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n the southeast corner of Tennessee, one rural hospital has fallen into such dire financial straits it suspended inpatient services earlier this month. Now, the new CEO of the Copper Basin Medical Center has launched a GoFundMe campaign to save the hospital.

“Please help save our local area hospital!!!” the website urges. “Without the help of our community we will not be able to survive!”

The campaign seeks to raise just $100,000. That’s just a fraction of its debt — and it’s nothing in the world of online crowdfunding; the team behind an extra-heavy blanket marketed as a treatment for anxiety recently raised more than $3.5 million.

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But so far, the tiny hospital in the Appalachian foothills has brought in just $845.

CEO Dan Johnson finds hope in looking back to the way the hospital was originally funded. In the 1950s, miners who worked for the Tennessee Copper Company contributed portions of their paychecks to help pay for the medical center. Johnson is confident that local residents, who have relied on Copper Basin in medical emergencies, will now help their hospital in its time of need.

“I’m a positive thinker,” he said. “There should be health care in this community. There’s a definite need for this hospital.”

But the fundraising campaign has exposed rifts in the community, too. Some employees are openly urging people not to donate, noting that the hospital recently laid off workers with just three days’ notice. Registered nurse Robert Pinion posted on Facebook that the “once thriving facility that boasts some of the best, most caring employees” had been “mismanaged into oblivion.”

“An incredible shame!” he wrote.

Tracy Rhodes Robinson, a registered nurse who was among those laid off this month, told STAT she was angry at the hospital’s treatment of employees. Their health insurance was eliminated; some are still owed paychecks and aren’t sure they’ll ever get them.

“The town needs the hospital,” Robinson said. “I have already found another job — but I’m hopeful my old job opens back up.”

Copper Basin Medical Center, the only critical access hospital in Polk County, Tenn., faces the same strains as many other small and isolated hospitals. A third of rural hospitals in the US are currently operating at a loss. And more than 75 have closed since 2010.

Rural Hospital Closures: 2005 – 2016

Press play or drag the timeline handle to see the locations of rural hospital closures over the last decade. The size of the bubble represents the number of hospital beds.

Total for JAN 2005 -

Natalia Bronshtein/STAT Natalia Bronshtein/STAT Source: The North Carolina Rural Health Research Program GIF / Youtube

Copper Basin isn’t in immediate danger of shutting down, but the hospital has cut staffing from about 130 employees to fewer than 80. Johnson said he had no choice: “It wouldn’t have been fiscally responsible or morally responsible to have people work without paying them every two weeks. And to raise capital, we need to reduce payroll.”

Speaking by phone from his office, Johnson told STAT he was hired last month by board members to orchestrate a turnaround for Copper Basin, though it’s deep in debt — and barraged by calls from lawyers. He said he inherited a “perfect storm” from his predecessor that resulted in the hospital becoming “technically bankrupt.”

Still, he said the 25-bed hospital will keep its emergency department open and offer outpatient services.

Johnson, a veteran hospital executive, said he believes Copper Basin can raise the $100,000 to improve its financial stability. Meanwhile, he and chief financial officer Tim Henry are spending their days trying to keep the place afloat, “figuring out who to pay $200 or $300 for supplies,” he said.

There’s also a matter of collecting for weeks of unpaid patient care after Copper Basin’s billing vendor quit earlier this year. To help on that front, Johnson has launched a major collections effort; past patients can pay half their overdue bills and get their remaining medical debt written off.

“People in the community are probably weary of the troubles the hospital has had, but we don’t have that negative outlook,” Johnson said. “We’re trying to get cash from any source we can.”

Or, as Henry wrote on the GoFundMe page, “We are asking for any donations that the community, or anyone willing to donate to a valuable cause can make.”

None of the 18 donors to date has contributed more than $100, but some included heartfelt notes of encouragement. “Rural health care providers are struggling to make ends meet all across the country,” one wrote. “We need to help save them to ensure all Americans have access to critical care.”

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