Pinnacle Lancaster

UPMC Pinnacle Lancaster, known to many Lancaster County residents as the former St. Joseph Hospital, is set to close Feb. 28.

THE ISSUE

The process of closing UPMC Pinnacle Lancaster is underway. As LNP staff writer Heather Stauffer reported last week, the hospital, at 250 College Ave., “discharged the last patient in its rehabilitation program Tuesday and isn’t accepting any more.” The system announced Dec. 11 that it would close the hospital by March; some of its 505 employees (but not all) will find new positions at UPMC Pinnacle Lititz, the system’s sister hospital in Warwick Township, where inpatient services are being consolidated. As Stauffer reported in last week’s Sunday LNP, the city hospital “was founded as a Catholic nonprofit called St. Joseph Hospital. The name changed to Lancaster Regional Medical Center in 2000 when it was acquired by the first of two for-profit chains that would run it. Last year, the hospital returned to being a nonprofit under the name UPMC Pinnacle Lancaster.”

We’re among the many Lancaster County residents distressed by UPMC Pinnacle’s decision to close its College Avenue hospital.

The decision hit many of us in a personal way, as the former St. Joe’s was the repository of many of our most significant life moments: the deaths of parents and other loved ones, the births of children and grandchildren. The 135-year-old hospital was a Lancaster city mainstay and, though we knew it was underutilized in recent years, we still hoped it would be there forever.

So we understand the sadness and even anger of some city residents. We worry, too, for the hospital employees who won’t be retained by UPMC Pinnacle. It’s never easy to lose a job, but this is a particularly rough time of the year for it to happen.

We also understand city residents’ concern that the very busy Lancaster General Hospital will be, come the spring, the only hospital within the city’s limits.

But we’re not sure why so much anger was directed last week at Lancaster Mayor Danene Sorace and the Lancaster City Council.

We agree that it wasn’t helpful when Randy Patterson, the city’s director of economic development and neighborhood revitalization, said he hoped the hospital would be razed to create a “blank canvas” for development.

The hospital complex covers a full city block — a significant piece of real estate in a city that is desperate to expand its tax base. So we understand what Patterson was thinking, but he probably should have curbed his enthusiasm for demolition, given the circumstances.

Patterson’s comment drew the wrath of activist Tammy Rojas, coordinator of the Lancaster Healthcare Rights Committee of the advocacy organization Put People First! As LNP’s Tim Stuhldreher reported, Rojas demanded at a city council meeting Tuesday evening that city officials work to keep the hospital open.

And at that meeting, Pastor Kevin Brown of Kingdom Life International Assembly said, “Taking this hospital out of the city is an outrage.”

We’re not sure what the city can do about it. The hospital is owned by the UPMC Pinnacle system, which operates a chain of hospitals in Lancaster, Dauphin, Cumberland and York counties. The system says it has a charitable mission, but it still has to heed its bottom line.

The hospital business

In modern American health care, a hospital stays open only if it makes financial sense to keep it open. Efficiency and market share may not have been the foremost concerns of hospital administrators in the past, but they are pressing concerns now.

And a hospital system — they’re mostly all systems now, as smaller hospitals are acquired by larger ones and health care entities consolidate — is run like a business, even if it’s a nonprofit.

This may sadden us, but it’s the reality. That we accept it doesn’t diminish our concerns about the health care needs of county residents.

What we don’t know, however, are the precise reasons UPMC Pinnacle is closing this hospital.

Its website addressed frequently asked questions, but didn’t really deliver on this particular one. The answer to why it was closing was mostly a word salad describing a vague “three-part plan to ensure the continued availability of the high-quality clinical care expected of UPMC for Lancaster-area communities.” We read and reread it, trying to discern the meaning, to no avail.

Burden on LGH

We share the concerns of members of the health care community who told LNP’s Stauffer that so much depends now on how Lancaster General Hospital — which Stauffer described as “the dominant force in Lancaster County health care” — responds in the wake of the closure of UPMC Pinnacle Lancaster.

“It’s kind of going to be laid in their lap to figure out how they’re going to handle the extra volume, to a system that’s already pretty stressed,” said Michael Fitzgibbons, president and CEO of Susquehanna Valley EMS.

Fitzgibbons said that without an emergency department at UPMC Pinnacle Lancaster, his agency’s calls will take longer, “which then has a domino effect on the whole system.”

Bob May, executive director of Lancaster EMS, said in an email to Stauffer that his agency has had an ambulance station at the former St. Joseph Hospital since the early 1970s.

“Busiest unit in the county,” he wrote, noting that the agency is evaluating its options. “It’s vital to have a base of operations in or near the west part of the city.”

As Stauffer noted, UPMC Pinnacle Lancaster had 136 beds set up and staffed, with 3,513 admissions and 23,360 emergency department visits, according to state records from 2017.

Lancaster General Hospital had 533 beds; 31,941 admissions; and 115,990 emergency department visits.

The math makes clear the pressure that will be on LGH.

Penn Medicine Lancaster General Health has proven to be a fine system and we have faith that it will continue to serve this county well.

But there is real trepidation in the community.

“We are in need of more services, not less, if we wish to have healthy lives,” Rojas said in a news release. “Lancaster can’t afford to lose the jobs or the access to care that local hospitals provide.”

Alas, this is the state of play in American health care today. Smaller hospitals with close ties to their immediate locales just don’t have the patient volume to survive in an era when consolidation and financial calculation reign.

We think there ought to be more important considerations than a health system’s bottom line. Obviously, it needs to be solvent to operate, but its solvency should be the means to its central end — serving the community — and not the end itself.

It’s not asking too much to have some choice in where one gets one’s health care. But increasingly, we are being left with fewer choices — and no way of changing that reality.

The resulting helplessness might be mitigated if health systems communicated in more straightforward ways with the community they serve. We wish UPMC Pinnacle had done this.

Now, we'd urge LG Health officials to address, in a more detailed way than it has so far, people’s concerns over the closure of the only other city hospital.

Time isn’t the only thing that heals. Communication does, too.