As a sibling of a couple of physicians, I get to hear a lot about the quality of personnel in small and rural hospitals. In general, the advice I have been given is that unless I am about to expire, I am to head for the nearest large city and a hospital therein. Why? The spectrum of support staff at smaller, more isolated hospitals tends to the lower end in skill. It is unfortunate intersection of cost (cannot pay as well in small cities/hospitals) and availability of better trained staff. As an outsider, I see this as partly due to the increase of turning many formally well trained support positions into ones held by what the human resources want to term as 'technicians'. Nothing wrong with being a tech, but the push is for the lowest training and therefore lowest cost. After all, the machine cannot make a mistake and anyone can hook up the tube/insert the sample/draw the blood/distribute the medicine, etc. However, complete ignorance of the meaning of test results/medical weights an measures/meaning of standards, etc. leads to some funny results (deadly, not ha ha). In essence, if you or an advocate (family or friends) are not on duty 24/7, you can be at the mercy of mistakes through ignorance, negligence or simply chance. YMMV.