GREENWOOD, Miss.—Pearman Casanova thinks it’s time to get Greenwood, Mississippi, and Leflore County out of the hospital business. The local resident told the Greenwood City Council as much at its Tuesday meeting, explaining his belief that those in charge of the financially ailing Greenwood Leflore Hospital have been unable to get the facility back on track.
“I think there is a general understanding across the city that most people want the hospital to stay working in one way or another,” Casanova said. “To best serve the community, in my opinion, I feel we just need to sell it or we need to lease it out. Let somebody else run it—somebody that’s trained to run a hospital that knows how to run a hospital.”
City Council President Ronnie Stevenson responded that Casanova’s opinion is shared by both of the hospital’s current co-owners, the council and the Leflore County Board of Supervisors.
“What you’re saying is actually the truth as far as what makes sense as far as that hospital,” Stevenson said. “And believe me, that’s what we’re trying to do. We’re not trying to stop anything for the benefit of that hospital. Without just going into details about it, somebody else needs to be running that hospital and that is being worked on as we speak.”
Greenwood Leflore Hospital is currently in negotiations with the University of Mississippi Medical Center for a plan that leaders hope will preserve the hospital in some form or fashion. Greenwood Mayor Kenderick Cox told the Mississippi Free Press after the council’s meeting that he couldn’t provide a timeline for when these negotiations will conclude; only that both sides are working as hard as possible to keep the hospital open.
The hospital filed for bankruptcy last month and warned employees that it may close on June 15 if its negotiations with UMMC are not successful.
Few Options Remain
Greenwood Leflore Hospital has been in a slow financial decline ever since the COVID-19 pandemic. Officials have tried everything—cutting services, laying off staff and taking out loans—to keep the hospital afloat. The hospital appeared to turn the corner in the spring of 2025 when it was accepted into the Rural Community Hospital Demonstration program. The program cost-protects Medicare services and allows GLH to open swing beds, which can transition patients from acute care to extended care without having to send them to another facility.
However, soon after, the Mississippi Division of Medicaid began clawing back Medicaid overpayments due to adjustments to GLH’s patient volume made in June 2025. GLH was forced to request relief from the Hinds County Chancery Court in order to pause the payments while it entered negotiations with UMMC. Without that pause, GLH would have been forced to close months ago.
Proponents of Medicaid expansion have long seen it as an opportunity for GLH and other struggling rural hospitals to rebound; with as many as 300,000 more Mississippians insured under Medicaid, hospitals would have to swallow fewer costs from uninsured patients accessing emergency room services that they could not pay for.
Former Greenwood Mayor Carolyn McAdams told the Mississippi Free Press in 2023 that Medicaid expansion was one of the hospital’s best bets at remaining solvent. Democratic U.S. Senate candidate Scott Colom shared a similar view during a stop in Greenwood last month.
But the Mississippi Legislature never acted. The House and Senate could not agree in 2024 on a deal to expand Medicaid and expressed uncertainty in 2025 about the Trump administration’s approach to health care. Legislative leaders acknowledged this past session that expansion was dead because of cuts made in President Donald Trump’s Big Beautiful Bill Act budget that Congress passed last summer. Chartis reports that Mississippi has 24 hospitals vulnerable to closure.
Running a Hospital Effectively
Pearman Casanova told the council and the Mississippi Free Press after the meeting that he was told at one of the hospital board’s meetings last year that he could not ask questions of the board. Greenwood Leflore Hospital is not required to hold public comment sessions during its meetings and typically has not done so. The hospital declined comment through its spokesperson, Christine Hemphill, when asked Wednesday about Casanova’s comments.
Like Casanova, other residents have expressed publicly that leadership has not been transparent about the hospital’s status. Without Greenwood Leflore Hospital, the nearest hospital is in Grenada, more than 30 miles away.
“The hospital has been running under the premise of hoping for the best and keep going,” Casanova told the Mississippi Free Press after the council meeting. “I think Greenwood needs a hospital because it definitely provides a service that people use. I’m not against that. I’m just against the way that it’s been run, that we as a city or a county do not have the knowledge to run it effectively.”
