OHA denies Legacy Mount Hood Medical Center’s request to close its Family Birth Center

Published: Mar. 29, 2023 at 10:00 PM PDT
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GRESHAM Ore. (KPTV) - On Wednesday, the Oregon Health Authority announced it has denied a waiver application from Legacy Mount Hood Medical Center to stop providing required maternity services in its Family Birth Center.

According to the state’s waiver determination, “officials determined that the closure did not maintain or improve patient services. The birth center’s staff shortages were the result of management decisions, and the hospital chose to close the facility instead of placing staff at the birth center that were willing to implement management’s proposed new care model.”

To read OHA’s full press release click here.

You can read OHA’s waiver denial letter here.

Those who work at Legacy Mount Hood Medical Center say the last few weeks have been a rollercoaster of emotions.

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“I think we finally got our validation in regards to the staffing issue was created by the administration,” said Teddy Glemser, an emergency department charge nurse. “That it wasn’t because all of the nurses walked out and didn’t want to be a part of this hospital and this community anymore. They wanted nothing but that. So it’s just very reassuring to finally have that validation.”

“I think all the points OHA made in their declination of the waiver that Legacy applied for demonstrates what we have been saying all along,” said Christina Weathers, an ICU nurse. “The decision to close our Family Birth Center is not the right thing to do for the communities in which we serve and live. It poses a risk to them and I think that their decision and the way they worded their explanation is validation for what we have been saying. Those of us who are at the bedside, who take care of these people, who know what we are talking about, our voice was heard. I think it’s been a lot of effort, a lot of time, a lot of dedication, and total uncertainty for how it was going to play out. We are grateful.”

The Oregon Nurses Association issued a statement on the announcement:

“Nurses have been saying that Legacy’s decision to close the birthing center was a mistake for months. Not only has the community in East Multnomah County relied on Legacy Mt. Hood for these services for generations, but the closure of the birthing center would add additional burdens to accessing health care for an already underserved population. The decision by the Oregon Health Authority (OHA) to deny Legacy’s request is not only the right thing to do, it also gives Legacy yet another opportunity to step up and do the right thing for the people of East Multnomah County.

The advocacy of nurses and other front-line healthcare workers, along with legislative champions like Representatives Zach Hudson and Ricki Ruiz, and Senator Chris Gorsek, has raised significant awareness among the public of Legacy’s poor decision-making and their failure to act in the best interests of their community. Now, with their waiver request denied, nurses are clear: Legacy must reopen the birthing center as soon as possible and begin the difficult work of rebuilding trust between a health system that tried to put profit before patients and the dedicated staff, and community members, who rely on them.

Nurses and community members are grateful to OHA for their swift and decisive ruling to deny Legacy this request. The Oregon Nurses Association is also calling for support for House Bill 3592 which would require OHA to consider equity implications in maternity waiver processes.”

Despite not receiving approval, LMHMC closed its Family Birth Center earlier this month. OHA officials have opened a separate investigation into Legacy Health closing the center without an approved waiver.

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Glemser says the closure brought a level of uncertainty; the latest news from OHA brought another level.

“There are statements being made of not having the Medicare and Medicaid licensure anymore and that puts the entire hospital at risk,” said Glemser. “It puts many employees at risk as well and the community. Gresham is a very large community, the fourth largest city in the state of Oregon. It also serves several outlying communities. To have that level of uncertainty is scary. It really is.”

“I don’t know that we know what’s going to happen there and I think that most of us have some inherent concern,” said Weathers. “It’s a big deal and we knew it was a big deal when Legacy decided to close the Family Birth Center without authorization to do so. I know amongst us we kept asking what’s their end game? Why are they making that decision knowing that if they were to lose CMS coverage, lose Medicaid, lose Medicare, they systematically cannot operate as a hospital. So it seemed like such a big decision to go ahead and continue without that authorization, but none of us really understood why they would take that risk. Why they would make that decision instead of saying ok, we’ll pause. We’ll wait until we have authorization to close if, in fact, they were to receive that authorization. And we know today that they did not. It’s a little bit scary thinking about a closure possibly if those entities choose to take it to that level. That would be an unfortunate consequence of those actions that they took and unfortunate for our community.”

Both say they are going to continue to fight, and not just for their community.

“I want the community to know we are there,” said Weathers. “That the nurses of Mount Hood not only stood up for each other, but also we stood up for them. That we strive to take good care of people and we believed that in standing up to this decision that we were doing just that. We want them to know we are a good hospital. We are a safe place for them to come to and they should know that watching how much we have fought on their behalf. The points that were made by the Oregon Health Authority in the denial letter is validation for everything that we have been standing up for and against. That is a relief, but also uncertain still. I think, as Teddy said, and as I said the night of our candle lit vigil, we will not be silenced and we will not stop talking until this wrong is made right. I think the only way Legacy at this point can make this right is to apologize publicly for making a poor decision to the community, to the people, and to the staff that work there so tirelessly for them, for each other, and for the people we take care of. That’s the only way to make this right at this point, other than reopening our Family Birth Center.”

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“This is not the end,” said Glemser. “Christina and I, and a couple of other nurses at the hospital, we are currently actively fighting with enforcing a new house bill that is going to enforce equity evaluation within each community where maternity services are provided if other hospitals in the state of Oregon plan to close. We are still fighting that fight. We are going to keep fighting and hopefully that bill gets passed because then the other closures that have happened within the last three years will be re-evaluated to ensure that it’s still a safe option for those communities to not have maternity services. We are not giving up. We are still there.”

Both support House Bill 3592 which can be found here.

It would require general hospital licensed in Oregon to provide maternity services subject to exemption that Oregon Health Authority may allow under criteria prescribed by rule. Representative Zach Hudson, who represents House District 49, is one of the chief sponsors.

“The Legacy Family Birth Center closure was definitely the inspiration behind this bill, but the bill is going to have much more effect than just this situation,” said Hudson. “It would make sure that if a hospital applies for the kind of waiver that Legacy did, that would let them close an essential service like maternity, that OHA not only needs to consider the impact to the community as a whole but also the impact to historically marginalized communities within the area. One thing we heard from the community when this issue came up is that yes, it affects everyone, but it definitely affects some more than others. Families that are either low-income or for whom English is not their first language, or for those who are Black, Indigenous, or people of color, this birth center closure had much more of an impact. That was recognized in OHA’s denial of Legacy’s waiver application. If the bill I am sponsoring along with other colleagues of mine is passed into law, what it would make sure is that in the future any hospital in Oregon would have to do that same kind of analysis if they ever wanted to close one of their essential services.”

He says he was happy to hear OHA’s decision to deny the waiver to LMHMC.

“I think they made the decision that is best for the community and that was really due to having the whole east county community come together and let them know how important it was having a local birth center was to everyone,” said Hudson. “We heard from families and staff at the hospital and from community advocates and everyone made it very clear that crucial services like these are important for everyone in the community and no family should be having to drive a long distance away in a crucial moment like childbirth. I’m happy OHA recognized that and hope that this gives Legacy the chance to come back to the table and do what’s right for east county. Thank you so much to the nurses, not only for the work they do but for the voice that they provided. Letting us know not only what the decision-making behind Legacy’s original rationale for closing the birth center was, but why that birth center is so crucial for the community and just helping people activate to get the word out and to give this important issue the recognition it needs. We definitely couldn’t have done it without the nurses. As a dad whose youngest child was born at the Legacy Mount Hood Birth Center, I am very aware of how important that resource is to the community. I think OHA’s decision underscores the importance of having those services available to everyone.”

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In response to OHA’s decision, Legacy Health released the following statement:

Legacy Health is committed to providing the highest quality care to our patients. We take any concerns about the quality of care we provide very seriously. The Oregon Health Authority has reviewed Legacy Health’s request for a waiver to close the Family Birth Center at Mount Hood Medical Center. Today, we received their decision to deny our request.

We respect the state’s authority in this decision, and we are carefully reviewing the letter provided by the Oregon Health Authority. 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.

Our top priority remains ensuring the safety and well-being of our patients and our staff and physicians. We want to assure the public that we are fully committed to providing the best possible care to our patients.

We appreciate the thorough and focused approach the Oregon Health Authority is bringing to this important process, and we look forward to continuing this conversation with them. We are also committed to keeping our patients, staff, physicians, partners and communities informed as we move forward and work to ensure the highest standards of care at Mount Hood Medical Center.

It’s not known at this time if the Family Birthing Center will reopen.