Citizens General Hospital's closing 10 years ago start of a trend

For many residents in New Kensington and its neighboring communities, the closing a decade ago of Citizens General Hospital marked more than the end of an era.

The outcry at public meetings among those who worried they wouldn't have access to quality health care might have led some to believe the end of life as we know it was near.

Activists circulated a petition, asked the state attorney general to intervene and mounted an unsuccessful legal challenge aimed at keeping the hospital open. They were convinced the health care and economic impacts resulting from the closure would cripple the city.

Awash in red ink, officials at the independent facility saw no option for survival in what they said had become a "one-hospital market."

Their best option, the one that played out, involved closing the hospital and leasing the building to West Penn Allegheny Health System for use as an ambulatory care center.

West Penn Allegheny, as it still does, owned the nearest competitor -- Allegheny Valley Hospital in Harrison.

Out of what West Penn Allegheny officials deny was a "merger," was formed the Alle-Kiski Medical Center, which includes Allegheny Valley Hospital and the Citizens Ambulatory Care Center.

As part of the deal, West Penn Allegheny agreed to pay $10 million to the Citizens General Hospital Foundation, which foundation officials have said would be used to bolster medical services in the area.

Details of how the foundation is using its endowment locally weren't available. Some of those most involved with the foundation declined to talk or couldn't be reached for comment.

Despite the fears that existed in November 2000 when Citizens closed, Alle-Kiski Medical Center officials argue residents now have access to better medical care.

Bill Englert, vice president of operations and business development at Allegheny Valley Hospital, pointed to several changes and improvements he said make Alle-Kiski Medical Center "the premier provider of health care in the Alle-Kiski Valley."

Among the changes:

• A more than $11 million emergency department expansion at Allegheny Valley Hospital, now called Alle-Kiski Medical Center.

• The addition of a diabetes clinic and MRI at the walk-in care center in New Kensington.

• Having a mobile PET/CT scanner visit the New Kensington site one or two days per week.

Englert said West Penn Allegheny recently extended its lease to occupy the former Citizens General Hospital. He said he couldn't offer terms of the lease.

"We've been there 10 years and we plan to stay," he said.

Englert said the Alle-Kiski Medical Center has been profitable each of the past 10 years. It made a $2.8 million profit in the year following the Citizens closing.

And according to an annual report from the Pennsylvania Health Care Cost Containment Council, the center made a net profit of about $9.2 million during the 2009 fiscal year, which ended in June.

The West Penn Allegheny Health System as a whole, however, is struggling financially. Last week it reported an operating loss of $89.9 million for that same fiscal year.

Changing model

Pat Raffaele, an official with the Hospital Council of Western Pennsylvania, said a trend was unfolding at the time of the Citizens closing that involved a shift in the way hospitals delivered their services.

She said the shift focused on providing as much local care as possible. It's a trend she said will continue to play out over the next five to 10 years.

She said that while they don't offer a full range of services, the hospitals opened community clinics or urgent care centers such as Citizens that address a variety of medical needs so residents don't have to make the trip to a full-fledged hospital.

"They're trying to make as much care available as possible in the local community so that patients don't have to travel into Pittsburgh or too far away from their home," she said.

For instance, University of Pittsburgh Medical Center -- rival to West Penn Allegheny -- is preparing to open an urgent care center in Harrison next month.

While she couldn't speak specifically to the Citizens closing, Raffaele indicated it hasn't been uncommon for competing hospitals to align their services similar to the way West Penn Allegheny moved into the Citizens facility.

This type consolidation continues to unfold locally. Alle-Kiski Medical Center officials announced in September that LifeCare Hospitals of Pittsburgh was preparing to open an Alle-Kiski Valley facility for long-term acute care patients inside the Harrison hospital.

Altered perspective

Ten years removed from the event, some remain angered by the closing while others embrace the change.

Pat Petit, who was New Kensington's mayor when Citizens closed, said news of the closing affected him personally because of his family's history there.

"My mother worked there for 37 years," he said. "All of my children were born there. I admit, I took it personally."

Petit said his chief concern was the economic impact the closing would have on the city.

"Of course you're going to take a hit closing something of that status," he said. "You ended up with fewer employees in town -- fewer people buying gas, eating at restaurants and generally supporting the local economy."

At the time of its closing Citizens General Hospital employed about 600 people, according to news accounts at the time.

The Citizens Ambulatory Care Center of today has from 60 to 80 employees on site each day.

New Kensington City Clerk Dennis Scarpiniti said the economic impact of the closing was substantial: "I'm sure it hurt the tax base. It didn't shut us down, but it hurt."

Quantifying that effect wasn't possible, officials said, because figures detailing a before and after tax-revenue impact aren't immediately available.

Petit, meantime, said having the ambulatory care center is "better than nothing" in terms of supporting the local economy and the community's medical needs.

Gene Montemurro, who a decade ago was one of the residents leading the effort to keep Citizens open, said his perspective has changed.

"Things aren't as bad as I originally thought they would be because they opened the urgent care center," he said. "People who need medical care, they go there and they love it. It's the best around."

Montemurro said the one negative in his mind is that the entire Citizens building isn't being used. While the Citizens School of Nursing occupies the second floor, the other floors aren't used.

"It would be nice if they put something on the third and fourth floors," he said.

Referencing the LifeCare development at Alle-Kiski Medical Center, he said, "They should do here what they're doing up there: Put a hospital in a hospital."

Montemurro said he can see the trend unfolding that Raffaele talked about.

"It's all back to local today," he said. "That's the trend. Pretty soon you'll be able to walk into Wal-Mart and get checked out while you do your shopping."

He noted that local residents fared well compared to those in some other sections of the Pittsburgh region, such as the closing of UPMC Braddock hospital.

Four hundred workers at West Penn Allegheny Health System are losing their jobs as part of an ongoing restructuring plan. A majority of those lost jobs are positions at West Penn Hospital, which is closing its emergency department at year's end.

As part of the consolidation, West Penn will scale back its inpatient services and house mostly outpatient services. Allegheny General Hospital will become West Penn Allegheny Health System's flagship, offering a majority of the system's inpatient, surgical and outpatient services. AGH is undergoing a $60 million renovation to accommodate the influx of patients.

"There's nothing we can do to stop it," Montemurro said. "If they're not making money, that's it. They start to cut."

Additional Information:

Care center services

According to Alle-Kiski Medical Center officials, the Citizens Ambulatory Care Center in New Kensington treats more than 70,000 patients annually.

More than 17,000 people last year visited the urgent care center, where residents can seek care for minor emergencies. Other services in the ambulatory care center include:

• Lab services;

• Radiology services including x-rays, CT scans, ultrasounds, mammographies and MRI and PET/CT scans, among other services;

• Cardiology services, including EKGs, Holter monitors and echocardiograms;

• The Joslin Diabetes Center, which is a team of professionals trained to help people manage their diabetes. The staff includes a board certified endocrinologist and educators;

• Oncology services;

• A school of nursing, which taught 200 students last year;

• Education and screening programs.