Providence Hospital in Northeast Washington. (Justin T. Gellerson/For The Washington Post)

A D.C. Superior Court judge Thursday denied the District’s request for a temporary restraining order to stop Providence Hospital from shutting down most of its services.

The city’s oldest continuously operating hospital, owned by Missouri-based Ascension, began reducing operations last week. The medical campus in Northeast Washington, serving some of the city’s neediest residents, ended outpatient services, closed its operating room and drastically scaled back acute and critical care.

The city had claimed that the hospital failed to secure approval from regulators for its closure plans and that its move to shutter most of its operations had violated the terms of its operating license.

The attorney general’s office filed the lawsuit after the closures began, citing recently passed legislation that clarifies the city’s ability to challenge hospital closures.

At a Thursday hearing, Judge Geoffrey M. Alprin questioned why city officials had waited until after the closure began to protest the hospital’s action and denied its request to force the hospital to reverse the service cuts.

“They did not file anything or communicate with either Ascension or Providence that they were going to reject the closure,” Alprin said from the bench. “They knew it was coming, and it came.”

While the judge denied the city’s request for a temporary restraining order, the lawsuit is still pending.

The offices of Mayor Muriel E. Bowser (D) and her health director, LaQuandra Nesbitt, did not immediately respond to requests for comment on the ruling.

The hospital said it needed to close because it had been struggling financially and maintained that Washingtonians had enough options for acute care at other hospitals and facilities. In filings with the city, the hospital said it had lost $145 million over the past decade and cited a competitive market, declining patient volumes and aging facilities as factors.

But under pressure from city officials, Providence agreed to keep its emergency room open through April and maintain 10 out of 283 beds available for patients who need to be admitted. The hospital plans to eventually transform into a “health village” focused on primary and behavioral care.

Before the judge’s ruling, an attorney for the city said the lawsuit was a result of mixed messages from Providence about what services would be offered through April and concerns that the hospital was trying to turn away some patients to limit its emergency caseload to simple cases.

“It is critical that this be a fully functioning ER,” said Gregory Cumming, an assistant attorney general. “It’s been a shifting target over the past two months.”

But an attorney for Providence said that the hospital could not reopen at full capacity again and that meeting the city’s demands would cost at least $25 million.

“You just can’t assume you can reestablish a hospital and do it safely,” said Peg Warner, the hospital’s lawyer. “It is impossible to do this in this manner — this vague manner — that has been sought.”

Ascension praised the judge’s ruling on Thursday.

“We remain committed to reimagining health care at Providence that genuinely meets the needs of the community, as we have said many times,” said Ascension spokesman Nick Ragone.

Stephen Frum of National Nurses United represents nurses who are losing their jobs in the Providence closure. He said 103 of 248 nurses represented by his union were able to keep working at Providence, but about a third will be on-call and won’t have regular hours.

The community needs a fully functioning hospital, he said.

“A 10-bed unit is not much of a hospital,” Frum said. “The harm done to the public is not yet known.”

As Providence scales back, plans to open a new hospital in Southeast Washington to replace troubled public hospital United Medical Center are still up in the air, further aggravating concerns about access to health care on the east side of the city.