Grand View Health in Bucks County, Pa., admitted its first coronavirus patient on March 28. About three weeks later, the hospital was slammed, its 14-bed ICU overflowing with COVID-19 cases.

Mark Horne ’83 was prepared, if stressed. As chief operating officer, Horne’s primary responsibility is to make sure the hospital operates smoothly. He and the rest of the hospital's senior leadership team had been working nonstop since early March planning for a potential crush of patients, dealing with the logistics of caring for people with an unfamiliar disease.

As it became obvious that the ICU would be overwhelmed, Horne and a team of physicians, nurses, support staff and others set up a temporary ICU in the hospital’s post-anesthesia-care unit. At one point there were eight patients on ventilators, when on a typical prepandemic day there might have been one.

“We hadn’t had our system tested like this in the 20 years I’ve been at Grand View,” Horne says. “Your adrenaline is running so fast that even when you get home you don’t relax too much. You don’t sleep as well. And I’m not even on the front lines.”

Horne worked tirelessly in the spring to make sure that his facilities were sterilized and ventilated properly, that rooms and hallways were not overcrowded, and that the hospital was using its talent in the most efficient way.

Under Horne’s direction, Grand View modified rooms for Covid-19 patients so that they were negative-pressure (brought fresh air in and pushed stale air out). The hospital also limited the number of entrances and exits into its facilities and staffed the entrances with employees who screened all visitors.

Perhaps most important, Grand View maintained an ample supply of personal protective equipment (PPE). Thanks to some of Horne’s contacts in the community, Grand View was able to get plenty of eyewear and masks. Henry Thompson, a friend of Horne’s who runs American Safety Clothing, called Horne in April and asked if he needed the shop to sew masks for Grand View.

“We delivered 18 trash-can bags full of sterilized material, and they made 5,000 masks for us in about a week,” Horne says. “It was great, because it employed about 12 to 14 people, kept them working during this time, and then also provided masks for us.”

Another friend in the community, the owner of a local Ace Hardware, donated 1,000 pairs of goggles.

“I think that one of the neat things that we learned out of this pandemic is that relationships are really critical,” Horne says.

It took a lot of planning and work, but Grand View was able to weather the initial crisis. “It was probably been the hardest 60-day stretch I’ve ever had in my career,” Horne says.

Learning situation

Horne came to visit Wingate because his pastor at the time in Rutherford County, A.B. Bumgarner, had attended Wingate Junior College in the ’30s and talked glowingly about it. “It was the only place I ever visited, so I sort of fell in love with it from the beginning,” says Horne, who serves on the University’s Board of Visitors.

After starting out as a history major at Wingate, Horne switched to business, earning a B.S. in business administration before moving on to UNC-Greensboro to get his MBA. He gave those degrees a workout earlier this year.

Across the country, smaller hospitals have suffered for years, for a variety of reasons. According to researchers at the University of North Carolina, 172 rural hospitals have closed their doors in the United States since 2005, including more than a dozen in 2020.

The coronavirus pandemic has only exacerbated the problem. While the pandemic sent administrators such as Horne into crisis mode, people suffering from non-Covid-19 ailments stayed away in droves, hesitant to potentially expose themselves to the virus. As a result, revenues were down this spring at many hospitals, large and small, as patients put off having elective surgeries, making regular office visits, or even making appointments to check into potentially serious conditions.

Grand View started work on a $210 million facilities expansion in the fall of 2019 and was planning to add three outpatient centers this year. But Horne estimates that the hospital, which is about an hour northwest of Philadelphia, saw its operating margin drop 4-5 percent in both March and April.

Despite the steep decline in revenue, Horne and Grand View have taken a real human-centered approach to the pandemic. “We kept paying people. We had people working from home. We had people taking vacation time,” Horne says. “We redeployed staff, so we had the expensive people doing screenings and things like that. But everybody really pitched in to make this work well.”

In the aftermath, Horne expects changes to be made.

“It’s challenged us and tested us,” he says. “We’ll be revamping our emergency-management policy going forward, as every hospital is. We’re all thinking, Well, these plans are great, but now that we’ve gone through this, let’s throw those plans out and say, ‘This is what we really had to do in an emergency situation.’”