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Proposal gives Attorney General authority to oversee hospital consolidations

Healthcare workers say the state should have the power to review hospital consolidations to make sure levels of care are not reduced when a hospital is purchased.

Sen. Emily Randall, D-Bremerton, said she saw her own community hospital suffer after being acquired by a larger company. That’s why she introduced The Keep Our Care Act.

“In my own community, Harrison Hospital was acquired by CHI,” Randall said. “And I first started learning about it not from the lens of reproductive healthcare, but from nurses and hospital employees who saw impacts to their patients and then working conditions from that acquisition.”

The bill gives the Attorney General’s Office the power to assess whether hospital mergers undermine patient care. The bill explicitly states types of care that must be examined: “emergency care, primary care, reproductive health care, gender affirming care and end-of-life care.”

The Attorney General’s Office is already required to review and be notified of mergers and acquisitions, but this bill would give them more power to stop the deal. The bill has a few exceptions, particularly for smaller hospitals that generate less than $25 million in revenues.

In testimony, concerns were raised over Catholic hospitals that refuse to perform abortions, but Randall said this bill would not change a hospital’s right to not perform abortions.

"This bill doesn't make those hospitals do anything differently as far as their provision of care,” Randall said. “It says if a hospital is going to acquire another health clinic or hospitals, will there be a decrease in access to care? Will they make a hospital that's currently providing comprehensive care stop providing comprehensive care?"

The Washington State Hospital Association opposes the bill, arguing that mergers keep small hospitals afloat when they otherwise might fail.

And some say the cost will be high to the state, and others suspect the bill’s supporters have ulterior motives.

“I am concerned that this is an attempt to advance a social policy statement by the means of business regulation, and that's a bad mix,” said Jim Walsh, R-Aberdeen.

Supporters, however, don’t waver in their opinions.

“We see wings in departments of hospitals closed down, because it's not in the business interest of the company to offer ambulatory surgery or a birth center anymore,” Randall added.

Ian Mikusko of Washington State Nurses Association testified last year in support of the Keep Our Care Act, sharing some concerns he and his colleagues had about a merger in Yakima. He discussed Multicare acquiring Yakima Valley’s Memorial hospital, and the effects he had already seen on nearby facilities.

“We believe it is possible that this acquisition could be connected to the closure of two critical patient services at competing Yakima County hospitals,” Mikusko said. “Astria Sunnyside closed their cardiac unit, and Astria Toppenish closed their labor and delivery unit just two months later.”

Mikusko said he believes patients will die because of these mergers.

“This will result in local communities having to travel 30 to 45 miles to Yakima Memorial which is now fully controlled by MultiCare,” Mikusko said. “The closure of labor and delivery of Toppenish in particular has devastated the local community and resulted in the layoff of 13 nurses.”

Mikusko said concerns were brought to the Department of Health and the Attorney General's Office, but the acquisition was already completed.

“This is why it's so crucial that a public assessment is done to understand the impact on access to care equity in the community,” Mikusko said. “Healthcare systems like Multicare are driven by creating financial efficiencies, these financial efficiencies are often in conflict with access to care.”

Nurses are at the forefront of supporting this bill.

“As a registered nurse in a small community, we've had a large hospital system come in and take over our small community hospital,” said Amanda Campbell, a registered nurse in Bothell. “It's eliminated some care for our patients, and I've seen firsthand how it affects them.”

It’s not just care being cut altogether that Keep our Care Act is hoping to address.

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