The problem remains; small rural hospitals simply do not have the volume to support most hospital services.
However, help has come from an unexpected quarter. The Federal government has designated us a critical care hospital which means the government considers emergency medical services at regular intervals to be an integral part of the national highway system. So they'll help us pay for the emergency room - solving our most pressing financial problem.
We are going to continue developing clinic services - which are appropriate for small communities.
Thanks to both of you for your help and encouragement. Perhaps some of this will be helpful to someone else next time around.