Star Tribune
Doctors, nurses speak out against Allina’s closure of intensive care unit at Unity hospital
Allina Health is in the unusual position of publicly quarreling with doctors and nurses over plans to halt intensive care at the Unity hospital campus in Fridley and whether it will hurt an overburdened ambulance system in the north metro.
Unity’s patients will be transferred nine miles to Allina’s Mercy Hospital in Coon Rapids if they end up needing intensive care, but caregivers said that could prove harmful because ambulances aren’t always available.
“Ambulance transfers between Unity and Mercy take hours, even when the patient status is critical,” said Gail Olson, a nurse at Unity for three decades. “Reducing Unity’s ability to care for critically ill patients will make this worse.”
The grievance spilled out earlier this month when a recently unionized group of Allina doctors joined with nurses and others to protest the health system’s changes to Mercy and Unity, which are licensed as a single hospital with two campuses.
Allina leaders said the changes, including the elimination of inpatient pediatric beds, will replace underutilized services with those that can reduce hospital overcrowding and backlogs in the emergency room. More details are expected at a public hearing Tuesday.
Patients too often are “boarding” in ER bays while waiting for inpatient beds to open up, said Dr. Jay MacGregor, Allina’s vice president of medical affairs for both campuses. “That is something we need to be very proactive about solving.”
How hospital changes affect 911 response is a concern. Response times in the Twin Cities held steady from 2022 to 2023, when ambulances took about 10 minutes to arrive at emergency scenes in Hennepin County and 11 minutes in Anoka County, according to a report from Minnesota’s Emergency Medical Services Regulatory Board. But EMS leaders have raised concerns about the increasing requests to transfer patients when their agencies are running short on drivers and paramedics and need to prioritize emergencies.
MacGregor said the number of ambulance transfers is a problem that has worsened with the overcrowding and boarding in hospitals. More than 3,000 patients are transferred between the Mercy and Unity campuses each year, according to state EMS data. Many involve patients with psychiatric crises who are taken to Unity, which houses all of the inpatient mental health and substance abuse beds on the two-hospital campus.
Transfer times from Unity to Mercy have increased on average from 88 minutes in 2021 to 115 minutes so far this year, state data shows.
MacGregor said he believes that Allina’s changes actually will reduce transfers and delays. Unity since its 2016 merger with Mercy has lost the staffing to provide 24-7 intensive care, so some critically ill patients already have to be moved on weekends or at other times, MacGregor said.
Consolidating ICU care at Mercy will result in more patients with critical care needs going to Coon Rapids first, he said. “We really want our patients to go to one location and stay there.”
Unity will maintain a special care unit that can provide advanced care, but not long-term treatment of the sickest patients, such as those who are dependent on mechanical ventilators.
Hospitals have merged under one license in other areas to conserve funds and eliminate redundant or underused services. Allina also merged Regina Hospital in Hastings with United Hospital in St. Paul, and Mayo combined its southeast Minnesota hospitals in Austin and Albert Lea.
Even so, eliminating intensive care would be an unusual step at a hospital campus the size of Unity. While it is no longer a standalone hospital, Unity operates 150 beds and almost every U.S. hospital that size has intensive care beds, federal data shows.
Any hospital that size is going to have patients who deteriorate and need intensive care urgently, said Dr. Alia Sharif, a hospitalist who treats patients admitted to the Fridley campus. “Unity … needs to have an intensive care unit.”
The public dispute is the first since Mercy’s inpatient doctors voted to unionize and be represented by the New York-based Doctor’s Council. Several physicians said the union movement allows them to be more vocal against changes they think are hurting health care in their hospitals.
Mychel Stowers was released on parole from prison about seven months ago after he pleaded guilty to second-degree intentional murder in 2008 for fatally shooting a man in a drug deal gone wrong. According to charging documents, Stowers was living at a halfway house and granted a pass to visit his ex-wife at her North End apartment on the same day that she was killed.
Mychel Stowers’ description also matched the man witnesses saw fleeing Damara Stowers’ apartment moments after the shooting. One witness said they heard no fights or arguments before four gunshots rang. They heard another gunshot five seconds later, and another witness reported seeing a heavyset man with a white shirt and blue shorts run south afterwards.
The apartment’s owner said they were preparing to evict Damara Stowers, adding that her ex-boyfriend, a stocky man in his 30′s or 40′s, was living with her.
Police heard reports of a carjacking minutes later, finding a man shot in his leg on 99 Acker Street. Surveillance footage reviewed by authorities show someone approach that man and point something at him before a flash appeared. The man fell and the shooter ran away, but returned moments later to take the man’s vehicle and leave. That man was treated at Regions Hospital for a broken femur from a gunshot wound.
Authorities believe the gun used to carjack that man on Acker Street was the same used to kill Damara Stowers in her apartment.
There have been 25 homicides in St. Paul so far this year, according to a Minnesota Star Tribune database. There were 28 by this time last year.
The Minneapolis Police Department is on track to rack up $26 million in overtime this year — about $10 million over budget — as the number of extra hours officers work continues since a flood of officers left the force after George Floyd’s 2020 police killing and unrest that ensued.
Police Chief Brian O’Hara provided the OT figure to City Council members during a budget presentation Thursday in which he added that the department has about 210 vacancies.
“We’re using overtime every day to do the most basic functions of a police department,” he said. “It is critically low staffing right now.”
Last year, MPD paid nearly $23 million in overtime — about half of that “critical staffing overtime,” in which officers are paid double their hourly wage.
Overtime is being driven by a wave of resignations and retirements at the department, which had 578 sworn officers as of Thursday, down from nearly 900 in 2019, a 36% decrease that has left it with one of the nation’s lowest ratios of officers to residents.
MPD was averaging about $7 million in overtime prior to 2020, when it shot up to $11 million and has increased every year since, reaching $23 million last year.
Mayor Jacob Frey has proposed a $230 million budget for MPD next year, a 6% increase from 2024, or $13.7 million. Of that, $13 million is budgeted for “constitutional policing” to comply with a state human rights settlement. State and federal officials are forcing the police department into court-sanctioned monitoring for civil rights violations.
Most of that goes to personnel, which comprises 77% of the budget, according to MPD Finance Director Vicki Troswick. The mayor proposes 966 full-time total MPD employees next year, compared to 935 this year. Of those, 731 sworn officers are budgeted for 2025. The city charter requires the city to employ 1.7 officers per 1,000 residents, or 731 officers, although the city has struggling to reach that number amid a nationwide law enforcement staffing shortage.
Linemen Jason Walker, top, and Jimmy Brown work on a new service line to a garage in Minneapolis on Wednesday. (Richard Tsong-Taatarii)
If the downed cable is a power line, the problem’s not nearly as acute: Power lines like those belonging to Xcel Energy are closely monitored by the company. If one goes down, Xcel often knows about it, but the company still encourages people to call in, said spokesman Kevin Coss.
The company regularly inspects and replaces overhead power lines to make them resilient, but “severe storms and other weather impacts can still sometimes bring down well-maintained power lines, especially when high winds snap nearby trees or tree branches and cause them to fall into the lines,” said Koss. “If homeowners see fallen lines on their property, we urge them to steer clear. Assume all power lines are still energized, even if they have fallen, and keep a safe distance away.”
In Minneapolis, city residents can call 311 to report a downed line, said city spokesman Allen Henry. The message will get forwarded to city staff, likely in the Public Works department, to determine if it’s a power line or not.
Stillwater Public Works Director Shawn Sanders said residents could check their invoices from telecommunications companies they’ve bought service from — think CenturyLink, Comcast or others — for a number to call.
Lake Elmo Public Works Director Marty Powers said power lines are generally at the top of power poles and communications lines lower down, but a homeowner could do a Google search to see which provider is operating in their area or has service at their address. In Lake Elmo, it could be Comcast, Lingo Communications or CenturyLink, but doing a Google search first might show the resident that one or two of the companies doesn’t serve their house and make it easier to know who to contact.
“I have only had two or three inquiries in Lake Elmo over the past five years, but, yes, identifying overhead wires can be challenging,” he said.
