Health Care Experts Detail Impact of COVID-19 on Rural Hospital Systems

MONONGAHELA – Health care experts outlined the devastating impact of the COVID-19 pandemic on rural health systems during a workshop discussion of the Majority Policy Committee in Monongahela today.

“According to a report by WHYY, nearly half of our rural hospitals operated in negative margins in 2019,” said Senate Majority Policy Committee Chairman David G. Argall (R-29). “Given these troubling statistics, the Department of Health previously warned that there is a real danger of some of these facilities not making it in the future.”

The workshop discussion was requested by Senator Camera Bartolotta (R-46).

“Rural areas like ours rely heavily on small local hospitals to meet the healthcare needs of the community. Already-strained budgets are now being squeezed even further as a result of the pandemic,” Bartolotta said. “This conversation has never been more timely, and I am hopeful that today’s discussion will lead to solutions to ensure these facilities remain a critical part of our communities for many years to come.”

Testifiers noted that rural health care facilities play a critical role not only in serving the community, but also providing jobs and economic benefits to the region.

“Rural hospitals are community hospitals. That is what makes us different,” said Monongahela Valley Hospital President and CEO Louis J. Panza, Jr. “We take care of our communities’ health care needs, but we are also the largest economic engine of that community. The health of the community hospital is as important as the health of the communities they serve.”

Many participants raised concerns about the impact of the cancellation of elective procedures during the pandemic, both in terms of hospital revenue and patient care.

“In the third week of March when we started shutting everything down, we cancelled over 4,000 radiology procedures. 2,000 of those were mammograms for women,” said Washington Health System Greene President Terry Wiltrout. “The concern for me now is how many of those patients didn’t have their exams done and are now going to have some type of cancer that we might not have caught.”

The Hospital and Healthsystem Association of Pennsylvania Vice President of State Legislative Advocacy Stephanie Watkins noted that even though elective procedures have resumed, many patients are still apprehensive about visiting the hospital due to COVID-19.

“It is not a spigot that you can turn on and off,” Watkins said. “It will take a significant amount of time for patients to feel comfortable about coming back to the hospital.”

Panza and Wiltrout both said that layoffs were necessary at their facilities during the state-mandated shutdown. Although many of these employees have been brought back, a significant percentage of laid-off employees remain out of work.

Bartolotta, who serves as Chair of the Senate Labor and Industry Committee, said that health care workers were among the highest categories of employees who have filed for unemployment compensation during the pandemic.

Greene County Commissioner Betsy McClure, who has a background in nursing and health care, also noted that the financial impact of COVID-19 has affected the ability of health care practitioners to provide care to patients.

“Many changes have come about in health care in general, and many tools of our trade have changed,” McClure said. “The art of giving care and being caring can sometimes be a challenge when you know the bottom line is about the cost of delivering that care.”

Testifiers also raised concerns about one-size-fits-all approaches mandated by the state that did not make sense for rural hospitals in some cases. The lack of clear communication from the state also impacted the ability of health systems to provide the best possible care to patients.

“What was frustrating for all of us was hearing that we didn’t want to overwhelm our health systems,” said Washington County Commissioner Diana Irey Vaughan. “What we did was underwhelm our health systems to the point that it damaged them financially and hurt the health of our community.”

“If you articulate the reasons why you would make a decision, then people are more accepting of those decisions. But when you just get told that this is the way it’s going to be without any reasoning or thought behind it, that is part of the problem,” said Greene County Commissioner Mike Belding. “The lack of communication has been paralyzing. You don’t have foresight of what’s coming.”

Participants also noted that the rapidly changing guidance from the state created serious challenges in terms of patient care.

“It is like a roller coaster ride when those directives come out,” Wiltrout said.

Testifiers also suggested ways to bolster rural hospitals against further losses and ensure a high quality of care for patients, including clearer communications from the Department of Health, more input from local elected leaders on decisions that affect community health systems, and better availability of broadband internet coverage. Participants pointed out that broadband coverage not only would help improve response times, but also make telemedicine available to more patients.

Video of the full workshop discussion is available at


CONTACT:   Josh Paul (717) 787-2637 (Senator Argall)
Colleen Greer (717) 787-1463 (Senator Bartolotta)

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