Dan Bonk, the CEO of the Bellville Medical Center, said not having the space to treat its patients doesn't always happen, but sometimes, they are not always equipped.
"My best example would be 'Why don't we do cardiac catheterization here?'" Bonk said. "Well, we would do two to three a month, which is not cost effective. Our quality wouldn't be what it needs to be. There are certain standards. The [Texas Medical Center] probably does 15 a day, I would guess."
Bonk said not only is it not cost effective, but the hospital doesn't have the staff or equipment to perform some of the procedures needed.
"It's always a crisis," Bonk said. "It's a constant crisis. We have been fairly successful if you can call getting somebody out in three days instead of 30 minutes successful."
READ ALSO: Mother demands change after U.S. Army vet dies waiting for ICU bed
He said the hospital's transfer staff is working almost as a phone bank, trying to find beds for patients in other parts of the state.
He said they are having an extremely hard time with both COVID and non-COVID patients.
"It's actually been worse now than it was with the first COVID rush," Bonk said. "I don't know if it's because it hit unexpectedly."
There are 158 rural hospitals in Texas, according to TORCH, the Texas Organization of Rural and Community Hospitals, which serve 3.1 million Texans.
Many of those hospitals don't have ICUs.
Dr. Hashim Zaidi is the medical director of Harris Health's transfer center.
He and his team work to accommodate the requests for transfers, but said it has been increasingly tough during the pandemic.
"I would say in a week, it's probably in a given hundreds, and these calls can be from Arkansas, Mississippi, Alabama, Louisiana, which has become the norm over the last few weeks," Zaidi said.
He said they determine if they can accept a patient if they have the level of care they require.
Right now, they're mostly receiving requests for COVID patients who need ICU-level care.
"It really pains us to not be able to care for patients when all of our beds are full," Zaidi said. "It's hard to turn away transfers when people are calling for help."
Zaidi said they are doing what they can to expand their ICU capabilities, but they are still being outpaced by the demand for beds.
Harris Health has had to transfer some of their patients to other hospitals.
"It's a good rule of thumb for every operating ICU to have one or two beds available in case someone within the hospital, or someone who comes into the ER, requires, but with COVID, that is becoming much more of a luxury now," Zaidi said.
For updates on this report, follow ABC13 reporter Mycah Hatfield on Facebook, Twitter and Instagram.