Star Tribune
65,000 days of care avoidable if patients had somewhere to go
One in six days of inpatient care is unnecessary right now in Minnesota hospitals — a level of inefficiency that is causing backlogs in emergency departments and leaving patients waiting for hours to receive treatment.
The Minnesota Hospital Association issued that finding Wednesday after surveying 101 hospitals across the state and discovering that a backlog, which emerged during the COVID-19 pandemic, is becoming a permanent problem. Patients spent 65,000 more days in inpatient hospital beds than needed in the five-month period ending last October — after the COVID public health emergency had ended.
“We cannot have this become the new normal for our patients across the state and in all of our communities,” said Dr. Rahul Koranne, president and chief executive of the trade group for the state’s hospitals. “The sheer magnitude of the number of patients stuck up in the (hospital) units is immense and it is backing up the entire system.”
A loss of 3,000 nursing home beds in Minnesota since 2020 has left hospitals with nowhere to send patients who are ready to leave but still need rehabilitation services before they can go home. The backlog is costly for hospitals, which don’t get paid by insurers for unnecessary inpatient care, and frustrating for patients who suffer delayed treatment.
Melanie Wickersheim, a heart and kidney transplant recipient, said she endured delays getting into the emergency room at M Health Fairview’s University of Minnesota Medical Center last week, despite severe vomiting and diarrhea.
The medics that brought her by ambulance were surprised as well, she recalled. “They were looking at the clerks like, ‘Aren’t we going straight back?'”
Wickersheim said her health stabilized once she got beyond the ER waiting room and she received medications and fluids, but that the delay prolonged her discomfort. The 39-year-old Minneapolis woman then remained in the ER for three days, because no inpatient beds were available, which in turn left other patients sitting in the waiting room or receiving emergency treatment in the hallways.
“It feels like a crisis,” she said. “I’ve been a patient for a long time, going in and out of emergency departments … and I’ve never experienced this before.”
Lawmakers offered solutions last year, including $300 million to keep nursing homes open and $18 million in one-time funding to compensate hospitals for their boarding of patients who got stuck in inpatient beds in the first half of 2023.
Koranne said the nursing home funding should help by allowing facilities to hire more staff and take more patients from hospitals. However, he said, hospitals need longer-term financial relief as well, including an increase in payment rates from the state’s Medical Assistance program, to overcome the financial losses of boarding patients who are ready to be discharged.
“The hospitals are getting forced into a corner and have to make some very tough decisions about how to keep themselves open,” he said.
Newly released financial data for Minnesota’s hospitals showed that 43 of 118 had negative operating margins in 2022.
Other solutions include the expansion of inpatient rehabilitation facilities that could take more patients from hospitals in Minnesota. A Texas for-profit company wants to build a 60-bed facility in Roseville, but first needs lawmakers to grant it an exception to the state’s hospital construction moratorium.
M Health Fairview responded to overcrowding at St. John’s Hospital in Maplewood by opening a new 16-bed short-stay unit that can free up ER space by taking patients who don’t need prolonged hospital stays.
Fairview in a written statement did not address Wickersheim’s experience but said overcrowding and ER backlogs have caused “staggering financial losses” and disrupted patient care. Solutions are needed outside of hospitals that prevent medical emergencies and reduce patient demand, the statement said. “This is not something we can do alone.”
The overcrowding is most severe in the Twin Cities, where weekly hospital reports show that 99% of inpatient medical and surgical beds are occupied on most days.
Allina Health responded in 2022 by unifying United Hospital in St. Paul and Regina Hospital in Hastings under one license, making it easier to transfer patients between them to free up space. Overcrowding has remained a problem at the St. Paul ER, though, which set a record in December when it treated 5,500 patients.
“The patient in the emergency department, who needs to get up in the unit, can’t,” Koranne said. “The patient in the ambulance, who needs to get into the emergency department, can’t. It’s backing up the entire system.”
Rain and potentially heavy snow are on tap Thursday around the Twin Cities, just before families set out for Halloween trick-or-treating.
Temperatures were expected to drop throughout the day, creating conditions for flurries. A winter weather advisory is in effect from 10 a.m. to 4 p.m. covering the Twin Cities metro area and parts of south-central Minnesota. Steady rain drenched the Twin Cities on Thursday, making for a soggy morning commute.
“As colder air begins to move in this morning, the rain will transition to heavy snow from west to east with snowfall rates of an inch per hour at times into early afternoon,” the National Weather Service in Chanhassen said in a weather advisory.
The Twin Cities and surrounding areas could get between 2 and 4 inches of snow, according to the weather service. The winter weather advisory is expected to affect Anoka, Chisago, Hennepin, Ramsey, Scott, Washington and Le Sueur counties.
It’s unclear how much of the snow will actually stick, with warm surface temperatures likely leading to melting on contact in many areas.
“Exact totals will depend on snowfall rate, surface temperatures, and melting — which increases uncertainty with the snow forecast,” the weather service said in an early Thursday briefing.
“Thundersnow possible!” the weather service emphasized.
The good news for Halloween revelers is that the snow and rain are expected to wrap up in time for trick-or-treating, though temperatures will remain in the 30s with a sharp windchill.
An off-duty Washington County sheriff’s deputy caused a head-on crash while under the influence of alcohol and injured a couple in the other vehicle, officials said.
The crash occurred about 10:40 a.m. Sunday in Afton on Hwy. 95 at Scenic Lane, the Minnesota State Patrol said.
Campbell Johnston Blair, 58, of Hastings, was heading north in his Subaru Crosstrek, crossed into the opposite lane and collided with a southbound Ford Expedition, the patrol said.
Blair and the other vehicle’s occupants, 38-year-old Erik Robert Sward and 36-year-old Heather Lynn Sward, both of Lake Elmo, were taken to Regions Hospital with non-critical injuries, according to the patrol.
The patrol noted the alcohol use by Blair was involved in the crash.
Blair, who was driving a private vehicle at the time of the crash while off-duty, has been a deputy with the Sheriff’s Office since 2020 and is currently assigned to our Court Security Unit.
The Sheriff’s Office has been asked for reaction to the crash involving one of its deputies.
ST. CLOUD – On Tuesday, St. Cloud voters will be asked to make decisions on a new fire station and moving city elections to odd years, and — for those who live in Stearns County — how to fund a new county jail.
Here’s a look at the three referendum questions that are on St. Cloud-area ballots this year.
Ballot question: “Shall Stearns County be authorized to impose a sales tax & use tax of three-eighths of one percent to finance up to $325 million, plus associated bonding costs, for the construction of a justice center facility, consisting of law enforcement, judicial center and jail? The sales tax would be used solely to finance construction, upgrades and financing costs for the justice center and remain in effect for 30 years or until the project is paid for, whichever comes first. These services and facilities are mandated by the state of Minnesota to be provided by counties.”
Stearns County officials are planning to build a new $325 million justice center complex that includes a 270-bed jail, a judicial center with courtrooms, and a law enforcement center that houses the Sheriff’s Office. In the summer, Stearns County board members voted to move those facilities out of downtown and to a new location with more space. That site has yet to be determined.
The question before voters is how to fund that center.
County Administrator Mike Williams said a common misconception he’s heard at recent town halls is residents think voting “yes” gives permission to the county to build the facility, and if they vote “no,” the county won’t spend the money to build it.
“People [think they] are voting on the project — and they’re not. They’re voting on how we are going to fund it,” Williams said.
If voters approve the ballot question, the county will impose a sales tax to fund the project. If they vote it down, the county can instead pay for the project with property taxes.