Lock Haven, Pennsylvania, is losing its only hospital on April 20, but people won't have to leave town for emergency medical care. That's because UPMC plans to convert the hospital's emergency room to an outpatient emergency department.
This UPMC facility will be the first of its kind in Pennsylvania, though freestanding EDs have existed in other parts of the U.S. for nearly two decades.
Last year the state issued guidance governing the operation of outpatient EDs, with a clear goal: "The Department authorized the operation of [outpatient EDs] as a means to preserve and create access to health care in rural areas."
The state's Department of Health notes that 22% of Pennsylvania's rural hospitals are considered vulnerable to closure. According to the Sheps Center for Health Research at the University of North Carolina, Pennsylvania has lost five rural hospitals since 2005. (More than 180 have closed across the country during that time period.)
Rural hospitals often struggle to stay financially viable because many are situated in communities with declining populations. Additionally, more treatment is now being done on an outpatient basis, meaning that some older facilities have more inpatient beds than they currently need. Yet when these facilities close, patient populations can struggle to access emergency medical care.
"Making sure that there are options across the state in underserved areas is really important,” said Lisa Davis, director of the Pennsylvania Office of Rural Health. "And considering what those options need to be to meet the needs of the community is of paramount importance."
Freestanding emergency departments are in the majority of states. In some, such as Texas and Colorado, they can operate independently. In Pennsylvania, like Ohio and New York, the facility must operate under a hospital's license — essentially making it a satellite ED. The Lock Haven location will be licensed under UPMC Williamsport, a level-two trauma center.
Patients seeking acute medical treatment at Lock Haven may not realize they're at an outpatient facility since the current hospital's emergency department will simply become an outpatient ED in two months, retaining its same staff. Radiology, laboratory services and some physician practices will also remain on the former hospital’s campus.
"The difference is going to be for the small percentage of people who may require an inpatient admission," said Patti Jackson-Gehris, president of UPMC in North Central Pa. "They may need to go to the hospital for a hospital stay for further treatment — they will be transferred to an acute care hospital."
