Oregon Health Authority Rejects Legacy’s Closure of East County Birthing Center

In a rare rebuke of a major hospital system, the state cites risk to patients.

LABOR INTENSIVE: Legacy Health wanted mothers to travel from east county to the Emmanuel campus to give birth. (Blake Benard)

The Oregon Health Authority today firmly rejected Legacy Health’s request for a waiver that would give the hospital system permission to close the birthing center at Legacy Mount Hood Medical Center.

As The Lund Report and others have reported, Legacy not only applied for a waiver to close the facility in early March, it actually shut the center down March 17 before receiving state approval to do so.

That abrupt step angered many in the community, including east county lawmakers, because Mount Hood served more women seeking urgent obstetrical care than any other facility in Legacy’s six-hospital system and it served a population that OHA describes as particularly in need. “It served a disproportionate percentage of patients who had limited English proficiency, fewer or no prenatal visits, limited education and greater enrollment in the Oregon Health Plan (OHP),” OHA said today in explaining its rejection of Legacy’s waiver request.

Critics noted that the distance from Legacy Mount Hood to the alternative hospital, Legacy Emanuel in North Portland, is nearly 17 miles and often includes heavy traffic.

Unlike some regulatory pronouncements, OHA’s rejection carries real teeth. That’s because the agency licenses all hospitals in the state. That licensure is key to hospitals being able to get reimbursement for Medicaid (for low-income Oregonians) and Medicare (for seniors).

Once found to be noncompliant, Legacy Mount Hood would have 90 days to remedy the situation or lose its ability to get reimbursement.

OHA outlined what Legacy would have needed to show to be allowed to close the birthing center.

“Under state regulations, a hospital that requests a waiver of a licensing requirement must show that the proposed waiver maintains or improves the health and safety of the patients, meets the individual and aggregate needs of patients, and does not jeopardize patient health and safety,” the agency noted.

OHA determined that Legacy’s request for a waiver did not meet any of those conditions: It did not maintain or improve patient services, it did not meet community needs, and it did not improve patient safety.

“Our goal is to ensure patients have timely access to maternity care,” said OHA public health director Rachael Banks. “The closure of the Family Birth Center at Mount Hood Medical Center does not meet that goal.”

OHA said it is now investigating Legacy’s decision to close the birthing center prior to receiving a response to its waiver application.

Legacy said in a statement it is considering how to respond to OHA.

“We respect the state’s authority in this decision, and we are carefully reviewing the letter provided by the Oregon Health Authority,” Legacy said. “Once we have had the opportunity to thoroughly consider the decision and consult with the Oregon Health Authority to determine our next steps, we will provide additional information. In the meantime the Mount Hood Family Birth Center will remain on divert status due to the lack of adequate physician staffing to provide safe patient care.”

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