A shortage of patients, staff and money is proving to be a serious blow to many small hospitals in Idaho, with some of the facilities being forced to close.

In recent months, two rural hospitals have shut down and more are expected to follow suit. Low Medicare reimbursement is blamed, along with expensive medical technology and such local factors as empty beds and a shortage of physicians and other health professionals.One rural medical center facing the ax is Council Community Hospital, which has lost money over the past several years.

"With Medicare reimbursement the way it is now, I don't see how any small hospital in Idaho will survive," said Jeffrey McClanahan, the acting administrator for Council's hospital.

The hospital closed briefly in 1985 because it was short a doctor - a problem at many rural hospitals.

"We're struggling, but we're surviving," said Phillip Lowe, administrator of Weiser's 27-bed Memorial Hospital, located about 70 miles from Boise near the Idaho-Oregon border.

Officials with the Lost Rivers District Hospital in Arco report losing $39,000 last year but vow to stay open.

But for two rural eastern Idaho hospitals, money woes have proved fatal. Memorial Hospital in Downey and Ashton Memorial Hospital in Ashton have closed in recent months, forcing residents in those areas to drive 20 to 40 miles for emergency medical services.

But many rural hospitals are making changes to stay in business. The now defunct hospital in Ashton has become a nursing home, and the hospitals in Arco and Weiser have switched more beds to long-term care.

"We're losing less money than we had the previous four or five years," said Lowe on Memorial Hospital's move to create a nursing home within the hospital.

And voters in Weiser, Council and other small towns have approved hospital districts to support their hospitals with tax dollars.