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Attorney General Labrador Announces Consent Decree with Hospitals in Northern Idaho

Release from the Office of Attorney General Raúl R. Labrador
May 19, 2024

BOISE – Attorney General Raúl Labrador announced a Consent Decree to conclude his investigation of potential violations of Idaho’s antitrust law (the Idaho Competition Act) by Kootenai Health in Coeur d’Alene and Syringa Hospital and Clinics in Grangeville.  The Attorney General’s office opened the investigation in 2023, in cooperation with the Federal Trade Commission.


“My office is concerned about the trend of consolidation within healthcare markets in Idaho,” said Attorney General Labrador.  “We are committed to enforcing the laws that protect and promote fair competition in Idaho and we are pleased that we reached a resolution addressing our current concerns.”

In 2017, Kootenai Health and Syringa entered into a management agreement by which Kootenai Health hired and paid for Syringa’s CEO, making the Syringa CEO an employee of Kootenai Health. As a result of this agreement, Kootenai Health had access to Syringa’s significant competitively sensitive non-public information.

Then in 2020, Kootenai Health acquired St. Mary’s Health (in Cottonwood) and Clearwater Valley Hospital (in Orofino) from their out-of-state owner.  St. Mary’s Hospital, approximately 15 miles away, is Syringa’s nearest hospital competitor. After this acquisition, Kootenai Health owned or had a substantial relationship with the only two hospitals in Idaho County.

The investigation found that as a result of this relationship between St. Mary’s and Syringa, the hospitals may have engaged in conduct that violates the Idaho Competition Act. During the investigation, Kootenai Health and Syringa agreed to terminate the management agreement and at the direction of the Attorney General, sign a Consent Decree to provide further protections against potential future violations of the Idaho Competition Act.

The Consent Decree requires, among other things, that Kootenai Health terminate its employment of Syringa’s CEO; the hospitals terminate all existing agreements, contracts, arrangements, collaborations, or affiliations between them, except where the Attorney General does not object; and, in the future, provide notice to the Attorney General of any proposed agreements, contracts, arrangements, collaborations, or affiliations between them.

The Consent Decree also prohibits any agreements between the limiting competition for labor and the exchange of non-public labor information, such as compensation and terms of employment.

The Consent Decree has been approved by the Court.


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