Washington
Washington state hospital system ‘very fragile’ after two years of losses
Hospitals in Washington state continue to deal with daunting financial difficulties.
While hospitals generally fared a bit better in 2023 than in 2022, most hospitals are continuing to lose money, according to a survey by the Washington State Hospital Association. Some are cutting services and reducing beds.
During a media call Tuesday, Washington hospital leaders say some organizations are on the brink, and some aren’t poised to handle more financial pressures. Cassie Sauer, president and CEO of the Washington State Hospital Association, also pointed to financial difficulties from the Change Healthcare cyberattack, which has affected hospitals and healthcare providers nationwide.
“What we really see is that the state of Washington’s hospital system remains very fragile after experiencing more than two years of significant losses,” Sauer said. “And these losses are now being compounded by delayed payments from insurers and the impact of the cyber attack on Change Healthcare.”
‘Unprecedented, unsustainable’
Cumulatively, the state’s hospitals lost $3.8 billion in 2022 and 2023, said Eric Lewis, chief financial officer of the Washington State Hospital Association.
“These losses are unprecedented, unsustainable, and represent a huge-post COVID financial challenge,” Lewis said.
In 2023, the state’s hospitals had a -5.2% operating margin, which actually represents a bit of improvement from 2022, when the margin was -7%. Lewis said 85% of the state’s hospitals are losing money.
The state’s hospitals ran in the red during the first half of 2023, and the losses mounted as the year progressed. Washington’s hospitals took in more revenue in 2023, but the revenues were outpaced by higher expenses.
The net operating losses for Washington’s hospitals totaled $1.7 billion in 2023, compared to $2.1 billion in 2022.“The losses, though not as massive, continued,” Lewis said. He noted that the state’s hospitals have seen significant losses for eight consecutive quarters.
Adding to the difficulties, more residents in Washington are relying on Medicare and Medicaid, Sauer noted. Fewer people are using commercial insurance, which typically provides better reimbursements to hospitals.
“That piece of the pie that’s commercial has really diminished quite a lot,” she said.
‘A large hole’
Ettore Palazzo is the CEO of EvergreenHealth, a community-owned, two-hospital system based in Kirkland. He said, “These terms, unprecedented and unsustainable, are absolutely true. And there are other adjectives that we’re trying to come up with because it almost doesn’t seem like those words are really appropriate anymore.”
EvergreenHealth has lost $158 million over the past two years, he said.
To cut expenses, EvergreenHealth has had to reduce some positions, including some non-clinical positions and an executive role, Palazzo said. Some services have had to be cut, including a “helpline,” where residents could call nurses with health questions. The helpline had been operated for 30 years.
While EvergreenHealth has made some headway in reducing losses, Palazzo said the system still faces a difficult road.
“We have a large hole to climb out of,” Palazzo said. “And the thought of any other disruption, whether it be self-imposed, or as a result of another pandemic, or anything that changes the current, really delicate balance of how healthcare finances work now, could put all that in jeopardy. And I do worry about how hospitals will be addressing their capital needs as they work towards improvements.”
Closing delivery services
Cathy Bambrick, administrator of Astria Toppenish Hospital, a 63-bed community hospital, outlined some of the sober challenges her organization has faced. The hospital lost nearly $8 million in 2023, after losing $7.3 million in 2022.
The hospital serves one of Washington’s most impoverished and ethnically diverse regions, including a large Native American population. The hospital is the only one in the state located on a reservation.
Lawmakers are working with the hospital to sustain emergency and acute care services, but Bambrick said some services have had to be cut.
In December 2022, the hospital closed its labor and delivery unit, leaving local women with a drive of more than 30 minutes, even in good weather. “And you know, in eastern Washington, we have very difficult driving conditions in the winter,” Bambrick said.
The hospital typically delivered a baby a day, she said.
“We couldn’t have felt worse about closing that delivery unit,” she said.
In 2023, the hospital had to close its MRI service. “We are one of two hospitals in the state that doesn’t offer MRI services to its patients,” she said.
Needing a long-term remedy
Elise Cutter, CEO of Island Health in Anacortes, an independent, public hospital district, including a 43-bed facility, along with primary and specialty care clinics. Island Health is at a -12% margin over the past two years, she said.
“Over the past two years, we’ve seen an unprecedented increase in costs, yet have not seen corresponding increases in the payment for care,” Cutter said.
Even though Island Health operates a small hospital, Cutter noted that it’s “too big” for enhanced funding for rural providers from the federal government.
Despite the financial hurdles, Island Health’s hospital has received a 5-star rating from the Centers for Medicare & Medicaid Services for the past two years, she says.
“We need to find a long-term solution to ensure that independent, rural public hospital districts like Island Health can continue to be the safety net for our community, and provide 5-star care close to home,” Cutter said.
‘Heartbreaking decisions’
In addition to the losses, Sauer pointed to the gut-wrenching decisions some hospitals have had to make to reduce services in order to stay afloat. Even seemingly minor decisions, such as reducing a couple of beds, matters to people who are seeking care, she said.
“Over the course of the last year, we’ve seen hospitals make both what seemed like mundane, but also heartbreaking decisions, about service reductions and closures that are done to preserve access to other hospital services,” Sauer said.
And some of those decisions mean patients are waiting longer for the care they need, whether it’s closing a unit or even a couple of beds, she said.
“If you’re someone who’s looking for care, it can be a really big deal that your hospital now has less capacity,” Sauer said.
Washington
A look at the roots (and routes) of immigration to Washington
The Newsfeed
This week, the team brings you stories about how communities including Filipino immigrants, Sephardic Jews and Somalis arrived in the Pacific Northwest
Each week on The Newsfeed, host Paris Jackson and a team of veteran journalists dive deep into one topic and provide impactful reporting, interviews and community insights from sources you can trust. Each day this week, this post will be updated with a new story from the team.
Group hopes to boost recognition for Seattle’s Filipinotown
By Venice Buhain
The group Filipinotown Seattle hopes to make sure that the legacy of Filipino Americans in Seattle’s Chinatown-International District isn’t forgotten.
One of the group’s current projects is pushing for a Filipinotown placemarking sign in the CID.
“Filipino Americans have had a presence here for over 100 years in Seattle,” said Filipinotown Seattle Executive Director Devin Israel Cabanilla.
He said that the signage is important to remind people that “the International District is not just Chinatown. Japantown. Filipinotown is here as well.”
The group held a poll on what signage might look like and where it might be located. It would be similar to the Chinatown sign on South Jackson Street and Fifth Avenue South, or the Wing Luke Museum
In the early 20th century, the area now known as the CID was a hub full of businesses, entertainment, social groups and housing that served Seattle’s growing immigrant population from Asia and elsewhere. The communities all intermingled throughout the CID.
“This area was a central place for Asian Pacific immigrants simply because of segregation,” Cabanilla said.
Because the Philippines was a U.S. territory from 1898 to 1946, Filipino immigrants were unaffected by laws in the 1920s that restricted immigration from Japan or China. Many Filipinos came to study at the University of Washington or to work in burgeoning industries, like lumber, farming, canneries and factories.
While the physical Filipino presence in terms of buildings and storefronts in the CID dwindled in the later 20th century with redevelopment, Seattle Filipinos and Filipino Americans continued to make impacts locally, regionally and nationally.
“It may not have been in terms of storefronts, but our presence has always existed in terms of politics, culture as well,” Cabanilla said.
The Seattle Department of Transportation said it is aware that the group is working on its signage request, but the Department of Neighborhoods has not yet received a formal request. They are also working to develop a clearer process for this and other similar neighborhood signage proposals.
Filipinotown Seattle said it hopes that the sign helps remind Seattle of the CID’s unique designation as a neighborhood shaped by many immigrants and migrants to Seattle.
“Is it Chinatown? Is it Japantown? Is it Little Saigon? It’s all those things. And I think re cultivating that this is a multicultural district, Filipinotown is helping establish: Yes, it’s more than one thing,” Cabanilla said.

Venice Buhain is a multimedia journalist at Cascade PBS. She previously was the Cascade PBS’s associate news editor and education reporter. Venice has also worked for KING 5, The Seattle Globalist and TVW News.
Venice Buhain is a multimedia journalist at Cascade PBS. She previously was the Cascade PBS’s associate news editor and education reporter. Venice has also worked for KING 5, The Seattle Globalist and TVW News.
Washington
The Church of Jesus Christ has announced its 384th temple
The state of Washington is getting a seventh temple of The Church of Jesus Christ of Latter-day Saints.
The Marysville Washington Temple was announced Sunday night during a devotional in the Marysville Washington Stake by Elder Hugo E. Martinez, a General Authority Seventy in the church’s United States West Area Presidency.
“We are pleased to announce the construction of a temple in Marysville, Washington,” the First Presidency said in a statement. “The specific location and timing of the construction will be announced later. This is a reason for all of us to rejoice and express gratitude for such a significant blessing — one that will allow more frequent access to the ordinances, covenants and power that can only be found in the house of the Lord.”
The other temples in Washington are the Columbia River, Moses Lake, Seattle, Spokane, Tacoma and Vancouver temples.
The church has 214 temples in operation. Plans for another 170 temples have been announced; many of those temples are in various stages of planning and construction.
Sunday’s temple announcement follows the new practice of the church’s First Presidency, which determines where temples will be built — and when and how they will be announced.
The First Presidency directed a General Authority Seventy to announce the first temple in Maine at a fireside there in December.
In January, church President Dallin H. Oaks said the Maine announcement set the pattern for future temple announcements.
“The best place to announce a temple is in that temple district,” he told the Deseret News.
The First Presidency will continue to decide where future temples will be built. It then will “assign someone else to make the announcement in the place where the temple will be built,” he said.
This pattern came to him as a strong impression after he assumed leadership of the church in October, following the death of his friend, President Russell M. Nelson.
This came as a strong impression to him shortly after he assumed the leadership of the church, President Oaks said.
The church remains in the midst of an aggressive temple-building era. President Nelson announced 200 new temples from 2018 to 2025. All but one were announced at general conference.
Five dozen temples are now under construction.
President Oaks now has overseen the announcement of two temples, neither at a general conference.
At the October conference he said that “with the large number of temples now in the very earliest phases of planning and construction, it is appropriate that we slow down the announcement of new temples.”
Ten new temples are scheduled to be dedicated in the next six months.
- May 3: Davao Philippines Temple.
- May 3: Lindon Utah Temple.
- May 31: Bacolod Philippines Temple.
- June 7: Yorba Linda California Temple.
- June 7: Willamette Valley Oregon Temple.
- Aug. 16: Belo Horizonte Brazil Temple.
- Aug. 16: Cleveland Ohio Temple.
- Aug. 30: Phnom Penh Cambodia Temple.
- Oct. 11: Miraflores Guatemala City Guatemala Temple.
- Oct. 18: Managua Nicaragua Temple.
Two-thirds of the 170 temples still to be built are outside the United States.
Temples are distinct from the meetinghouses where Latter-day Saints worship Jesus Christ each Sunday. Temples are closed on Sundays, but they open during the week as sanctuaries where church members go to find peace, make covenants with God and perform proxy ordinances for deceased relatives.
Washington
Washington football displays depth, talent at first spring scrimmage
On a perfect day in Seattle for football, Washington took the field inside Husky Stadium for its first scrimmage of spring practice, and ahead of his third season at the helm, Jedd Fisch seemed pleased with the results.
“Guys played and competed their ass off,” he said after the Huskies ran 120 plays. “That’s the type of day we want to have…We have a lot to work on, but we’re excited that today gave us this opportunity.”
The 120 plays had a little bit of everything, but the biggest thing the Huskies showed during the day was that, despite the inexperience that Fisch’s coaching staff is looking to lean on at several positions, there’s plenty of talent littering the roster. The best example of that is sophomore safety Paul Mencke Jr., who had his best practice in a Husky uniform after Fisch announced on Saturday that senior CJ Christian is out for the year after suffering a torn Achilles tendon during Tuesday’s practice at the Virginia Mason Athletic Center.
“Paul’s done a great job of competing and being physical and playing fast, and you could see over these three years, he’s really grown into understanding now the system, and what’s asked of him as a safety,” Fisch said. “I think there’s a lot of in him that he wants to be like (safeties coach Taylor) Mays. He sees himself as a tall, linear, big hitter. So when you have your coach that is known for that type of play, I think Paul has done a great job.”
Mencke was all over the field. Not only did he lay some big hits, just like his safeties coach did during his time at USC, but the former four-star recruit also tallied a pair of pass breakups, an interception in a 7-on-7 period, and multiple strong tackles to hold ball carriers to limited yards.
While the defense did a good job getting pressure throughout the day and making the quarterbacks hold the ball with different looks on the back end, with safety Alex McLaughlin, linebacker Donovan Robinson, and edge rusher Logan George all among the players credited for a sack, quarterback Demond Williams Jr. got an opportunity to show off how he’s improved ahead of his junior year.
Early on, he showed off his well-known speed and athleticism, making the correct decision on a read option, pulling the ball and scampering for a 25-yard gain before displaying his touch. Throughout the day, his favorite target was junior receiver Rashid Williams, whom he found on several layered throws of 15-plus yards in the various scrimmage periods of practice.
On a day when every able-bodied member of the team was able to get several reps of live action, here are some of the other noteworthy plays from the day.
Spring practice notebook
- Freshman cornerback Jeron Jones was unable to participate in the scrimmage and was spotted working off to the side with the rest of the players rehabbing their injuries.
- The running backs delivered a pair of big blows on the day. First, cornerback Emmanuel Karnley was on the receiving end of a big hit from redshirt freshman Quaid Carr before the former three-star recruit ripped off a 13-yard touchdown run on the next play. Later on, every player on offense had a lot of fun cheering on freshman Ansu Sanoe after he leveled Zaydrius Rainey-Sale, letting the sophomore linebacker hear all about it when the play was whistled dead.
- Sophomore wide receiver Justice Williams put together a strong day with several contested catches, showing off his strong hands and 6-foot-4 frame, including a 25-yard catch and run off a drag route from backup quarterback Elijah Brown.
- Of all the tackles for a loss the Huskies were able to rack up throughout the day, two stood out. First, junior defensive tackle Elinneus Davis burst through the middle of the line to wrap up freshman running back Brian Bonner. Later on, freshman outside linebacker Ramzak Fruean wasn’t even touched as he shot through a gap in the offensive line to track down a play from behind, letting the entire offensive sideline know about the play on his way back to his own bench.
- The Huskies experimented with several defensive line combinations on Saturday, and for the first time this spring, it felt like freshman Derek Colman-Brusa took the majority of his reps alongside someone other than Davis, who he said has taken on an older brother role to help mentor the top-ranked in-state prospect in the 2026 class.
“Elinneus is a phenomenal guy. Great work ethic. He’s kind of taken on that older brother mentor for me. He’s been a great help just to learn plays and learn the scheme. Can’t say enough good things about the guy.”
- Ball State transfer Darin Conley took a handful of reps with the first team, while rotating with Colman-Brusa, who got a lot of work in alongside Sacramento State transfer DeSean Watts.
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