Tyler-based East Texas Medical Center is allowing its lease for ETMC Trinity to expire later this year, it said Monday, a move that apparently will close the hospital and cost an estimated 60 employees their jobs.

It cited poor usage and declining reimbursement rates from Medicare and Medicaid.

"The decision to not extend or renew our lease of ETMC Trinity was an extremely difficult one," Perry Henderson, senior vice president, affiliate operations, said in a statement. "ETMC has leased this hospital for 20 years, so this decision is one we struggled with and did not make lightly. However, the reality of the situation is that due to changes in health care and low patient volumes at this facility, we can no longer afford to operate a hospital in this community."

On Wednesday, ETMC notified the Texas Workforce Commission of the impending layoffs set for Aug. 1, the same date the lease expires.

Henderson said ETMC has worked with the Trinity Hospital Board since 2015 to try to find a potential partner. ETMC also will help employees as they seek other jobs, either with other ETMC facilities or elsewhere.

Since 2014, ETMC has shut down other rural hospitals in its system, including in Gilmer. It also has reduced ambulance services and closed clinics.

The Trinity hospital was founded and built in 1949 as Trinity Memorial Hospital. Its affiliation with ETMC began in 1997, with the Tyler-based health system responsible for management and agreeing to upgrade facilities.

Since then, ETMC has said, "significant investment" in the hospital's physical plant has enhanced the level of services available. That included renovating the emergency department and waiting areas, constructing a new 15-bed patient wing, two surgery suites and other enhancements.