The COVID-19 pandemic is exacerbating a health crisis that has claimed more than 120 rural hospitals in recent years.

But it is also raising the fortunes of at least one closed Yakima hospital and begs the question: Will more reopen?

As Washington residents adapt to Gov. Jay Inslee’s Stay Home, Stay Healthy order to stay home to slow the spread of coronavirus, the state is racing to add more hospital beds to handle the influx of patients.

The Washington Department of Health announced emergency steps that will add hundreds of beds to the system, including 250 in Yakima, where the bankrupt Astria Regional Medical Center closed in January.

Astria Health has filed notice with bankruptcy court that the state will lease the closed hospital for $1.5 million a month and reopen it as a “surge” facility to handle anticipated patient demand from COVID-19, the disease caused by coronavirus.

The health department expects to receive two 150-bed hospitals and six 40-bed hospitals from the Department of Defense, which likely will be sited in Pierce, Snohomish and King counties.

The state also has bought 1,000 beds that are ready to be positioned within the current system.

The race to boost capacity may be good news for closed hospitals but is likely temporary.

Health officials initially played down the possibility of reopening closed facilities, saying their focus was on bolstering the capacity of current medical facilities.

That said, it didn’t rule out pressing closed hospitals into service.

“We are considering the possibility that we may need to use closed facilities to support our response over time. We don’t have any specific details or plans at this time,” the health department said in response to a question about the status of several closed facilities in Southeastern Washington. That was before the decision was made to reopen Astria.

While rural hospital closures are somewhat concentrated in southern states that rejected the expansion of Medicaid, the Northwest hasn’t been spared.

Only two months ago, Astria Health closed the 214-bed Astria Regional Medical Center in Yakima, a victim of bankruptcy, $40 million in losses and unanswered pleas for support to the state.

Kennewick too has unused beds at the former Kennewick General Hospital, 900 S. Dayton St., now owned by LifePoint Health after a bankruptcy in 2017.

LifePoint is parent to both Trios Southridge Hospital in Kennewick and Lourdes Medical Center in Pasco. It could not  be reached to discuss what, if any, roles the unused beds buildings might play, either as primary care facilities or secondary treatment locations.

But Congress is paying attention.

In March, U.S. Rep. Dan Newhouse, R-Sunnyside, and 27 colleagues called for federal support to bolster rural hospitals during the pandemic.

“At a time when access to care is of paramount importance, rural communities are facing unprecedented rates of hospital closures. Additionally, workforce shortages are significant and further impede access to care for the communities they serve. Health care worker shortages and the physical geographic barriers—such as distance, terrain and seasonal weather—make it especially difficult to access care in normal circumstances, let alone a global pandemic,” their letter stated.

The letter calls on congressional leaders, including House Speaker Nancy Pelosi and Senate Majority Leader Mitch McConnell, to increase reimbursement rates for rural hospitals, to temporarily suspend the “Medicare sequester” to help their financial viability, provide federal support to address staffing shortages, to improve access to COVID-19 testing and increase the flow of medical supplies, including personal protective equipment, to rural communities.

The full text of the letter is posted at bit.ly/COVID-letter.

Gov. Jay Inslee signaled the need to expand hospital capacity when he signed a host of bills designed to combat the spread of coronavirus, including a budget bill.

“The law creates more hospital capacity to counter those projections,” it said.

While the governor’s steps focus on speeding up licensing for health care professionals, it highlights the challenges rural medical systems were already facing when the coronavirus pandemic first surfaced in late 2019.

As of April 11, Washington state reported 10,411 positive tests for COVID-19 and 508 deaths.

The Tri-Cities reported nearly 400 cases and 30 deaths as of April 13.

Chartis Center for Rural Health and IVantage Health, which tracks what it calls the rural hospital “crisis,” reported 120 closures in recent years in a Jan. 1 report.

The study is available at bit.ly/Chartis-report.

Chartis, based in Chicago, notes the coronavirus pandemic should push health care systems to expand virtual care.

“This situation should provide the impetus for all health systems to significantly expand virtual health capabilities so that patients can be monitored and treated at affiliated hospitals, at nursing homes and at home, where possible, to avoid core tertiary hospitals being deluged with these patients,” it said.

The Chartis study highlights the vulnerability of rural hospitals.

One in four—453 critical access and rural and community hospitals—is at risk for closure from shifting cost models, difficulty in recruiting staff to rural areas and a rural population that is older with more complex health needs than its urban counterparts.

In the interim, local hospitals are taking steps to control the spread of the virus within their current facilities. Here are the current rules governing patients and visitors:

• Kadlec Regional Medical Center: Elective inpatient and outpatient surgeries for non-life threatening and non-urgent care was halted as of March 19. Most visitors are prohibited.
• Kadlec ExpressCare Clinics are closed. Providers will care for patients through ExpressCare Virtual, a video chat site. Go to providence.org for information.
• Trios Southridge Hospital in Kennewick banned visitors with limited exceptions for pediatric patients, obstetric patients and end-of-life care. Go to trioshealth.org for updated information.
• Lourdes Medical Center prohibits all visitors with limited exceptions for pediatric patients, obstetric patients and end-of-life care. Go to yourlourdes.com for updated information.