Hospital cuts prompt pushback in rural Elk County

By Kris B. Mamula / Pittsburgh Post-Gazette

RIDGWAY, Pa. — Elk County commissioners are weighing the creation of an independent government authority that community and business leaders say is a line in the sand against further cuts to health care services in a sparsely populated, northeast of Pittsburgh.

Following a 90-minute public hearing Friday, the commissioners accepted a draft resolution from the Elk County HealthCare Coalition that would create — but not fund — the authority. No date was set for a decision by the board on the resolution.

Among the coalition members are 80 business leaders, who say the county’s economic vitality is linked to having a community hospital that offers comprehensive medical care.

Coalition members said the authority is needed to find ways of enhancing health care services in the county, five months after Penn Highlands Healthcare closed the maternity unit at its hospital in St. Marys and ignited worries about further cuts.

The end of OB/GYN services at Penn Highlands Elk Hospital created a maternity desert in a six-county swath of northeastern Pennsylvania — twice the size of the state of Delaware. Penn Highlands’ hub-and-spoke model of providing services, common among big health systems, has meant shuttering some medical services at Penn Highlands Elk Hospital and moving them 45 minutes away to Penn Highlands DuBois Hospital in Clearfield County.

“The health care delivery model has changed during the past 20 years,” Julie Peer, president of Penn Highlands Elk and Brookville hospitals told the board. “Gone is the model of every community hospital offering a complete continuum of services.”

Births at Penn Highlands Elk had fallen below 200 annually, straining finances and making it difficult for delivery doctors to maintain skills, she said. The hospital’s childbirth unit was closed to help assure the future of the facility.

But what has helped Penn Highlands’ operating efficiency may be hurting residents of small towns who have to travel farther for care.

“The people of Elk County aren’t getting the care they need,” Ridgway primary care physician Kathleen Fernan testified. “Moms and babies are being endangered and that’s not tolerable.”

Ridgway native Zack Pontious moved back home from Pittsburgh with his wife, Jess, three years ago. They’re renovating a house that had been vacant for 10 years. In January, they’re expecting their first child.

“It never dawned on us that we would not be able to have a baby in Elk County,” said Mr. Pontious, who serves on Ridgway Borough Council. “We’ve seen services end, we’ve seen quality decline.”

But Penn Highlands Healthcare Director of Government Relations Karin Pfingstler questioned whether creating an authority was the answer.

“What is the specific purpose of the authority?” she asked commissioners. “Is there a business plan? Where will revenue to support the authority come from?”

Instead of solving health care issues in Elk County, the new authority could cause public confusion, duplicate existing health services and compete with Penn Highlands for patients, market share and grant funding, she said.

“Penn Highlands Healthcare maintains that the formation of a hospital authority does not serve any tangible purpose,” she said.

Most rural hospitals in the U.S. have closed their maternity units, according to a new study by the Center for Healthcare Quality & Payment Reform, a Pittsburgh-based advisory firm.

Over the past five years, more than 100 rural hospitals across the country have stopped delivering babies — and hundreds more are at risk of closing due to the “serious financial and workforce challenges rural hospitals are facing,” according to the study.

“It is not an exaggeration to say that rural maternity care is in a state of crisis, and a crisis demands immediate action,” the center’s President and CEO Harold Miller wrote.