Nobody carried a bullhorn or a protest sign to Aliquippa's Commonwealth Medical Center yesterday to decry its possible closure.

Petitions were not circulated outside. Nor were there emotional rally speeches about generations of babies born there, or how the half-century-old hospital built with steel worker contributions gave an often struggling community a reason for pride.

Those sentiments were all expressed long ago, residents said. Instead, with a state-imposed deadline looming tomorrow to save the ailing facility, a community weary of the fight offered mainly laments like those of Susan Jones, 64, who has spent her life in Aliquippa.

She paused yesterday morning outside the U.S. Post Office long enough to ask what might happen if her husband has another problem with his heart when the closest emergency room is no longer seven minutes away.

"If I have to go all the way to Beaver, or to Sewickley, then anything could happen," she said.

"It's very sad," agreed Tina Fischer, 54, a nurse who worked for the hospital during the 1990s.

"The hospital always had its ups and downs, but always found a way to come back," she said yesterday while raking leaves at her home just up the street. "I think this time, this might be pretty much about it."

The state Department of Health on Wednesday announced the latest -- and some fear final -- chapter in the community's dogged bid to save the hospital founded 51 years ago as a nonprofit institution and sold last year after losing $12 million since a 2004 bankruptcy restructuring. The buyer, Commonwealth Medical Center, sought to operate it as a for-profit facility.

The department said it will move to permanently close the debt-ridden, 96-bed facility, formerly known as Aliquippa Community Hospital, unless the hospital can prove by tomorrow that it is capable of functioning for at least six months to a year.

The department said Wednesday it was imposing an indefinite ban on inpatient, outpatient, emergency and non-emergency admissions. It said the hospital violated licensing requirements, was short of supplies and faced other problems, including a gas company warning that service could be shut off due to unpaid bills.

The department's move came after its latest visit to the center on Tuesday, during which it confirmed complaints that the lab lacked supplies needed to conduct a type of blood test, department spokeswoman Stacy Kriedeman said Friday.

The department wants, among other things, an operating budget for 2008-2009 and a statement regarding cash flow.

"We're willing to work with the management," she said. "But the deadline is [tomorrow] and if we don't hear anything from them, we will move to start license revocation, we will move to start closing the facility."

Jan Bove, a hospital spokeswoman, did not respond to a phone message left Friday. Hospital workers yesterday said only senior administrators could authorize comment, and they were unavailable at least until Monday.

A worker did say the emergency room remained open, but anyone who needed to be admitted after seeking treatment there would be transferred elsewhere.

Ms. Kriedeman said last week she did not know how many employees still work at the hospital. But there were 189 workers in January, down from 305. All union workers were let go in January to reduce staffing costs, officials said at the time.

The hospital last week had four remaining patients who were allowed to stay with the approval of their doctors, Ms. Kriedeman said. Others were advised to go to Heritage Valley hospitals in Beaver and Sewickley.

A department-ordered closure would require disposition of equipment, securing the facility and ensuring access to medical records, she said. Such an action is so unusual, if not unprecedented, that she said she was not aware of any formal process.

"To be honest, it's something that doesn't typically happen," she said. "Hospitals generally close themselves and notify us on how they are going to shut down."

Meanwhile, some in the community yesterday expressed varying emotions, from anger and frustration to resignation about a fight they no longer feel they can win.

Some pointed to changes in health care nationally that have made it harder for smaller, independent hospitals to compete with larger institutions or hospital systems. Others placed blame on the hospital's administration, saying in recent years managerial moves had marginalized the community's role in one of its most prized institutions.

"If somebody has an idea of what we can do, tell us," said Emanuel Panos, a pharmacist and owner of Hoffman's Drug Store in Aliquippa's business district. "Because rallying, jumping up and down and screaming hasn't helped."

Dr. Wallace Zernich, 82, a retired doctor who was among the hospital's founding workers, said the loss to the community would be hard to fathom.

"The city of Aliquippa deserves better," he said.

John Hock, 81, was among the J&L steel workers who contributed a portion of his pay to open the hospital. Now retired and living within sight of the building where he still gets his diabetes blood tests done, he remembers spending two weeks there decades ago when he developed phlebitis in his leg.

"They took good care of me," he said.