State Rep. Cyrus Javadi, R-Tillamook, hopes that the plight of kidney patients in Tillamook after a dialysis center’s closure will help drive reforms to prevent delays when health care facilities change hands.
In February 2024, Texas-based U.S. Renal Care abruptly closed its dialysis clinic at Adventist Health’s hospital in Tillamook. The move left its patients with harrowing choices — and some fearing death — due to a lack of nearby facilities offering the life-saving treatment.
Many patients with renal disease require a grueling schedule of thrice-weekly visits to facilities for treatment, roughly four hours per session, to clean their blood because their kidneys no longer do the job.
That’s why it was such welcome news six months ago when Tillamook Adventist found another company to take over the space — not one with profit-oriented private equity ownership, like the earlier operator, but Tennessee-based Dialysis Clinic, Inc., a nonprofit known as DCI. So excited were hospital officials that they rented the space for $1-a-month to make the numbers work.
“They are a non-profit company, so their business model is better aligned for our community,” Adventist Tillamook President Eric Swanson wrote of DCI in an email in mid-September 2024 announcing the news.
The company planned to open in mid-November. But that’s not how it played out. The Oregon Health Authority still hasn’t approved the facility, as The Oregonian recently reported. The clinic is expected to open the first week of April, Javadi said he's been told.
But he plans to introduce legislation to address what he calls unnecessary delays by the agency. “It’s too costly and too much of a burden on these communities to have to jump through all these hoops to reopen a facility that is essentially the same as when it closed down, maybe with a few more emergency exit signs,” he told The Lund Report.
State health officials, however, defended the delays and said part of the problem has been federal rules.
“We recognize the importance of access to local dialysis services,” an agency spokesperson wrote in an email to The Lund Report, adding that officials “have been prioritizing this project since it was submitted Nov. 27, 2024 – ensuring that all internal reviews are expedited.”
Sharon Shreve has been driving her husband of 50 years, Michael, to Lincoln City for dialysis sessions three times a week. Due to complications from his kidney failure and diabetes, he lost a leg four years ago as well as half of his thumb on his right hand and two and a half fingers on his left hand, so he can’t drive himself. He’s not the only disabled patient who now is making a long and painful trip to places like Forest Grove. Another patient has two broken hips.
“These patients are exhausted, along with their caregivers,” she said. “No matter which direction you go out of Tillamook, you have to go over a large mountain of some sort. We continue our advocacy not just for my husband; it’s for all of the patients, because it breaks my heart to see how hard it is for them.”
Months of pressure
Javadi, a dental surgeon, sits on the House Behavioral Health and Health Care Committee, and has been deeply involved in larger policy debates, helping drive bipartisan efforts to curb corporate influence of medicine. Last year he even spoke at a conference held by Health Care for All Oregon, the single-payer advocacy group.
Regarding the dialysis patients, Javadi has been pressuring the agency for months and met with OHA Director Sejal Hathi on March 3.
“I was pretty direct with her in saying, ‘This is something we have to fix,’ especially when this is a critical care facility remaining shuttered just because of rules and regulations,” Javadi told The Lund Report. “She felt like there were statutory requirements as to why there were so many delays, and they don’t have much wiggle room.”
Among the delays were safety reviews required by the agency. The decision to close the earlier dialysis clinic came after a safety and fire inspection required upgrades, according to records obtained by The Lund Report. Patients speculated that the findings helped drive the closure as the firm didn't want to pay to fix the facility.
In an email to The Lund Report, an agency spokesperson said Oregon has no statutory provision to allow the transfer of a terminated license or to issue a retroactive license. But Javadi points to state rules that allow OHA to grant waivers for facilities that are similar to previously approved ones, and notes the agency has the authority to temporarily suspend rules.
Javadi told The Lund Report has asked the Legislature’s lawyers to draft a bill to ensure the situation does not repeat itself. He hears about clinics closing all too frequently in rural areas and would not want other rural Oregonians to ever suffer the same fate.
“Because this situation could happen again in other rural areas, I am working on a legislative solution that would create an expedited relicensing process for health care facilities that close but remain structurally unchanged, allow interim operating licenses while OHA completes its reviews and require OHA to use its waiver authority in cases where delays could harm rural patients,” he said.
Leaders of nonprofit Dialysis Clinic Inc. say they are optimistic about opening soon.
“We appreciate the Oregon legislators and Tillamook community for advocating for the clinic. We are eager and look forward to caring for the Tillamook-area dialysis patients,” the dialysis clinic’s Senior Operations Manager Sharon Marti wrote in a statement.
She said she had a “productive meeting” with OHA on March 12 and is providing additional information to them in the coming weeks, saying she looks “forward to serving Tillamook area dialysis patients in the near future.”
