State considering action against Astria Toppenish Hospital following closure of maternity center

The Washington State Department of Health is considering possible disciplinary action against Astria Toppenish Hospital over the December closure of the Family Maternity Center.

The issue centers on Astria Health's certificate of need with the state. The Department of Health requires that some health care organizations get approval to build new facilities or offer new services through a certificate of need. The process aims to ensure that facilities and services are needed for quality patient care in a region or community.

Astria Health, then called Regional Health, requested a certificate of need from the state in 2017 when it purchased Toppenish Community Hospital from Community Health Systems. The certificate of need issued to Astria by the state included a condition that required the hospital to provide labor and delivery services and other health care until 2027.

Astria fell out of compliance with the agreement in December when it shut down the Family Maternity Center at its Toppenish hospital without first seeking to have the certificate of need amended, DOH staff said.

“An applicant should apply to have their certificate amended if they feel a condition needs to be changed prior to making that change without approval,” DOH staff said in an email to the Yakima Herald-Republic. “Failing to do so subjects the applicant to potential enforcement action.”

Astria Toppenish Hospital’s certificate of need states that  “Regional Health (now Astria Health) will continue providing the essential services identified in the application for a minimum of 10 years.”

The first service listed is perinatal/obstetrical services, including cesarean sections and labor, delivery, recovery and postpartum care.

Astria Toppenish stopped a service that is a condition of the certificate of need, DOH staff said in the email.

"Because this process is ongoing, we don’t want to speculate about what action(s) might or might not be taken,” the DOH email said. “That said, it’s important to note that patient safety and access to quality health care options are both critical factors in our decisions. If a disciplinary action reduces access to other health services, that is not a positive outcome.”

Astria Health and the DOH are now in the process of amending the hospital’s certificate of need.

A letter of intent from Astria CEO Brian Gibbons to the state on Jan. 30 requested changes to the certificate.

In mid-December, Astria said it would shutter the Toppenish maternity center in January, citing a drop in Medicaid reimbursements, staff recruitment issues and financial losses. A news release from Astria Health said a 50% decrease in births in Toppenish over the last five years and a $3.2 million loss in 2022 made keeping the center open unsustainable. The closure happened much sooner than expected, on Dec. 23, after Toppenish lost contract staff right before the Christmas holiday.

Expectant mothers are being directed to Astria Sunnyside Hospital or MultiCare Yakima Memorial Hospital to give birth.

Astria Health did not immediately respond to a request for comment.

Editor's note: This story has been edited for clarity.