Bradford Regional Medical Center is not closed — and it’s not for sale.

And while the consolidation of services with Olean (N.Y.) General Hospital is not popular with a vocal group in the Bradford area, Upper Allegheny Health System officials believe this is the best path forward to keep the hospital in the community.

Jeff Zewe, president and CEO of Upper Allegheny, and Rick Braun, senior vice president and chief operating officer, spoke to The Era about what they called misconceptions, updates and the difficulty of separating emotion from facts.

“The building is not for sale and, quite frankly, we have had zero discussion about that,” Zewe said, addressing a narrative that perhaps Upper Allegheny should sell BRMC to another hospital system in Pennsylvania.

Not only has the board of UAHS never discussed selling the Bradford campus, he said, no one has approached them asking to buy it.

Would they consider selling it? No, both officials said. There are plans for the physical space at BRMC that are in the early stages.

“We are trying to come up with a reuse plan that would involve goals of the Rural Health Demonstration Project that we’re in in Pennsylvania,” Braun said. “We want to redesign primary care into a wellness model and we have our architects looking at some of that as well, to figure out, if we have an old nursing unit or two, how can we convert that into very usable community space?”

Zewe said he wanted to address a misconception — BRMC is not closed or closing. In fact, services that remain — the services that were most heavily used by local residents — are behavioral health, the sleep disorder center, WIC program, Upbeat cardiac rehab, SMART rehab, The Pavilion at BRMC, SAFE center (sexual assault forensic examiner), imaging services, occupational health, lab services, School of Radiology, emergency department, diabetes and nutrition center and the wound clinic. Ten medical beds remain at the facility as well.

“I would be the first one to say, yes, we want to save the hospital,” Zewe said. “And to the extent that we needed to transform our model, all the services that are the most utilized services still remain at the Bradford campus to serve the entire community.”

He explained there’s a lot of misinformation about Bradford hospital closing, but it is simply not true.

“At this time, there will be no further changes to Bradford,” Zewe said.

A grassroots, online movement has been developed to “Save Bradford Hospital,” created by local women looking to return BRMC to a full-service hospital.

UAHS officials have pointed out that the population and demand in the region isn’t sufficient to support it.

“It’s tough to separate emotion from the facts when it’s your community and I get that,” Zewe said. “We obviously don’t want to make any change, either.”

However, he said, “To secure healthcare to the extent that we need to, we had to reimagine, redefine a delivery care model for the region focusing on Centers of Excellence and all the services that — again — are most utilized at Bradford, stay.”

How we got here

BRMC didn’t get to this point overnight. For years, the facility operated in the red, and officials sounded the alarm over inadequate reimbursements and dwindling patient counts. It reached a point that many small hospitals around the nation did — change or perish.

Things came to a head at the same time the world faced an unparalleled, unforeseeable crisis — COVID-19. Zewe said that while communication is always key, the pandemic stood in the way of the public meetings and community forums that are normally involved in a process such as this.

Acknowledging that, Zewe explained the board — made up of eight people from Bradford and eight from Olean — is made up of community members, who stood for the good of the community throughout the process.

“You can never take this kind of change and go out and ask for a public referendum of approval because you’re never going to get it,” Braun said. “Nobody’s going to say, ‘Yes that’s OK, let’s change something that will affect a business or a service in the community.’”

He explained the process took most of a year with a committee that included seven board members from Bradford. Each idea the officials proposed for making changes was immediately “beat up,” Braun said, with members of the board asking why it had to be done.

“When we got all done with the plan, we had unanimous agreement with all 16 of the board members … and they were all on board with ‘this is not wonderful, but it’s the best we can come up with.””

Hospitals all around the country are in similar situations, and have been for years.

“This is not a new thing,” said Dennis McCarthy, UAHS spokesman, referring to the plight of rural healthcare. “I think we tried our best in years past to say we’re facing some pretty significant challenges.”

UAHS isn’t in this alone.

“This isn’t just a local issue, it’s a national issue,” Zewe said.

More than 140 hospitals nationwide have closed over the last decade. “It’s all related to inadequate reimbursements, population shifts.”

Centers of Excellence

Combining the assets of Bradford and Olean has created an excellent end product, he said.

“I think, to our credit, we have the best rural platform in the region,” he said. “Look at our specialists and our clinical bandwidth. Nobody can touch it.”

Critics have said that BRMC, with fewer services than it had before and only 10 remaining medical beds, could be a detriment to economic development and impair efforts to draw in new residents. Hospital officials disagree, saying the Centers of Excellence model that UAHS offers could be seen as a plus.

“We have a fully operational emergency department staffed by docs 24/7,” Braun said. “We have our mental health unit, which has 30 beds in it, two units plus some opioid and drug detoxing. We have our medical beds, so if somebody … needs overnight care, we have that. We’re seeing six to eight patients a day in those 10 beds.”

For surgical or intensive care needs, the 23-mile trip to Olean is far easier than a trip to Erie, Pittsburgh or Buffalo, N.Y., Braun said.

While he acknowledged that many in the Bradford community see the consolidation as a loss, he said it could be interpreted as a positive.

“How many communities can say we have in the system locally, not in Pittsburgh, not in Erie, not in Buffalo, but in the system locally,” all the specialist services that are offered in Olean?

“In a hundred miles, nobody has what we have in infrastructure and physicians, locally,” Braun said. “Yep, you have to go 23 miles for a bunch of it when you’re in Bradford, but you’d be going 100 miles at one of these other places. We think it’s a selling point, not a negative.”

Zewe addressed the process through which decisions were reached.

“When we formed the improvement task force, we looked at the data, the utilization, the population. That determined where we were going,” he explained. “The Bradford community is just as equally important as the Olean community. We don’t look at them any differently.

“There was never a time we ever thought about (closing). In fact, it’s the other way around, how can we keep services in Bradford?”

The financial picture

Braun, who started at UAHS as chief financial officer, mentioned that throughout the existence of UAHS, Olean’s stronger financial position has helped BRMC slog through some rough terrain.

In 2011-12, before the two hospitals were merged into one, BRMC found itself in a precarious spot.

“Bradford was out of cash, we hadn’t merged it to Olean and we had a large pension obligation we had to pay,” Braun said. “We went to (former state Sen. Joe) Scarnati and he got us a million-dollar grant and we used it for the pension.”

However, the grant was held up for nearly two years.

“Olean lent the money to Bradford at the time to make the pension payment,” he explained. When Bradford received the grant, they were able to pay back the loan from Olean.”

In the early years, bills of the two hospitals were handled through Olean. Braun said about $2 million of BRMC’s debt was paid off by Olean.

“We looked at Bradford and said, ‘They don’t have the cash, they’re not going to be able to pay it.’ We’re one entity,” he explained.

“In January 2018, UAHS took $12 million in long-term debt that Bradford had and used Olean’s balance sheet and strength to refinance it locally with M&T Bank, saving $800,000 a year.”

So rather than Bradford being the proverbial red-headed stepchild in the merger, Braun said the relationship with Olean has benefitted Bradford.

“The board is committed to serving the joint communities. Period. There’s never been a point where anyone said, ‘Let’s cut (Bradford) loose and move on our way,’” Braun said.

Zewe reiterated the commitment to both communities.

“There’s nobody in any of our organizations who don’t want to do the best for the community,” he said. “Hopefully, over time, we can get the community to support this awesome, awesome resource.”

The CEO continued, “We need people to continue to have faith and use the services, because it almost seems there’s a rally against it. What a wonderful resource — again — we have in both our communities.”

Regarding the transportation plan to take patients from the Bradford ER to the Olean hospital, Zewe said, “It’s been seamless. We’ve had very few to no incidents. The other thing we’re doing is to make sure we are making followup calls to patients.

“I think at the end of the day, things are going very well in the early innings of the transformational plan. We’re very pleased. All the key metrics we’re looking at are in the right direction. It’s good news.”