. “We have to be mindful everyday how we position ourselves and how we stay in tune with the community and meet the community needs."

Hospital officials said while they're closing the ER in King they will continue to operate the 24/7 emergency services in Danbury, and there's plenty of other options within 30 minutes.

"Wake Forest, Novant and Mount Airy all have 24-hour emergency departments," said Tillman.  

Both Tillman and Dearmin said feedback from community members has been positive.

"I think the urgent care is going to be a better service for citizens, and I think folks seem to understand that," said Dearmin. "People are more inclined to go to an urgent care facility where there is a lower co-pay."

Dearmin said the hospital plans on keeping all of the current doctors and nurses on staff. The conversion from an emergency room to an urgent care facility should take place in either December or January.