It was a slow and steady decline for 25-bed Tyrone (Pa.) Hospital, starting in the early 2000s. A key doctor left. Revenue started to dwindle. And gradually, the community of 2,500 residents nestled at the base of the Bald Eagle Mountain in central Pennsylvania lost confidence in the critical access hospital.

Mired in bankruptcy and just a few short months from closing, Tyrone has pulled an about-face. Quality scores are on the upswing, the medical staff is rounding out, the hospital is profitable and leaders just announced plans to build a 38,000-square-foot, $20 million addition that will double its size when completed.

CEO Stephen Gildea says Tyrone Hospital’s management is trying to operate with an eye toward the future by forging partnerships, focusing on the burgeoning outpatient side, and championing a community wellness and fitness center. There will be a celebration this fall commemorating the hospital’s 60th anniversary. The hospital also unveiled a new logo that symbolizes its journey.

When Gildea became CEO in 2009, two years after the bankruptcy filing, boosting the quality of care became a key focus. A turning point came 18 months later, he says, when Tyrone recruited hospitalist Greg Kimble, who eventually became chief medical officer. Under his leadership, protocols started to improve and the hospital began to attract high-caliber, highly specialized physicians, such as a breast surgeon who attracted new patients.

Tyrone’s efforts were recognized last year when the National Rural Health Resource Center presented hospital leaders with an award for their work in community engagement.

If independents want to survive in today’s environment, it’s critical that they emphasize quality, says Larry Baronner, rural health systems manager and deputy director of the Pennsylvania Office of Rural Health, who presented the award. If Tyrone had not done so, patients could have traveled a half-hour so so farther to larger medical centers.

“If we can’t provide quality care, people will go elsewhere. They’ll drive right by these small rural hospitals,” Baronner says.

However, no small hospital can go it alone because of the high costs of specialized care. So, Tyrone has forged partnerships across Blair County, culminating this past June with the announcement of the new Tyrone Regional Health Network. The new name formalizes the hospital’s collaborative, community-based approach with partners such as the Breast Cancer & Women’s Health Institute of Central Pennsylania, Tyrone Fitness and Wellness Center, and a rural health center focused on primary care, in nearby Houtzdale.

Board President Kelly Wike says Tyrone continues to seek out partnerships and is keeping its options open to whatever may materialize.

“We have to look at all the possibilities, and we have been looking,” she says. “The costs of specialists and different programs are just too expensive for a small hospital on its own to carry. We’re not looking to sell out, but we are looking for partners who can help us in the areas where we just can’t afford to get people.”