COLUMBUS, Ohio — For the second time in three months, Ohio’s top court has refused to hear an appeal from the last abortion facility in Montgomery County.

On Tuesday, the Ohio Supreme Court declined to hear an appeal from the Women’s Med Center in Kettering, near Dayton. An earlier request to take up the case had been denied in August by the same court and in April by Ohio’s 2nd District Court of Appeals.

The case involves the Ohio Department of Health revoking the business’ operating license in 2016 because it had not obtained the required patient transfer agreement from local hospitals. The facility challenged the decision.

Under a 2013 law, abortion facilities in Ohio are required to have a transfer agreement with nearby hospitals in case of a medical emergency. To be exempt from the requirement, a facility must indicate that it has sufficient backup physicians, and its request must be approved by the state health director.

According to The Columbus Dispatch, the facility has been operating under an exemption waiver that had expired. State Health Director Amy Acton denied the request for a renewed exemption. She said that while Women’s Med Center had four backup physicians, the application “does not sufficiently address how coverage by the backup physicians is to occur and in what order the backup physicians should be contacted.”

Acton wrote a letter to the facility’s attorneys in August, stating that “now that the Ohio Supreme Court has declined jurisdiction in the litigation regarding the 2016 revocation, that revocation is final, and (Women’s Med Center’s) license is revoked,” The Columbus Dispatch reported.

Supporters of the facility argued that the hospital-transfer requirement is unjust. Kellie Copeland, executive director of NARAL Pro-Choice Ohio, called the law an “an undue burden (that) should be ruled unconstitutional.”

“It is shameful that Premier Health has shirked their responsibility to sign the transfer agreement that would allow the community’s only abortion provider to remain open — especially when you consider that the agreement would not require the hospital to do anything that federal law does not already require of the hospital,” she said, according to the Dispatch.

But Bob Wurzelbacher, director of Respect Life Ministries for the Archdiocese of Cincinnati, applauded the court’s decision.

“We are grateful for this decision to close a facility whose operation was not health care but, in reality, a threat to the health of women,” Wurzelbacher told CNA. “We need to continue to be committed to truly helping women in crisis pregnancies, who can be served at several pregnancy-care centers available to all women in the Dayton area.”