The U.S. Department of Veterans Affairs has proposed closing its hospitals in West Philadelphia and Coatesville due to population shifts and because more care is being provided outside hospitals.

In its recommendations dated March 14, part of a national review, the agency did not provide a timeline for the closures, and indicated that the West Philadelphia facility could be replaced by a newer hospital.

Overall, the VA plan calls for shutting 35 old or underused centers in 21 states as well as building 14 new hospitals. The plan must still be approved by an independent commission of veterans advocates, which is expected to hold hearings next year, and Congress.

The potential closure of the Coatesville VA medical center represents another health-care blow to a region in Chester County that lost Jennersville Hospital on Dec. 31 and then Brandywine Hospital on Jan. 31.

U.S. Rep. Chrissy Houlahan, a Democrat who represents Chester County, reacted with dismay to the prospect of losing a 302-bed facility that offers in-patient behavioral health and substance-abuse treatment.

“I’m inclined to fight the Biden administration on the proposal,” she said in a statement, but she plans first to talk with “veterans in our community who would be most impacted by this potential move to get their views and concerns.”

The services at the Coatesville facility would be shifted to other VA properties, including new outpatient facilities planned nearby. Residential rehabilitation for substance-use disorders would be moved to proposed new facilities in Camden, King of Prussia, and Wilmington.

Built in 1930 and located on 129 acres, the Coatesville facility would cost $120.8 million to bring up to modern design standards, the VA said.

The hospital operates long-term care, a pharmacy and two community outpatient clinics. It employed 1,212 full-time employees in 2021, including 180 nurses and 35 physicians, according to its web site. Its operating budget was $184.6 million.

The VA also plans to close its medical center, abbreviated as VAMC, in University City, but will replace it if it cannot establish a “strategic collaboration” with the University of Pennsylvania to assume many of the services provided there. Penn already has close ties with the VA medical center next door.

“Establishing a strategic collaboration between the University of Pennsylvania and the Philadelphia VAMC, while maintaining capacity to provide all Philadelphia VAMC’s current services, will strengthen care quality and the academic and research missions,” the report said.

Penn said that its physicians have provided services to military veterans at the facility since 1948.

”We are incredibly proud of this partnership and are reviewing the recommendations in the VA report released this week to determine how we can best support the VA,“ Penn said in a statement.

The VAMC in University City is known for its research and earned a National Research Centers of Excellence designation for work in Parkinson’s disease, mental illness, health equity, substance abuse treatment, and its Regional Sleep Center. It had 2,840 full-time employees in 2020 and an operating budget of $591 million.

The recommendations were the result of a study required by a 2018 law, the VA Mission Act, which also created the Veterans Affairs Asset and Infrastructure Review Commission, which is expected next year to hold hearings on the proposals.