The Sumter Item reports that trustees told Tuomey Healthcare System CEO Michael Schwartz on Monday he could pursue Chapter 11 bankruptcy if needed.
A jury ruled last year Tuomey made more than 21,000 false Medicare claims from 2005 to 2009. The hospital was ordered to pay almost $240 million in reimbursement and fines.
A South Carolina federal judge has ruled Tuomey must set aside $70 million to continue its appeal.
Tuomey is appealing the ruling, saying it would have to close if it had to pay the full amount. The hospital has also asked the 4th U.S. Circuit Court of Appeals to lower the amount it must keep in reserves.