Tribune editorial staff

Next week marks a third anniversary for Ironton and Lawrence County. The date - Jan. 29, 2001 - is one hundreds of Lawrence County residents wish held absolutely no significance. But it does.

The date marks the final day employees left the now

shuttered River Valley Health Systems facility, previously known as Lawrence County General Hospital.

After decades of serving the medical needs of countless residents - generation after generation - the hospital was closed in the shadow of an ever-increasing mountain of debt.

Almost immediately following the announcement that the hospital would close, former employees began talking of gross mismanagement, flagrant use of public funds and what can only be regarded as hard-headedness on the part of several key managers.

Some of the remaining records of the hospital paint a rather bleak financial period beginning in the late 1990s. Patient counts dwindled, physicians sought greener pastures and federal medical reimbursement laws were changing.

But sadly the hospital didn't change as the world around it did.

In fact, just the opposite seems to have occurred. As the amount of money coming in dropped significantly, little to no serious effort seems to have been made to stop the bleeding cash flow. And, by the time administrators began to make changes it was too little, too late.

So who is to blame for the hospital's demise? We can all sit around and point fingers at all sorts of things, from the declining economy to the Balanced Budget Act, but in the end, a handful of people were ultimately responsible. Included among them was the hospital's administrator, first and foremost. The role of any CEO is to keep the business afloat. The business of medicine is no different.

And, when the CEO is deemed unfit or incapable of performing his or her duties, the owners (in this case the hospital's board of trustees) must act.

This didn't happen, or at least not soon enough, in the case of River Valley.

Are there lessons to be learned here? Perhaps the most obvious one is simply holding our leaders accountable when the going gets tough.