Life in a COVID world isn’t easy for anyone or anything, especially the beleaguered health-care industry. Navigating it as a rural hospital, in less densely populated regions, is particularly challenging.

Yet the mission is no less important.

“Rural hospitals are community hospitals, and what makes them different is that the health of community hospitals is as important as the health of the communities,” said Lou Panza, president and chief executive officer of Monongahela Valley Hospital.

Panza was on his home turf Monday morning – his Carroll Township facility – for a live-streamed workshop about rural hospitals throughout Pennsylvania, with a focus on the southwestern corner. State Sen. Camera Bartolotta (R-Carroll), likewise in her hometown, spearheaded the event, organized by the Senate Majority Policy Committee.

Panza and two other state health-care officials – including Terry Wiltrout, president of Washington Health System Greene – were among a panel of 13 who discussed the vagaries of operating as a rural hospital. Joining them were Washington County’s three commissioners; two Greene commissioners; and five Republican senators.

Topics ranged from finances, costs, health-care furloughs, elective surgery delays, COVID fears, telemedicine’s rapid rise and broadband issues.

Rural hospitals, according to, maintain “no more than 25 acute care beds. ... (They) must be located more than 35 miles, or 15 miles by mountainous terrain or secondary roads, from the nearest hospital – unless designated by a state as a Necessary Provider prior to 2006.” Many struggle financially more than urban hospitals.

Stephanie Watkins, of the Hospital and Health System Association of Pennsylvania, called hospitals in rural areas “economic drivers and lifelines for residents.”

These lifelines, though, haven’t had it easy since the outbreak began blitzing this region nearly five months ago. Because of a rise in coronavirus patients, the state eliminated elective surgeries in mid-March before allowing them to resume, on a phased-in basis – two months later. That had an adverse effect on Mon Valley.

“About 70% of what we do is elective. That was a major killer for any community hospital. PPE (Personal Protective Equipment) costs skyrocketed,” Panza said, adding that Mon Valley lost $12 million over COVID testing. He complimented Washington County Emergency Management for its support of the hospital.

Panza is somewhat surprised Mon Valley has a federal designation of “urban hospital,” while it is considered a rural facility in Pennsylvania.

Wiltrout said WHS Greene has lost at least $2 million during the pandemic, “which is substantial for a small, 23-bed hospital.”

The possible shutdowns of community hospitals concerns Washington County Commissioner Larry Maggi. “One in 5 Americans come to community hospitals for health care,” he said. “If these hospitals close, people will have to travel one or two hours for treatments expressed concern. This is a complex problem. We need health-care providers.”

Fears of infection have dissuaded some residents, including older people dealing with potentially serious health issues, from visiting hospitals and physicians in recent months. Panza anticipates seeing a rise in stroke victims “and more stage three and four cancer cases because people delayed coming in. People need to be aware that hospitals are safe places.

Telemedicine was hailed Monday as a valuable tool during this global outbreak. “Telemedicine has jumped five years in literally two months,” Panza said. “Insurance companies have to reimburse properly for telemedicine after this. We have to eat the cost.”

Broadband became a broad subject during the last third of the 90-minute workshop. It is a major concern of Mike Belding, chair of the Greene County commissioners, who said “40% (of county residents) don’t have that capability. We have five school districts with hybrid education (plans for the upcoming school year), so potentially 40% of our students won’t be educated. We can’t afford to not educate 40% of our students.”

Bartolotta captured the essence of the event during her closing remarks, saying: Community hospitals are the lifeblood of our communities.

Business Writer

Rick Shrum joined the Observer-Reporter as a reporter in 2012, after serving as a section editor, sports reporter and copy editor at the Pittsburgh Post-Gazette. Rick has won eight individual writing awards, including two Golden Quills.

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