As a Cook County property owner and a current Minnesota hospital chief executive officer I am concerned over the projected financial losses at the Cook County Hospital and Care Center.
My foremost concern is that residents and visitors have access to primary and emergency care. This includes family practice physicians, ambulance and first responders, and a well-staffed and equipped emergency department. The hospital should be well funded to ensure this access.
To support this access, the federal Medicare program has designated Cook County hospital a critical access hospital. This means that the Medicare program reimburses the hospital actual costs for care. No unfunded mandates. In addition, federal stimulus dollars are available to fund conversion to electronic health records. These funds become available in 2011. Most critical access hospitals in Minnesota either make a profit or break even.
My guess is that the losses projected are attributed to the Care Center. With the State of Minnesota facing a $6.2 billion shortfall and having an excess of nursing home beds in the state there is little reason to believe that the State will increase payment to nursing homes in the short or long term.
Most hospitals with attached nursing homes have either added assisted living facilities that meet a community need and added private paying residents without state mandates or have found reputable buyers for the nursing home.
The hospital board should think outside its current paradigm. With federal health reform lurking it should seek alternatives to the county owning and operating a hospital/nursing home.
Duluth has three excellent and reputable healthcare systems that have already assumed ownership of many hospitals/nursing homes throughout Minnesota, Wisconsin and North Dakota. I don’t work for any of these—Essentia (formerly St. Mary’s Duluth Clinic), St. Luke’s Hospital or Benedictine Health System—but I know that these non-profits do not require tax subsidies to operate. They also have the resources and talent to enhance the existing health services in Cook County.
Imagine high quality health services in Cook County without needing taxpayer support/assessments.
I administer a hospital in a town of 10,000 that converted from a city-owned municipal hospital to a private nonprofit community hospital in 2000. Our hospital has grown from 900 employees to over 1600 today; we have not needed tax subsidies, and in fact pay the city to lease the hospital facilities.
Hospitals/nursing homes in at least 16 other Minnesota cities/counties have converted or been acquired by nonprofit health systems in the past decade.
This may or may not be right for Cook County. However, before asking taxpayers to pick up a large portion of the hospital’s budget, you should be open to changing your business model to meet the health care needs of residents and visitors.
Robert Stevens
Hovland/Waconia MN
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