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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.
See what a ‘super’ El Niño could bring
USA TODAY Network reporter Brandi D. Addison breaks down what a strong El Niño could mean for weather patterns across the country.
It may be the middle of July, but the Old Farmer’s Almanac is already looking ahead to the fall with cooler temperatures ahead.
The Almanac, which has been one of the most trusted weather prediction sources for more than two centuries, recently released its fall forecast, showing a wide range of weather throughout the United States.
But what about in the Washington DC region? Here’s what the Almanac says.
What is the fall weather forecast in the Washington DC area?
DC sits along the Almanac’s Atlantic Corridor, and that region should expect a “cool, dry” fall, according to the forecast.
“Expect cooler and wetter conditions than usual this fall,” the Old Farmer’s Almanac says. “Below average temperatures are forecast, along with an uptick in precipitation over traditional averages.”
Last year, DC received 6.53 inches of rain during September, October and November — significantly lower than the city’s 30-year average of 10.50 inches, according to the National Weather Service.
September’s average temperature was 72.2 degrees, with October at 60.3 and November at 49.9 degrees. The season had an average temperature of 60.8 degrees, slightly below the 30-year average of 61.0 degrees.
What does the Farmer’s Almanac say about winter in Washington DC?
In its long-range forecast, the Almanac forecasts above average temperatures this winter in DC with snowfall below normal.
“The coldest periods will occur in mid- to late-December and early and late January,” it says. “The snowiest periods will be in late December, early January, and late February.”
The Old Farmer’s Almanac says it is 80% accurate, but a 2017 University of Illinois study found it to be just 52% accurate.
This story is from an installment of The Oeno Files, our weekly insider newsletter to the world of fine wine. Sign up here.
While Washington State has become well known for its Cabernet Sauvignon and Bordeaux-style blends in recent years, it is also home to many producers making outstanding Syrah. With just a 40-year history of cultivation in the state, Syrah is now the second most-produced red wine there as well as its best-kept secret. First planted in Washington in 1986, some early releases were treated like Cabernet Sauvignon with a lot of new oak and one-size-fits-all production method, but over time a broad spectrum of expressions has arisen among the state’s Syrahs.
Elsewhere in the U.S.A. it might seem like wineries are holding back the most exciting bottles for their neighbors, but Washington Syrah is more widely available than one might think, especially on restaurant tables. Landry’s Inc.—which operates more than 500 restaurants across the country including steakhouses such as Morton’s, Del Frisco’s, and the Palm—serves more than a dozen Washington Syrahs and a wide range of Syrah blends from the state. Scott Tarwater, corporate director of wine and special events, describes Washington Syrah as “a rugged, mountain man, unshaven, but worldly, down to earth, and plain spoken.” While he enjoys it for its savory character, he also likes that it is full of jammy notes such as boysenberry, black raspberry, and pomegranate alongside hints of ripened olives and pipe tobacco.
One of the drivers of quality in the last 20 years is the adoption of Old World techniques like stem inclusion and the use of concrete vessels, large‑format oak casks, and neutral oak barrels to let the fruit do the talking. Improved vineyard techniques have allowed for site expression to become clearer as well, with the Rocks District and Royal Slope showing savory and mineral characteristics, Red Mountain and Horse Heaven Hills bringing out more power and ripeness, and Yakima Valley showcasing a mix of the two styles.
Matt Reynvaan, founder and winemaker of R|A Family Wines, makes his JDA Project Syrah from a vineyard in the Rocks District that is defined by ancient riverbed soils layered with dense cobblestone. “These stones retain and radiate heat, lending intensity, structure, and unmistakable minerality to the fruit,” he explains. Replanted in 2020, the vineyard was designed with clonal diversity and precision farming practices tailored block by block. “Syrah is interplanted with small amounts of Viognier, and each section contributes a unique dimension, from power and structure to elegance and purity, resulting in a wine that is both complex and site driven,” Reynvaan says.
At Two Vintners, winemaker and partner Morgan Lee produces four different Syrahs including a Columbia Valley cuvée, a Rocks District bottling and single-vineyard expressions from Horse Heaven Hills and Yakima Valley, working with 13 distinct vineyards across six AVAs. “Each patch of dirt puts a stamp of individuality on the wine,” he says. “The beauty of Syrah is that it absorbs its surroundings like nothing else. It is a chameleon. It is so exciting to taste these individual parcels side by side and see how thrillingly different they are from one another.” Leaning heavily into a Northern Rhône style in his vineyard sourcing, Lee also employs Rhône techniques like native-yeast fermentation and whole-cluster pressing.
Washington’s first Syrah was planted in the Red Willow Vineyard in the foothills of the Cascades in the far northwest portion of the Yakima Valley by Mike Sauer in 1986, and winemaker Nick Bernstein utilizes fruit from that original block for DeLille Red Willow Syrah. “The Syrah here thrives on steep slopes of poor volcanic soils and creates powerful wine with deep concentration,” Bernstein says. In addition to that and DeLille’s Grand Ciel estate vineyard on Red Mountain, Bernstein also buys fruit from Boushey Vineyard, whose proprietor Dick Boushey has been a prominent grower for 45 years. This cooler site allows for more hang time, flavor development, and acid retention, leading to an earthier Syrah with dark fruit notes.
The wide diversity of Syrah can be seen in Liminal’s two offerings, High Canyon Syrah and Block 16 Syrah, which come from blocks in the WeatherEye Vineyard in the Red Mountain AVA that are about 500 yards apart but differ in aspect, elevation, and clonal selection. Liminal winemaker and partner Chris Peterson says the High Canyon block has elements of black fruits, minerals, and cured olive that remind him of Côte-Rôtie. “This is why we co-ferment with about 4 percent Viognier and choose the specific barrels to age it in and accentuate these aspects,” he explains. Meanwhile, the Block 16 exhibits the “wild herb, cured meats, and firm structure” characteristics that recall Cornas, so he ages it in 500-liter puncheons, with a style of new barrel “that shows off this more feral side.”
One of the newest additions to the Evergreen State scene is Dossier Wine Collective, whose head winemaker Billo Naravane crafts its flagship Syrah with an eye on the Northern Rhône, especially Côte-Rôtie and Cornas. Sourced from three vineyards, it offers the aromatic elegance and finesse of Côte-Rôtie alongside the structure, focus, and depth of Cornas. “Our use of concrete during fermentation is intentional. Concrete preserves purity and freshness while lending the wine a tighter, more focused profile, a hallmark we admire in many traditional Northern Rhône Syrahs,” Naravane says.
On the east coast, diners at JF Restaurant’s eateries can enjoy Syrah from Walla Walla and Columbia Valley. Beverage director and partner Amy Racine tells clients unfamiliar with the style that “Washington Syrah is a crossover between the States and Rhône Valley. It has a savory, peppery backbone similar to the northern Rhône and a ripe and juicy fruit you can find in the States.” Calling it “a category that rewards curiosity,” she tells Robb Report, “Most guests come in with a fixed idea of what Syrah is supposed to taste like, usually a Rhône reference point, and Washington Syrah surprises them by being a little familiar yet entirely its own thing.”
Do you want access to rare and outstanding reds from Napa Valley? Join the Robb Report 672 Wine Club today.
Authors
Mike DeSimone and Jeff Jenssen
Washington
Divorces granted July 2-8 in Washington, Benton counties | Northwest Arkansas Democrat-Gazette
The following divorces granted were recorded July 2-8 in the Benton and Washington county clerks’ offices:
BENTON COUNTY
25-1094. Heather Jones v. Michael Mazzarisi
25-1993. Sarah Waddle v. Brandon Waddle
26-46. Samantha Hines v. Garrett Hines
26-266. Donna Boyd v. Russell Boyd
26-329. Tara Whitwam v. Brett Whitwam
26-354. April Timboe v. Matthew Timboe
26-397. Troy Hull v. Kaley McManamon
26-419. Mark Hagel v. Michelle Hagel
26-437. Deborah Luper v. Donald Luper
26-470. Amanda Russell v. Christopher Russell
26-561. Audrey Mosher v. Dustin Mosher
26-562. Jacob King v. Ashley King
26-649. Chris Edwards v. Sara Edwards
26-664. David Carpenter v. Hannah Holtrey
26-774. Lauren Armfield v. Alexander Armfield
26-775. Sandra Saldana v. Luis Saldana
26-785. Maritza Campos v. Luis De Los Santos
26-798. Darell Shepard v. Rachel Lipscomb
26-802. Jeffery Nicholas v. Tracy Nicholas
26-809. Alicia Moreland v. Travis Moreland
26-814. Mellisa Dugger v. Matthew Crowne
26-817. Sabra Utting v. Derek Utting
26-825. Laura Wortman v. Brian Wortman
26-827. Laura Dean v. Seth Dean
26-845. William Austen v. Krystal Austen
26-846. Janine Robin v. Henry Robin
WASHINGTON COUNTY
24-472. Breayonda Bendickson v. Zackery Thompson
25-1333. Joshua Stephens v. Tiffany Pershall
25-1475. Jacqueline Lybrand v. Zachary Lybrand
25-1720. Jennifer McMahon v. Timothy McMahon
26-10. Janiky Rosario Madera v. Angel Ortiz Fuentes
26-225. Carol Kaufman v. Charles Axtell
26-268. Elizabeth Lasiter v. Prashanth Kumaresan
26-367. Shawn Harp v. Angela Harp
26-414. Patricia Johnson v. Robert Pritchard
26-518. Francisco Ramirez v. Nicole Franz
26-633. Debra Andrews v. Randy Brown
26-695. Jorge Azahares v. Dianelis Rodriguez
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