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.
SEATTLE – As more heavy rainfall is expected in western Washington this week, the region remains under a Flood Watch, with road closures, evacuations, and power outages persisting.
A Flash Flood Warning was activated and later canceled for parts of south King County after a Green River levee failed. The levee has since been repaired, patched by sandbags after nearby businesses were evacuated.
Desimone Levee breech. (Dana Ralph, Kent Mayor)
Keep reading for live weather updates for Tuesday, Dec. 16.
8:05 a.m.: Resources available in Pacific, WA
Valley Regional Fire listed several resources on behalf of the city of Pacific:
- Warm location that will be serving coffee and breakfast: Senior Center and the gym at the Pacific Community Center (100 3rd Ave SE)
- Auburn Community and Events Center (910 9th ST SE) is open with Red Cross resources
- The Filipino American Community of Puget Sound in Algona (103 6th Ave N) is also offering a warm location
- Alpac Elementary School (310 Milwaukee Blvd N) parking lot is available in addition to restrooms.
- Sandbags are available at 224 County Line Road
7:42 a.m.: Puget Sound Energy crews make significant progress in restoring power outages in WA
Puget Sound Energy (PSE) crews made great progress overnight after more than 50,000 people in western Washington lost power on Monday. As of 7:42 a.m. on Tuesday, there are only 56 outages impacted 1,343 customers.Snohomish PUD is reporting outages impacting 490 people. Clallam County PUD is reporting 0 outages.
7:40 a.m.: SR 167 remains closed between Kent and Auburn
‘Go Now’ evacuation in Auburn
Flooding from the Green River is forcing Level 3 ‘Go Now’ Evacuation order in the area between South 277th and north of 42nd, and east of SR-167 and west of Green River.
The Washington State Department of Transportation said both directions of State Route 167 remain closed on Tuesday between South 212th Street in Kent and 15th Avenue West in Auburn due to flooding.
Drivers are advised to take alternate routes and expect delays on I-5 and I-405.
WSDOT’s David Rasbach told Good Day Seattle there was still water over the roadway in the area.
State Route 167 remains closed between Kent and Auburn.
7:30 a.m.: Level 3 ‘Go Now’ Evacuation in Auburn, WA
There are still evacuation orders in effect in Auburn, Washington. This flooding from the Green River is forcing Level 3 ‘Go Now’ Evacuation order in the area between South 277th and north of 42nd, and east of SR-167 and west of Green River.
There are also Level 2 ‘Get Set’ Evacuations in several neighborhoods along both sides of the Green River, including areas near 104th Avenue Southeast, Pike Street Northeast and Pike Place Northeast – south of the Auburn Golf Course. Anyone who lives there should be prepared to leave at a moment’s notice if things get worse.
Officials say evacuees seeking shelter can go to the Auburn Community and Event Center and Ray of Hope Shelter in Auburn.
7:24 a.m.: Person dead after driving car onto flooded roadway in Snohomish County
A driver died overnight in Snohomish after reportedly bypassing road closure signs and plunging into a flooded ditch near East Lowell Larimer Road.
7:03 a.m.: Level 3 ‘Go Now’ Evacuation in Concrete, WA; School district closed
There is a Level 3 ‘Go Now’ Evacuation order in place for the Erikson Road neighborhood in Concrete, Washington.
The town says they found a landslide there last week, and with more rain and wind coming, they are asking people to leave the area.There is also an upgraded Level 2 ‘Get Set’ Evacuation near Burpee Hill Road that is impacting 32 homes. This comes after a landslide in the area on Monday.
The Red Cross opened a shelter for people impacted by those evacuations at the Mount Baker Presbyterian Church off Main Street.
County officials say pets can be accommodated.Schools in the Concrete School District are closed Tuesday. The district will continue to monitor conditions to make decisions for later this week.You can find more school closures across western Washington here.
6:20 a.m.: How you can help
GoFundMe has updated their list of verified fundraisers and non-profits providing help to those affected by the flooding.
To donate to Washington and Pacific Northwest flood relief fundraisers, click here.
6:09 a.m.: Flooding impacting local blood supply
The flash flood evacuation from the Green River levee breech is near Bloodworks Northwest’s Renton Lab and Donor Center.
Officials say the stored blood supply remains safe, but the donor center is closed.
Critical blood storage, supplies and vehicles were moved to a different location, and upcoming blood drives may be affected.
Bloodworks Northwest said more than 300 potential donations have been canceled since last week, which created a shortage.
The company is asking donors of all blood types are needed. To donate, click here.
6:04 a.m.: Evacuation efforts in Pacific, WA
Valley Regional Fire Authority crews are working to help residents evacuate in Pacific.
Officials said about 100 residents have been evacuated and no injuries have been reported.
The affected areas primarily are S of 1st, and E of Butte, S of Stewart, and Skinner Road.
5:20 a.m.: Tracking school closures and delays
Several school districts in western Washington announced delays.
Here is the latest list.
5 a.m.: New evacuation orders in Pacific
Early Tuesday morning, police in Pacific announced after 1:30 a.m. there was a Level 3 “Go Now” evacuation order due to a levee break on the White River.
The evacuation order affects the areas east of Butte and South of Third.
National Weather Service Seattle issued a Flash Flood Warning before 1:45 a.m. Tuesday.
Tuesday weather forecast
Heavy rain, gusty winds and mountain snow returns to western Washington by Tuesday evening, with the potential to push river levels even higher and knock out power to thousands due to downed trees.
The Skagit, Snoqualmie, Green, White, Cedar, Cowlitz, Stehekin and Skykomish rivers are back under Flood Warnings.
A Flood Watch remains in effect for parts of Western Washington through Thursday afternoon. (FOX 13 Seattle)
A Winter Storm Warning and Winter Weather Advisory will be in effect Tuesday afternoon through late Wednesday for heavy mountain snow.
Green River levee fails, Flash Flood Warning
A Flash Flood Warning was activated on Monday after a Green River levee failed in Tukwila, prompting evacuations in areas downstream from the levee break.
While the warning was canceled just before Monday evening, the Desimone levee breach was at one point described as “life-threatening” and reportedly threatened nearby structures.
Most of western Washington remains under a Flood Watch through Thursday due to the rainy forecast ahead, along with already high river levels.
Road closures in Western Washington
Several critical roadways across western Washington are closed due to weather effects, including highway washouts that will continue to impact travel.
On Interstate 90, eastbound lanes of the freeway are closed near North Bend due to a landslide. Additionally, though not weather related, all westbound lanes are closed near Cle Elum due to construction of the Bullfrog Road overpass.
U.S. 2 Stevens Pass is closed at Tumwater Canyon after a section of the highway was washed out by flooding last week. It’s blocked between Skykomish and Leavenworth, and there is no estimated time for when the road will reopen. Highway 410 is also closed at Enumclaw due to a washout.
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The Source: Information in this story came from the websites and social media pages of various agencies and emergency management departments across western Washington, and FOX 13 Seattle reporting.
NC State (16-2-4)
NC State secured a 2-1 victory over Saint Louis on Saturday, weathering a late Billiken rally to hold onto the win. After dominating the middle portion of the match, the Wolfpack survived a tense final 10 minutes following a successful Saint Louis penalty conversion.
The Wolfpack offense broke through in the 69th minute when Donavan Phillip scored off a clinical sequence involving Isaac Heffess and Calem Tommy and ending in a perfectly placed header. Taig Healy quickly doubled the advantage at the 72:04 mark, burying another header assisted by Riley Moloney to put NC State up 2-0.
Saint Louis found a lifeline in the 80th minute. Following a foul in the box by NC State’s Justin McLean, Quinten Blair stepped to the spot and converted the penalty kick to cut the deficit to one.
Defensively, both goalkeepers remained busy. NC State’s Logan Erb made two crucial saves, including a stop on Jack DiMaria in the 85th minute to prevent an equalizer. Saint Louis’ Jeremi Abonnel finished with four saves, notably denying Ibrahim Conde and Frankie DeFrancesco in quick succession to keep the Billikens within striking distance early in the second half.
Washington (15-6-2)
Behind a dominant multi-point performance from Charlie Kosakoff, Washington defeated Furman 3-1 in the semis to advance to the national championship. The Huskies controlled the tempo from the opening whistle, outshooting the Paladins and consistently testing the frame.
Washington’s offense ignited late in the first half. Zach Ramsey opened the scoring in the 32nd minute, converting a pass from Alex Hall. Kosakoff, who was a constant threat throughout the match, doubled the lead in the 40th minute with an unassisted strike to give the Huskies a 2-0 cushion at the break.
Despite a more aggressive Furman side in the second half, Washington put the game away in the 86th minute. Asher Hestad, appearing as a late substitute, found the back of the net off a surgical assist from Kosakoff. Furman managed to spoil the shutout just over a minute later when Luke Hutzell scored off a double assist from Braden Dunham and Connor Dunnigan, but the Paladins could not find a path to a comeback.
Furman goalkeeper Ivan Horvat delivered a heroic performance in defeat, recording eight saves to keep the score respectable. His work was highlighted by a string of four saves in the second half against a relentless Washington counter-attack. Washington’s Jadon Bowton earned the win, making one key save on a Wilfer Bustamante attempt late in the first half that could have switched the momentum.
Bolt transitions into role after driving impact as Fractional CMO earlier this season
Washington, D.C. (12/15/2025) – The Washington Spirit today announced the appointment of Kim Bolt as Chief Marketing & Strategy Officer, a newly created executive role that reflects the club’s continued evolution into a high-performance, growth-oriented organization.
Bolt transitions into the role after joining the Spirit earlier this season as Fractional Chief Marketing Officer, where she played a key role in strengthening the club’s marketing strategy, analytics foundation and demand-generation efforts during a pivotal stretch of the year.
In her expanded role, Bolt will oversee Marketing, Communications, Brand, Strategy and Analytics, with a mandate to build a modern, data-driven commercial engine that accelerates fan growth, deepens engagement, elevates the Spirit’s brand and supports the club’s long-term ambitions on and off the pitch.
With more than 20 years of marketing and strategy leadership across technology, fitness and sports, Bolt brings deep experience scaling mission-driven brands. Her career includes senior leadership roles at Google, Lyft, Under Armour and Disney, as well as serving as Chief Marketing Officer of the Washington Nationals. An expert in marketing technology centered around fan data, Bolt has also advised League One Volleyball and served as Fractional CMO for OnDeck Partners, an Avenue Sports Fund portfolio company focused on minor league baseball.
“As we evolve from a team that wins into an organization built for sustained excellence, Kim’s experience and mindset are exactly what we need,” said Kim Stone, CEO of the Washington Spirit. “She understands this market, this moment and the scale of the opportunity in front of us. Her global brand experience, strategic rigor and early impact with our organization strengthen the foundation we’re building and position us for long-term, sustainable growth.”
A former youth soccer player, Bolt was drawn to the sports industry by her belief in its unique ability to create emotional connection and lifelong memories, a passion shaped early by her family’s love of the game. Throughout her career, Bolt has championed a leadership style grounded in empathy, resilience and accountability. She is committed to supporting women in sports and business and believes high performance and personal balance can, and should, coexist.
“The first time my daughters came to a Spirit match, they memorized the roster and their eyes lit up when they saw a player who looked like them,” said Bolt. “That was the moment I knew I wanted to be part of this organization. Having worked closely with the team this season, I’ve seen firsthand the ambition, the talent and the opportunity ahead. I’m honored to step into this role and help build a brand and growth engine that matches the excellence we’re striving for on the field.”
Bolt resides in Silver Spring, Maryland with her husband, three children and two dogs. She holds an MBA from The Wharton School at the University of Pennsylvania as well as a master’s degree in Communications and a bachelor’s degree in Psychology from Cornell University. As the Spirit’s first Chief Marketing & Strategy Officer, Bolt will lead the club through the offseason and into the 2026 season, helping shape the next chapter of the organization’s growth.
About The Washington Spirit
The Washington Spirit is the premier professional women’s soccer team based in Washington, D.C. and plays at Audi Field in Buzzard Point. The Spirit was founded on November 21, 2012, and is an inaugural member of the National Women’s Soccer League (NWSL) the fastest growing sports league in the US. The club is home to some of the best players in the world who have won championships for both club and country. For more information about the Spirit, visit WashingtonSpirit.com and follow the club on Twitter, Instagram and Facebook.
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