Oregon health officials deny request to close Gresham-based birth center

By Lillian Mongeau Hughes (OPB)
March 30, 2023 12:22 a.m.

Legacy Mount Hood Hospital requested a waiver from the state to close their Gresham-based birth center when they no longer had enough doctors to safely staff the center

The Oregon Health Authority has denied the Legacy hospital system’s request to close its Gresham-based birthing center.

Since March 17, anyone showing up at Legacy Mount Hood Hospital in the throes of labor could not expect to deliver their baby there. Citing a lack of sufficient medical staff to safely deliver babies at the small hospital, Legacy officials had effectively closed the birthing center.

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But technically, the hospital wasn’t allowed to do that, according to a ruling today by the state’s health agency.

Under state regulations, health care facilities are required to meet the terms of their state license, which in Legacy’s case includes the provision of birthing services at its Gresham location. According to a statement issued by the Oregon Health Authority, the state is now investigating Legacy for noncompliance because the system closed its Gresham-based birth center without first getting an approved waiver from the state. If the investigation finds that the hospital acted wrongly, it would have 90 days to return to compliance or risk losing its ability to bill Medicare or Medicaid — the two largest federal health insurance programs.

“We respect the state’s authority in this decision, and we are carefully reviewing the letter provided by the Oregon Health Authority,” reads a statement released Wednesday by leaders at Legacy Health. “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.”

The statement goes on to say that the Mount Hood Family Birth Center will remain on “divert status” — meaning anyone in labor who can safely be sent elsewhere will be — because the center still does not have enough physicians to provide safe care.

The state’s waiver denial and newly launched investigation are the latest moves in what began late last year as an attempt by hospital leadership to change the way the birthing center worked. It had always been staffed around the clock with obstetrics doctors. The new model would have included on-call obstetrics doctors, rather than full 24/7 coverage.

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Many doctors quit over the proposed changes, arguing that the center could not properly care for its vulnerable population without 24/7 staffing.

By late January, Legacy leadership saw no path forward to keep the labor and delivery services operating in any form, according to an online statement released several weeks ago.

In their assessment of the waiver request, state health officials appear to agree broadly with the Legacy doctors who quit over concerns that the new model would not serve their patients.

“Before its closure, Legacy Mount Hood Medical Center served more women seeking urgent obstetrical care than any other hospital in the Legacy system,” reads the Oregon Health Authority statement. “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).”

Because so many of the center’s patients arrive in need of urgent care, health authority officials reasoned, many of them would have to deliver at the hospital’s emergency department, rather than be safely diverted to one of the five nearby Portland hospitals that offer birthing services.

“In those circumstances, emergency physicians may not have adequate training and experience in deliveries and there would not be enough time to transport patients facing complications,” according to the health authority’s statement.

As part of the waiver denial, the state suggests in its statement that the hospital should have placed doctors at the facility who were willing to implement the proposed new care model.

Results of the investigation are expected in the coming weeks.

Editor’s note: This story has been updated to include a statement released by Legacy Health several hours after the initial story published.

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