“We are con­stantly ex­plain­ing to po­ten­tial fam­i­lies that we are not clos­ing and we will be ready for the next school year,” Mr. Jack­son said.

Phi­lip Parr, the school’s board pres­i­dent, said three sites are be­ing con­sid­ered to house the school as early as this fall: two in Down­town and one at the Energy In­no­va­tion Center on Bed­ford Avenue in the Hill Dis­trict.

“I’m con­fi­dent we can move for­ward … and we are well-po­si­tioned for a smooth tran­si­tion,” Mr. Parr said last week dur­ing a com­mu­nity meet­ing where the Hill House As­so­ci­a­tion an­nounced it will soon go out of busi­ness.

The Kauf­mann Center

that houses the school is one of seven prop­er­ties Hill House As­so­ci­a­tion needs to un­load as it winds down its op­er­a­tions.

In some ways, Hill House Pass­port Acad­emy’s con­nec­tion with Hill House As­so­ci­a­tion — a so­cial ser­vices hub that has op­er­ated in the neigh­bor­hood for 55 years — has ben­e­fited the school, said Mr. Jack­son.

“Ev­ery­body knows you and knows where you are,” he said.

But as he re­sponds to ques­tions about the school’s long-term vi­a­bil­ity, “You can only convince peo­ple so much over the phone.”

An ob­vi­ous rem­edy would be to change the name.

“We are ex­plor­ing it,” Mr. Jack­son said.

To do that, the school

needs per­mis­sion from the Pitts­burgh Pub­lic Schools, the dis­trict with which it is af­fil­i­ated. Mr. Jack­son hopes that will hap­pen “sooner rather than later.”

Cur­rent en­roll­ment stands at about 170, and most are stu­dents ages 17-21 who dropped out of other schools in the city or sur­round­ing sub­urbs.

Some are home­less or re­fused to at­tend schools in their home dis­tricts be­cause of bul­ly­ing or other emo-

tional sup­port is­sues, said Mr. Jack­son. About 40 per­cent have spe­cial ed­u­ca­tion needs and about 25 per­cent are sin­gle par­ents.

“Com­ing from schools where there may be 1,000 to 2,000 stu­dents, to a place with 170, they feel a great safety net,” he said.

Many re­turned as 18- or 19-year-old stu­dents af­ter they re­al­ized, “I need my di­ploma to get a bet­ter job,” Mr. Jack­son said.

Stu­dents at­tend the school

for three hours daily, choos­ing ei­ther morn­ing or af­ter­noon ses­sions to ac­com­mo­date their work, fam­ily and child care sched­ules.

Staff in­cludes a read­ing spe­cial­ist, coun­sel­ors and a school psy­chol­o­gist to as­sist stu­dents with some of the is­sues that brought them to the school.

About 50% of the class set to grad­u­ate in June will go on to col­lege or trade schools, and the rest will en­ter the work­force, said

since 2010, ac­cord­ing to the U.S. Cen­sus, and the hos­pi­tal ex­pects it will con­tinue to drop through 2023.

The county’s pov­erty rate of 14.7% ex­ceeds the state­wide level of 12.5%, which could in­crease the num­ber of pa­tients with­out in­sur­ance or with Med­ic­aid cov­er­age. Med­ic­aid re­im­burse­ment of­ten does not cover hos­pi­tal costs.

But the prob­lems go be­yond de­mo­graph­ics.

Although av­er­age hos­pi-

hos­pi­tals have sought to align with big­ger health care sys­tems, like Pitts­burgh-based UPMC.

But Mr. Wolfe said that’s not in the cards for In­di­ana Re­gional Med­i­cal Center, which be­lieves that stay­ing in­de­pen­dent is in the best in­ter­ests of the com­mu­nity.

“It’s a very dif­fi­cult time,” he said. “Re­main­ing in­de­pen­dent is bet­ter for ev­ery­body. We will do what we need to do to keep the hos­pi­tal in­de­pen­dent.”

The med­i­cal cen­ter could even­tu­ally ben­e­fit from a state pro­gram de­signed to help small, ru­ral hos­pi­tals. Nearly half of the ru­ral hos­pi­tals in Penn­syl­va­nia have neg­a­tive op­er­at­ing mar­gins, put­ting them in dan­ger of clos­ing, ac­cord­ing to Gov. Tom Wolf’s ad­min­is­tra­tion.

Start­ing with five tiny hos­pi­tals, the Penn­syl­va­nia Rural Health Model is us­ing a global bud­get pay­ment method to pay hos­pi­tals for treat­ing pa­tients based on the hos­pi­tal’s his­tor­i­cal net rev­e­nue. Global pay­ments will re­place the less pre­dict­able fee-for-ser­vice model that is com­monly used.