I have been reluctant to express my thoughts regarding our community’s access to healthcare because I never want my thoughts to be construed as not supporting Bradford Regional Medical Center, a facility I dedicated my life’s work to for 30 years.

Although leadership has eliminated positions once held by talented, thoughtful people asking difficult but necessary questions, I still love the dedicated colleagues that remain.

The situation, however, has devolved to such a degree that I feel a sense of responsibility to my former colleagues and my community to speak out.

I understand the trend for regional hospitals to affiliate with larger health systems with more buying and leveraging power and resources. But if a larger hospital affiliates with a smaller organization and wants a referral pattern to the larger facility, the intent should be to manage both businesses well enough to remain financially healthy while also serving the needs of the communities that fall under this affiliation.

It should be a reciprocal agreement in which the larger system gains revenue through the referral stream while ensuring the community’s health care needs are met.

While this was the stated purpose for the communities served by both Bradford Regional and Olean General Hospital, I think it is time to acknowledge that our affiliation with Upper Allegheny Health System and Kaleida has failed us miserably.

The mission and intent may have been otherwise, but it often has felt that the approach is “what can BRMC do for us” and never “what can we do for each other.” Maybe it isn’t about being in a hospital system as much as about being in the RIGHT hospital system.

Someone recently asked me what I would want if I could have my “dream community hospital.” If the days are over of what I once knew and had in my community hospital, which included serving critical-care patients, doing everything from major to minor surgery and delivering babies, then this is what I dream of for OUR community hospital within a hospital system.

Put simply: I want our hospital to be safe and effective at meeting the basic healthcare needs of the community as well as a referral system for the larger hospital for more complex care. Even if the bed capacity is reduced, we need to have the proper clinical resources, doctors and staff equipped to care for the community’s needs, during “regular” times and during a “pandemic.”

That means vital services are not simply cut without a suitable and realistic alternative plan for meeting those healthcare needs.

That means healthcare standards and regulations are not ignored. That means that the larger hospital that is supposed to accept those patients whose needs cannot be met at BRMC are able to be transferred to a viable alternative hospital.

There have been way too many times that OGH has not been able to receive our patients, and that was long before the pandemic, which has simply made the situation worse.

Bottom line, it is the responsibility of the leadership to ensure both the larger hospital and small feeder hospital are viable entities meeting the needs of both communities.

I am confident the current plan is not working for the citizens of our community and I daresay it isn’t working for Olean, either, but that is for the community of Olean to determine.

What I want in a hospital system is that they understand the unique needs of my community and establish care in the community “to deliver the care to the need, not send the need to the care.” That doesn’t mean we need 80 beds or exorbitant services. I want basic services, good equipment, dedicated physicians and staff in the appropriate numbers who are supported and provided the critically needed continuing education.

I want support and assistance for the transportation services that are so dedicated to getting us to larger systems in difficult weather conditions. I want a system that acknowledges reality; we either have a strong hospital to which we can reliably send patients or we have resources at our hospital so that we at least have a chance to manage them on our own.

To accomplish the vision of quality healthcare in our community, we need strong leaders at both the larger hospital and at BRMC.

These leaders must understand the business is caring for people and being profitable. We see when other systems have affiliated with community hospitals in the area, they have invested money, time, talent and leadership into the communities that they serve. These hospitals are becoming profitable while keeping market share AND providing access to needed services at home. I want the same for our community. When the leaders do their part, I think we will be able to say, from the current employees at BRMC to the community members, we support our community hospital.

But we are also saying, right now, it isn’t working and we MUST get to a better place!

Can Kaleida and UAHS leaders/board of directors deliver? Or are the fires so big in their own buildings that they simply are overwhelmed and can’t help? If that is the case, can our own community come up with a plan to deliver adequate care to our own community? Honestly, it is a huge lift either way.

Nevertheless, here we are. As a community, we must decide if collectively we can come together to do something about it.

Sometimes the right path isn’t the current path; it is finding a new path. And sometimes it is people on the current path realizing “this isn’t working, we need to readjust.”

Whatever it is, I will say this to Kaleida and the UAHS board: Your absence in our community to date is palpable. You have left this mess to a few who are probably swimming in so many issues, they do not know which way to turn.

Do something, acknowledge the missteps and commit to a plan of change that addresses issues at both BRMC and OGH, which we are to expect is an extension of our community’s care. Make changes, show up, tell us how we can come together to help or tell us we must find our own solution as a community and start anew.

I am not even foolish enough to think it couldn’t get much worse. Time has proven otherwise.

(Anne Hardy, BSN, RN, CEN, is former director of the Emergency Department at BRMC, eight years; director of nursing, one year; staff nurse ED, Imaging services, Clinical IT RN, Nursing Supervision; personal health nurse, Conifer Health Solutions, 2015-18; acute medical surgical at Boston’s Beth Israel Hospital, 1986-88.)