[5] In January 2004, Tenet announced that it would not be renewing the leasing arrangement, and the district resumed administration of the hospital on July 31, 2004, until its closure in April 2015.

[1][3][6][7][8] The hospital also struggled to secure funding necessary to retrofit and modernize to meet the state's strict earthquake proofing building standards.

[8][7] In March 2015, the West County Health District Board voted to close the hospital and sell the property.

[2] At the time, it offered the only full service emergency room in west Contra Costa County, receiving 41,000 patients annually,[3] so its financial instability was of significant public interest.

[8][11] The site, when open, was accessible by AC Transit bus lines that connected it with local BART and Amtrak stations.