LOUISBURG - It's a long 35 miles from Raleigh to Louisburg, much of it a two-lane ride past horses, tractors and a hand-painted sign offering cauliflower for sale. As the seat of Franklin County, the town has always stood proudly outside the Triangle's economic hum. But now a pair of crises threatens to stop its tiny heart.

Louisburg College, an anchor since the 18th century, could lose its accreditation over shaky finances -- a loss that would jeopardize North Carolina's only private two-year college.

Franklin Regional Medical Center, the only hospital for thousands of the rural poor and Franklin County's No. 3 employer, has seen a damning report about the death of an elderly patient in elective surgery. It comes just as the hospital wants permission to leave for a more affluent and populous spot farther south near Wake County.

Even the town's annual international whistling competition has moved to Japan for a year, and though organizers promise its return, they call it very expensive to put on.

These are the types of institutions that keep small towns alive as tobacco crops fade and textile jobs flee, and townsfolk in Louisburg believe both the college and the hospital will survive these rough patches. Keeping them alive, though, will be tricky at best.

"I'm cautiously optimistic," said Boyd Sturges, a town council member and attorney for the college. "I'm a lawyer, and frankly, I wouldn't have wanted to live in a dying town."

Louisburg sits along the Tar River, its population split roughly half and half between black and white -- just 4 percent Hispanic.

Median income there rises only to about $39,000, well below household totals in the Triangle, and a large chunk of the town's citizenry rides the two-lane highway outside of Louisburg for work in the Triangle.

But ask regular people on the streets there and they'll brag about the new Super Wal-Mart arriving soon, or the 100-year-old houses being renovated.

One of those along North Main Street belongs to Melissa Tegeder, 40, who chose Louisburg after she and her husband --then-boyfriend -- lost their homes to Hurricane Katrina in Mississippi. Now she cares for their new child while he commutes to the Triangle.

"It was just so charming," said Tegeder, whose in-laws live in Holly Springs. "Of course, it was a great buy."

Great buy is an understatement. The Tegeders bought their 3,400-square-foot home for about $120,000 -- a sliver of a comparable Raleigh price. It has stood just north of downtown for more than a century and had been carved up into apartments, so the patch-up work has been extensive.

"It's a good payoff," she said.

Near the county courthouse, the town of little more than 3,000 supports an independent book shop and coffee house. There's a British-style ale house down the street and a barbecue lunch buffet on the main street.

Trouble on campus

But the college is the town's center, and it has problems. The school caters to students who can't yet compete at a four-year school but want a more enriching, full-time experience than community college offers.

But tuition costs about $20,000 a year, placing the college at a competitive disadvantage for two-year students who could just attend a cheaper, state-supported equivalent and forgo a dorm experience.

In December, the school got notice from the Southern Association of Colleges and Schools that its finances merited a six-month warning period, and that its accreditation could get pulled without a turnaround. Then in March, President J. Michael Clyburn left his post after less than a year, not long after he cut 20 jobs at the college to help stave off a deficit estimated at $2 million.

"We kind of feel like he abandoned us," said student Vanessa Weidrick, 18. "Things were too tumultuous, and he got scared."

Sturges, who is counsel for the college, predicts the school will go on probation at the end of the warning period -- accreditation intact. The school has already cut staff, held a successful fundraising party at First Citizens Bank in Raleigh and named an interim president, Rodney Foth, who had previously been a vice president.

Hospital convulsions

The hospital, meanwhile, has been in newspaper headlines in both Louisburg and Raleigh.

A recent report found the hospital acted improperly when a 76-year-old patient complained of chest pain and having no feeling in his arm before a knee replacement surgery.

There is no written proof that the man's complaints got to the surgeon or anesthesiologist, and he died after his December operation, said the report from the Centers for Medicare and Medicaid Services, which threatened the hospital's funding.

That threat was removed after hospital officials submitted a plan of action that included the replacement of top medical administrators.

That has hurt the reputation of Franklin County's only hospital, but the town is also faced with the possibility of it moving to Youngsville. Franklin Regional and Rex Healthcare have partnered on the move, and a decision from the state should come late this month.

Sturges predicts this proposed move will also fail. On Monday, members of the state's legislative black caucus will protest the move. The state has already turned down the hospital once before.

State Sen. Doug Berger, who represents Franklin County, agrees. The hospital has a historic obligation to serve the rural poor, he said, especially when aided by the UNC Health Care System's wholly-owned subsidiary, Rex Healthcare.

"There's no question a hospital can thrive in Louisburg," he said. "The hospital has just been stubborn about having a broader vision and a broader obligation."

Without the school, without the hospital, townsfolk agree Louisburg will wither.

But people there will tell you they are country-tough, sturdy enough to survive in the Triangle's shadow.

(Staff researcher David Raynor contributed to this report.)

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