UPMC Cole, Coudersport, Pennsylvania

December 2020
National Rural Health Resource Center (The Center)

UPMC Cole, located in Coudersport, Pennsylvania, is one of three critical access hospitals (CAHs) that received national recognition for demonstrating an innovative approach to post-acute care that supports a patient’s continued recovery from illness or management of a chronic illness or disability.

Coudersport and the surrounding region is considered to be one of the most remote areas in Pennsylvania. The area includes the Allegheny National Forest with much of the area accessed by a few two-lane mountainous roads, which are often impassable in the winter months. As the only hospital in the area within 35 miles, UPMC Cole has been dedicated to ensuring that they meet and exceed the needs of the communities they serve. Comprehensive community needs assessment activities identified a population of high risk, vulnerable patients who experience a lack of support for comprehensive palliative services.

Existing hospital services did not adequately meet and support the physical, emotional, spiritual, and social needs of those suffering from a serious or life-threatening illness. End of life care services were limited to a home-based hospice program or placement in a skilled nursing facility. In response, UPMC Cole developed a robust and innovative palliative care service. UPMC Cole appointed physician champions to lead this program to implement palliative services across the continuum of care. These palliative care services emphasize pain and symptom management, care coordination, emotional support, advanced care planning, and spiritual care.

“An interdisciplinary team, passionate about palliative and end of life care, met routinely to identify service gaps and community needs and formulated concise goals utilizing best practices for end-of-life care,” said Timothy Brown, President, Vice President of Operations, UPMC Cole Medical Group. “Kristin Kratzer and Andrea Heller, MD, were appointed to lead this program to implement palliative services across the continuum of care. The team provided community education to ensure that palliative care services did not replace primary care, but rather supported and complemented established and trusted services.”

Positive Outcomes

  • Continued expansion of palliative care services to include the addition of patients in three local skilled nursing facilities and rehabilitation facilities.
  • An overall increase in Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) scores rating of 4 (above average) and willingness to recommend score of 4 (above average).
  • Inpatient palliative care penetration rates increased from 3.83% in 2018 to 11.55% in Quarter 1 2020.

Top Accomplishments

Over the past year, palliative care services have grown to become a premier service in UPMC Cole’s post-acute care program. Patients and families now receive the support they need when dealing with advanced illnesses, which were lacking prior to program implementation. Patients, families, and the community also have expressed appreciation for the palliative care program as evident by the increased community support and increased contributions to the hospital’s philanthropic unit, the Cole Foundation. UPMC Cole has also seen an increase in patient census requesting specific services from the palliative program to include pain and symptom management, care coordination, emotional support, advanced care planning, and spiritual care.

“UPMC Cole is dedicated to providing a comprehensive system of high-quality health care to include premier post-acute and palliative care services for their patients,” said Jennifer Edwards, Rural Health Systems Manager and Deputy Director from the Pennsylvania Office of Rural Health. “This program is a shining example of innovation, and commitment to the transition to value that the CAHs in Pennsylvania are pursuing every day.”

This project is/was supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) under grant number UB1RH24206, Information Services to Rural Hospital Flexibility Program Grantees, $1,560,000 (0% financed with nongovernmental sources). This information or content and conclusions are those of the author and should not be construed as the official position or policy of, nor should any endorsements be inferred by HRSA, HHS or the U.S. Government.