Star Tribune
Bemidji hospital unit closure will further reduce Minnesota’s rehab supply
Sanford Bemidji Medical Center in Bemidji, Minn., is planning to close an acute rehabilitation unit, reducing post-hospital care options that are becoming increasingly scarce in the state.
The hospital intends to send patients elsewhere for rehab but couldn’t justify keeping the unit open when insurance restrictions and other changes left it half-full, said Karla Eischens, chief executive of the regional hospital in northwest Minnesota.
“How we care for patients is more than just one unit or one facility,” she said. “Closing the [acute rehabilitation unit] will allow us to reallocate scarce resources to other high-need areas within our hospital.”
A state public hearing on Wednesday will review Sanford’s plans to close the unit by April and convert it into more inpatient medical and surgical beds.
Inpatient rehab helps patients recover from strokes, traumatic injuries and surgeries when they aren’t ready to go home but are strong enough to participate in three hours of daily therapy. It’s a little-used level of care in Minnesota — only a dozen units statewide — that has been in decline over the past decade because of improved surgical techniques that have allowed more patients to recover at home.
Sanford had already reduced its unit from 14 beds to five, but its closure comes as other providers are trying to expand the level of care in response to emerging pressures on Minnesota’s health care system.
Hospitals in Minnesota often relied on nursing homes to provide rehab treatment, but those facilities have closed 3,000 beds statewide since 2020 because of declining staffing and rising costs.
The loss of access has caused logjams in hospitals, which can’t discharge patients in need of rehab until they find openings for them and can’t free up their own beds for waiting patients. The overcrowding extends into emergency departments, where patients sometimes wait for hours or receive treatment in hallways or waiting rooms.
The pressure is greatest in the Twin Cities, where 99% of inpatient beds are full on any given day, according to state tracking data developed during the COVID-19 pandemic. But even rural hospitals see occupancy rates above 90% during peak times, such as flu season.
A Texas for-profit company has responded by seeking an exemption to Minnesota’s hospital construction moratorium so it can build a 60-bed inpatient rehabilitation hospital in Roseville. Minneapolis-based Allina Health similarly submitted plans to open a rehab facility, but delayed them because the system won’t be ready to seek legislative approval this year.
Eischens said patients qualifying for inpatient rehab after hospital stays in Bemidji will be transferred to Sanford’s unit in Fargo. Sanford also renovated its small, critical access hospital in Bagley, Minn., which has federally designated “swing beds” that can be used either for inpatient care or for post-hospital rehab.
Extended care puzzle for patients
Patients with the greatest needs after surgeries or severe illnesses are placed in long-term acute care hospitals, though those facilities also are in short supply in Minnesota after M Health Fairview reduced the number of beds at Bethesda Hospital in St. Paul and relocated. For-profit Regency Hospital offers this care in Golden Valley and recently sought state permission to move 26 beds to St. Paul to increase access in the East Metro.
The pandemic reduced access to all levels of post-hospital care, including rehab units and nursing homes, said Toby Pearson, executive director of Care Providers of Minnesota, a lobbying group for nursing homes. Many workers burned out and quit, and didn’t return to care facilities when the pandemic receded.
“It was no longer, ‘Are there enough people to be in your beds?'” he said. “It was, ‘Do you have enough staff to operate your beds?’ So you started to see an access issue for folks.”
Wednesday’s hearing on the Sanford closure is the seventh since 2021, when the Legislature required them in order to inform the public about substantial changes within hospitals.
Prior hearings covered Allina’s relocation of an inpatient adolescent mental health unit from St. Paul to Minneapolis, the closure of an addiction unit at New Ulm Medical Center and the relocation of the Astera Health hospital in Wadena, Minn.
The Minnesota Department of Transportation closed part of a state highway Wednesday evening near Austin because of a “major hazardous materials release” in the area.
Hwy. 56 from Hayfield to Waltham, a stretch covering about five miles, was closed in both directions and drivers were directed to follow a detour to Blooming Prairie on U.S. Hwy. 218.
No information on the hazardous materials released was immediately available.
A federal judge dismissed a civil lawsuit against Minnesota state trooper Ryan Londregan in the shooting death of Ricky Cobb II during a 2023 traffic stop.
The decision is the latest development in a case that has drawn heated debate over excessive use of force by law enforcement. Criminal charges against Londregan were dismissed by Hennepin County Attorney Mary Moriarty in June, saying the prosecution didn’t have the evidence to proceed with a case.
On Wednesday, U.S. District Judge Nancy E. Brasel granted Londregan’s motion to dismiss the civil suit, arguing he acted reasonably when he opened fire as Cobb’s vehicle lurched forward with another state trooper partly inside.
Londregan’s attorney Chris Madelsaid Wednesday that it’s been a “long, grueling journey to justice. Ryan Londregan has finally arrived.”
On July 31, 2023, the two troopers pulled over Cobb, 33, on Interstate 94 in north Minneapolis for driving without taillights and later learned he was wanted for violating a felony domestic no-contact order. Cobb refused commands to exit the car.
With Seide partly inside the car while trying to unbuckle Cobb’s seatbelt, the car moved forward. Londregan then opened fire, hitting Cobb twice.
In her decision, Brasel said the troopers were mandated by state law to make an arrest given Cobb’s domestic no-contact order violation. She said it was objectively reasonable for Londregan to believe Seide was in immediate danger as the car moved forward on a busy highway, which would make his use of force reasonable.
GREEN BAY, Wis. — Donald Trump walked down the steps of the Boeing 757 that bears his name, walked across a rain-soaked tarmac and, after twice missing the handle, climbed into the passenger seat of a white garbage truck that also carried his name.
The former president, once a reality TV star known for his showmanship, wanted to draw attention to a remark made a day earlier by his successor, Democratic President Joe Biden, that suggested Trump’s supporters were garbage. Trump has used the remark as a cudgel against his Democratic rival, Vice President Kamala Harris.
”How do you like my garbage truck?” Trump said, wearing an orange and yellow safety vest over his white dress shirt and red tie. ”This is in honor of Kamala and Joe Biden.”
Trump and other Republicans were facing pushback of their own for comments by a comedian at a weekend Trump rally who disparaged Puerto Rico as a ”floating island of garbage.” Trump then seized on a comment Biden made on a late Wednesday call that “The only garbage I see floating out there is his supporters.”
The president tried to clarify the comment afterward, saying he had intended to say Trump’s demonization of Latinos was unconscionable. But it was too late.
On Thursday, after arriving in Green Bay, Wisconsin, for an evening rally, Trump climbed into the garbage truck, carrying on a brief discussion with reporters while looking out the window — similar to what he did earlier this month during a photo opportunity he staged at a Pennsylvania McDonalds.
He again tried to distance himself from comedian Tony Hinchcliffe, whose joke had set off the firestorm, but Trump did not denounce it. He also said he did not need to apologize to Puerto Ricans.
”I don’t know anything about the comedian,” Trump said. ”I don’t know who he is. I’ve never seen him. I heard he made a statement, but it was a statement that he made. He’s a comedian, what can I tell you. I know nothing about him.”
