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Rural health care systems like Kittitas Valley Healthcare provide crucial services for patients who may otherwise have to travel long distances to receive the care they need. When another hospital in the region closes, the impact is most certainly felt in surrounding communities, and Kittitas County is no exception.

Astria Health announced in January 2019 that it would close the 214-bed Yakima Regional Medical and Cardiac Center after filing for Chapter 11 bankruptcy protection the previous May. Although the provider’s hospitals in Sunnyside and Toppenish remain open, the closure of the Yakima location has placed pressure on other regional hospitals including KVH to provide necessary services for patients.

“I think one of the first things a closure like that really does is bring home for every rural hospital just how vulnerable the system is,” KVH CEO Julie Peterson said about the bankruptcy.


Peterson said rural hospitals like KVH maintain strong relationships with referral centers like Virginia Mason Memorial Hospital in Yakima and Astria before it closed and that the two health care markets are accustomed to sharing services. With the closure of Astria, Peterson said those referral channels have been strained.

“Their community medical staff, cardiology, cardiothoracic services, orthopedic services worked between both of those hospitals,” she said. “As we saw Astria’s capacity getting tighter and tighter as money got tight there, it really does influence our ability to access those services from our emergency department and the referrals from our primary care system. It has had a significant impact on us.”

Another impact of the Astria fallout on KVH is the impact on turnaround time for patients who need to be transferred from KVH by ambulance to another hospital for service. Peterson said the turnaround time to return an ambulance back to service in Kittitas County is approximately two hours after making a transfer to VM Memorial in Yakima. Having to take a patient to the West Side or north to Wenatchee effectively doubles the turnaround time.

“Our initial concern is about how we get people to a higher level of care,” she said. “Immediately our chief medical officer and our director of emergency medicine and hospital medicine, they always talk to their counterparts at VM Memorial. As strong as those relationships are and as supportive as VM Memorial is, they still are at capacity. There are times where we’re calling and calling to other hospitals trying to find places for our patients to go, especially for specialty services. I think that’s the first place where that resonated for us.”


The bankruptcy also had the effect of creating a market of skilled health care workers who suddenly found themselves out of jobs. Peterson said KVH had a strong presence at a job fair in Yakima that attracted many of those workers. With the additional volume placed on VM Memorial due to the fallout, Peterson said she expects a large number of those employees to migrate to that hospital due to their close proximity to Astria.

“We did pick up some highly-skilled employees on the clinical side,” she said. “We had nurses who have worked here previously who came back to work for us. We were able to pick up some people to increase the bench strength of some of our ancillary services. You don’t like to feel predatory in a situation like that, but KVH is a great alternative for people who like a smaller environment and people who are looking for a place to land.”

Two of the areas that are in high demand for positions at KVH were the ear, nose and throat and urology specialists. Peterson said positions have been filled in the ENT sector, and she is confident that they will be able to fill the need for urology.

“We hope to work with VM Memorial on infusion services,” she said. “We have a lot of cancer patients and patients who get regular infusion services, and that’s a place where it’s absolutely in the patient’s best interest to receive that care in their community so they’re not having to drive. Right out of the gate, these are specialties where we were already recruiting and already had on the radar, but this certainly created an opportunity for us to start searching around in that market for people who might be able to fill those spots.”


Peterson explained that Astria was much more than one hospital, having operated a network of primary and urgent care clinics, as well as home health and specialty clinics throughout the Yakima Valley. As KVH has worked on building out their primary care network in Kittitas County, Peterson said they have seen a number of patients primarily from the West Valley and Selah area utilizing KVH primary care services such as pediatrics, family medicine and women’s health.

“We have seen folks move this direction for primary care, because we some availability,” she said. “People get appointments fairly quickly and all of our practices are open to new patients.”

Despite KVH’s ability to take in some of the patients from Astria’s failed network, Peterson said the bankruptcy should be a wakeup call for all that hospitals are capable of closing.

“Our health care delivery system is fragile,” she said. “When rural communities and communities like Yakima have the burden of Medicare and Medicaid and the uninsured that we do, our elected (officials) need to listen to us when we talk about the consequences of underfunding healthcare in these communities.”


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