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Soon after, he was named board chairman and then interim administrator.

It didn’t take long for him to realize North Sunflower had to develop sources of revenue outside the core hospital.

And it has helped keep the tiny town of Ruleville afloat.

It opened eye and dental clinics, a gift shop, a diagnostic center and a hospice in downtown stores, many of which had been vacant and in disrepair.

North Sunflower isn’t immune to the problems plaguing its peers.

Its costs are going up at a time when its reimbursements aren’t.

It serves as a lifeline in a county where nearly 40% of residents are living in poverty and in a state with some of the highest levels of obesity, diabetes and deaths from cardiovascular disease in the nation.

Along with all internal changes, the hospital developed extensive marketing campaigns.

Its slogan, Take me to Ruleville, is everywhere – on billboards and bumper stickers, wrapped around its shuttle vans, in TV advertisements and You Tube videos. North Sunflower received higher than average ratings from patients on a variety of quality measures, according to Medicare’s Hospital Compare profile.

The shift increased the medical center’s Medicare reimbursements.

A federal loan and a county bond helped pay for a new surgical unit and the Beacon Wellness Center, which contains a sleep clinic, community gym and rehab programs.

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Marlow had no background in health care when, in 2004, he was asked to join the board and help save the hospital.