RENOVO — Tracy Bruno had just ordered breakfast at Socky’s Restaurant when she suddenly felt dizzy.
The next thing she knew, her husband Gene Bruno, the mayor of Renovo Borough, was calling 911. But rather than wait for first responders, the couple decided to drive five minutes to Bucktail Medical Center, rural Clinton County’s only inpatient hospital.
Bruno, who had felt sick all weekend and planned to see a doctor on Monday, was treated for hypoglycemia. Without Bucktail Medical Center, her options for care would’ve been 35 minutes away in Lock Haven at an outpatient center or an hour away in a Lycoming County hospital.
“It’s winter. What if it started snowing? Better yet, what if I went into convulsions,” she told Spotlight PA earlier this month. “It could have been a lot worse if we didn’t have this facility.”
That fear, however, was a real possibility in recent years.
In September 2023, Bucktail Medical Center was on the verge of shutting down, a closure that would make UPMC Williamsport, an hour’s drive away, the closest emergency room. But thanks to a $1 million state grant — offered through a program for distressed hospitals — the facility has a future, for now.
The funds from the state Department of Community and Economic Development can cover payroll, facility repairs, training, equipment, and research on alternative ways to pay for services.
Health officials and elected leaders announced the grant on Jan. 13, the same day Bruno, who is on the hospital’s board, went to the emergency room.
For years, health care administrators and experts have said workforce shortages and increased operating costs have exacerbated financial problems, especially for hospitals in rural areas where residents are typically older and more reliant on Medicare and Medicaid, which reimburse at lower rates than private insurance companies.
Bucktail is no exception. Tax documents for 2023 show the hospital reported $7.09 million in revenue but $9.2 million in expenses. In September of the same year, then-CEO Timothy Reeves launched a GoFundMe to raise $1.5 million to sustain services. He later resigned.
Alarm bells went off for Clinton County Commissioner Angela Harding that fall. She then went to Democratic Gov. Josh Shapiro’s administration for help. A collaboration began between county officials, state lawmakers, and health experts in monthly strategic planning meetings.
Laura Murnyack — who previously served as chief nursing officer — took over as Bucktail’s CEO in 2024. Under her leadership, the hospital cut costs by closing a long-term care facility last spring and outsourcing payroll services.
Without those changes and collaboration with elected leaders and health experts, Bucktail would’ve closed, Board of Directors President John Lugg said.
In recent years, Pennsylvania has seen several rural hospitals cut services or shutter altogether due to financial strain. State Sen. Cris Dush (R., Jefferson) said the push for funding in Clinton County stemmed from local outcry and concerns about a wide service gap if Bucktail closed.
“No place else in the state are you going to be an hour one way to get to an emergency room,” Dush told Spotlight PA.
The one-time grant doesn’t mean Bucktail — which has about 80 employees — is safe from future challenges. Hospital administrators didn’t say how long they expect the $1 million to last.
The medical center’s annual budget is $7.5 million, Murnyack told Spotlight PA. However, the financial relief will help stabilize operations, she added. Monthly planning meetings to discuss opportunities to make operations more sustainable will continue, Harding said.
Lisa Davis, director of the Pennsylvania Office of Rural Health, said the state funding and guidance from the national nonprofit Rural Health Redesign Center helped Bucktail stay open.
“This hospital is now on a right path, but they need much more,” she told Spotlight PA.
Outside of funding for rural health facilities, Davis cited legislative efforts to prioritize telemedicine and offer student loan forgiveness to medical professionals working in rural areas as ways to bolster care in these communities.
Janice Walters, CEO of the Rural Health Redesign Center, said the current health care system isn’t sustainable “without innovative solutions.” The center’s work focuses on improving access to health services in rural areas, as well as negotiating alternative payment methods.
Dush said there needs to be changes at the state and national level to address insurance reimbursement challenges — something he previously discussed when another nonprofit health system in his district shuttered a local maternity unit last year. He added that policymakers should take action to ensure nonprofit facilities prioritize community-level care, not generating profits for chief administrators to pocket.
“When my dad broke his back, and he wasn’t working, but when he was going to college, the local physician — our family doc — he just told my mom: 'If you can come in two days a week for a month and clean, we’ll call it even,’” he said. “We don’t have that anymore, but I want to see us start going back [to] that trend.”
Dush added that officials are working on partnerships to boost care for veterans, who might have to travel from Clinton County to Altoona or Pittsburgh for various services, such as physical therapy. He hopes that residents utilize existing and future services to ensure success.
Mary George Rhone, a Renova resident, said Bucktail is the community’s lifeline. If the hospital shuttered, not only would current residents take the hit, but she guessed the loss would deter future economic growth because people and businesses likely would not move to an area with such limited access to care.
“We need that hospital,” she told Spotlight PA.
