<div><strong>Urgent Request! 							       Help Now!</strong>
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<div>Bucktail Medical Center (BMC) is a fully community owned healthcare facility located in Renovo, PA, the most remote town in Pennsylvania. <strong>The residents of Western Clinton County are the owners of this facility.</strong> If you, as owners of the facility, want the hospital to survive, we need your donation today. Using the facility for your healthcare needs is just as important. If you live in any other rural area and you have healthcare available in your community, please pay attention. Your facility will be facing these same challenges soon.
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<div><strong>Why this urgent call for help? </strong>
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<ul>
<li>Despite our best efforts, we simply do not have the cash available to continue providing services. 
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<li>Our budget is extremely tight. Over the past year we have monitored cash carefully, routinely updated projections, and focused on collecting revenue as quickly as possible. 
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<li>But any single unexpected event can be catastrophic.
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<div>Last week, we learned that our final Employee Retention Credit (ERC) payment of $381,941.00 is delayed indefinitely. That event is catastrophic.
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<div>Today we learned the Department of Human Services wants reimbursed $255,467.00 for care for 2018-2019 fiscal year. FOUR years ago! That event is catastrophic.
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<div><strong>What’s at stake? </strong>
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<ul>
<li>BMC is the largest employer in Western Clinton County, employing about 85 people. 
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<li>Jobs will be lost
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<li>The local economy will suffer a sharp decline. 
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<div><strong>What about healthcare? </strong>
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<ul>
<li>The next closest emergency room is UPMC Lock Haven, 28.6 miles away from BMC - 37 minutes down a two-lane country road that winds along the West Branch of the Susquehanna River. That facility closed all inpatient and surgical services in April 2023.
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<li>The next closest hospital with inpatient services is Geisinger Jersey Shore 40.4 miles away from BMC – 50 minutes away down the same road. 
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<li>Patients west of our facility will have even longer distances to travel. 
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<li>BMC is the only hospital in the entire county. Without BMC, the only medical care available in Clinton County will be a single ER in Lock Haven. 
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<li>Should BMC close, no healthcare services would be available. No ER, no blood tests, no X-Rays, no medical appointments, no nursing home, and no ambulance. Every medical need will require a trip down the road. Lives will be lost.
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<div><strong>BMC currently has the only ambulance service in the area. </strong>
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<ul>
<li>The two next closest ambulance services are 28.4 miles down the road – 36 minutes – and 29.2 miles down the road – 37 minutes. 
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<li>A patient would have to wait for one of these ambulance services to drive nearly 40 minutes just to get to the patient, then drive another 40 minutes back down the road to one of the other hospitals.
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</ul>
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<div><strong>Rural hospitals across the US are closing at an alarming rate: 136 from 2010 to 2021</strong>. Nineteen occurred in 2020, a record for hospital closures. The Center for Healthcare Quality and Payment Reform (CHQPR) reports: <strong>“Small rural hospitals are being forced to close because they are not paid enough to cover the cost of delivering care to patients in rural areas.</strong> Most small rural hospitals lose money delivering services to patients, while most urban hospitals and larger rural hospitals make profits on patient services.” The CHQPR goes on to explain <strong>“Small rural hospitals lose money on patient services because of inadequate payments from private insurance plans</strong>, whereas urban hospitals and larger rural hospitals make large profits on services to patients with private insurance. Most hospitals, regardless of their size, lose money on Medicaid and uninsured patients. However, while large hospitals can offset these losses with the profits they make on patients who have private insurance, small rural hospitals cannot.” 
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<div>BMC is no stranger to adversity; we’ve successfully weathered a Chapter 11 bankruptcy, the COVID-19 pandemic, and near constant financial challenges. Every time we’ve landed on our feet. This time we need your help.
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<div>Through these challenges, we recognize that it will be difficult for BMC to be viable long term with its current limitations, so <strong>we worked over the past year to outline what is necessary for the facility to better serve our communities</strong> and to be viable moving forward. 
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<ul>
<li>We’ve created a Master Plan. 
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<li>We’ve completed the projections and see the potential to thrive, but we need to get from here to there. 
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<li>We’ve put an ambulance service in place
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<li>A CT scanner – our first - is due here next month.
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</ul>
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<div><strong>We secured a USDA Emergency Rural Healthcare grant to:</strong>
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<li>Replace a leaking roof
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<li>Update 43-year-old heating boilers
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<li>Replace leaking water pipes, and purchase some necessary equipment.
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</ul>
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<div><strong>We have implemented a plan to reduce costs by: </strong>
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<li>Directly hiring physicians
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<li>Nearly eliminating agency staff
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<li>Adding a new provider to our clinic
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<li>Adjusting rates we charge for services
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<li>Renegotiating contracts with health insurance companies
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<div><strong>But insurance companies don’t want to pay.</strong>
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<div>CHQPR explains the problems with current payment methods. <strong><em>“Standard payments for hospital services are not large enough to cover the higher cost of delivering services in small rural communities.</em></strong> The average cost of an emergency room visit, inpatient day, laboratory test, imaging study, and primary care visit is inherently higher in small rural hospitals and clinics than at larger hospitals because there is a minimum level of staffing and equipment required to deliver each of these services regardless of how many patients need to use them. <strong><em>For example, a hospital Emergency Department has to have at least one physician available around the clock in order to respond to injuries and medical emergencies quickly and effectively, regardless of how many patients actually visit the ED. A smaller community will have fewer ED visits, but the cost of the ED will be the same, so the average cost per visit will be higher.”</em></strong>
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<div>I am now quite concerned we will not have the opportunity to implement this plan. 
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<ul>
<li>I’m concerned about meeting the next payroll. 
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<li>I’m concerned vendors will stop providing products and services. 
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<li>I’m concerned that the people living in Western Clinton County will lose not only medical care close to home, but also their largest employer. 
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<li>I’m concerned that residents in long term care will have less contact with family when placed in facilities farther away.
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<div>We have exhausted every available option I can think of, and we are doing our best to implement projects to increase patient volumes and revenue. <strong>But without help now, I fear we will not be open long and Western Clinton County could be without any healthcare services.</strong>
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