Star Tribune
Fosston mayor says city will take back hospital if Essentia halts baby deliveries
City leaders in Fosston, Minn., are prepared to take back control of their hospital if Essentia Health follows through on plans to permanently end scheduled baby deliveries.
Mayor Jim Offerdahl said the loss of baby deliveries would be profound for an isolated community on the northern border of the White Earth Reservation, but he has deeper concerns. The shutdown of labor and delivery units in small hospitals across Minnesota has led to an erosion of other medical services. In Fosston, Essentia recently stopped providing dermatology and started sending blood samples out of town for blood sugar tests, delaying results, Offerdahl said.
“Maybe some of these large health care organizations will pay attention and maybe rethink what they are doing,” he said.
The dispute has been simmering since June 2022, when Duluth-based Essentia announced that it was suspending baby deliveries at the Fosston hospital due to a lack of doctors and nurses with training and experience in obstetrics.
Essentia considered the move temporary at the time. The community of 1,400 people between Crookston and Bemidji responded with “We Are Fosston” T-shirts and events to try and make their community enticing to new doctors and nurses. But the health system eventually decided to make the move permanent, and filed a required notice of the change earlier this year with the state of Minnesota.
Essentia is continuing prenatal care locally but scheduling births at its hospital in Detroit Lakes, 65 miles south of Fosston. The regional hospital is better prepared to respond to unexpected complications during labor and to switch within minutes to an emergency surgical delivery if needed, said Dr. Stefanie Gefroh, an associate chief medical officer for Essentia Health’s western Minnesota market.
Deaths from these complications are twice as likely in hospitals with low birth numbers, Gefroh said Tuesday during a public hearing on the closure. “These complications do happen and must be at the forefront of our planning as we consider acceptable labor and delivery practices.”
The Chartis Center for Rural Health counted 22 hospitals in Minnesota that stopped scheduling baby deliveries from 2011 through 2021. Mayo Clinic’s hospital in New Prague is the latest, announcing that it will stop providing that service on Feb. 9 after aggressive recruitment efforts failed to secure new specialists to the hospital. A hearing on that closure is set for Feb. 6.
“We are delivering fewer than 100 babies per year at the New Prague hospital, and our teams need to have frequent opportunities to deliver babies to maintain their skills. In addition, we have reached a critical physician staffing shortage. Our New Prague site has only one obstetrician remaining,” said Dr. James Hebl, a regional vice president for the Mayo Clinic Health System.
Fosston has unique leverage in its dispute, though, because a local nonprofit retained ownership of the hospital in 2009 when it hired Essentia to run it. Offerdahl said the city plans to return operation of the hospital to that nonprofit, First Care Medical Services, if it can’t reach an agreement through arbitration by which Essentia restores labor and delivery services on its own.
“Every day that goes by … more mothers are put at risk, having to travel well over an hour to deliver their babies,” he said.
Declining birth numbers can be a problem for small hospitals, leaving doctors and nurses with too little experience to keep their obstetric skills sharp. Insurance costs also go up for low-volume hospitals, preventing investments in other areas of health care. However, research by the University of Minnesota’s Katy Kozhimannil, who studies public health issues, has found negative consequences when rural hospitals shut down their labor and delivery units. Emergency deliveries increase in these hospitals when mothers go into labor and are too far from birth centers, she said. Preterm births also increase, because prenatal care options also decline in communities where hospitals stop scheduling deliveries, she said.
Most rural Minnesota hospitals have aligned over the past two decades with health systems such as Essentia and Mayo, which can provide access to medical specialists and lower-cost medical supplies and electronic recordkeeping. Only 38 of 128 Minnesota hospitals were independent in 2019, and nearly half of them were designated by the state as financially distressed.
None has switched back and taken independent control of their hospitals, but Fosston leaders are confident they can do it. Evan Fonder, owner of Nord’s Pharmacy in Fosston, conducted research for the city by talking with leaders of successful independent hospitals across the state.
“They were very candid that, ‘Hey, it’s harder today than it was. But if you’re well run, it’s still very doable,'” said Fonder, who is chairman of a charitable foundation that supports the local hospital.
The Fosston hospital has a history of financial strength, posting revenue gains every year since 2018, and could affiliate with other health care systems in the region besides Essentia. The hospital reported 70 to 90 births per year prior to the COVID-19 pandemic, and Fonder said he believes those totals are high enough to support an obstetrics program and provide enough experience to its doctors and nurses.
Surrendering the obstetrics program could have downstream impacts, he added, because new mothers often choose the hospitals and health systems where they give birth for other family health care needs.
“That slowly … signs a death warrant for your hospital” as it loses patients in other areas of care, he said. “So, we’re taking a risk by going independent again, but it’s probably no worse than the alternative.”
Star Tribune
Long Prairie, MN school board dismisses its superintendent, the latest controversy in this small town
LONG PRAIRIE, MINN. — The school district superintendent dressed up as the school mascot, Thor, on football nights. He read the graduation address in both English and Spanish. He even set up office hours in the cafeteria, granting easier approachability to students.
But now, two months into the school year, Daniel Ludvigson is gone. Or, rather, “on special assignment,” according to the terminology of the Long Prairie-Grey Eagle School Board, which voted 4-3 earlier this month to remove him as superintendent. The move came weeks after voting to not renew his contract, which expires at the end of the school year in June.
Four board members — two of whom voted to oust Ludvigson, including Board Chair Kelly Lemke — are up for re-election next week.
The dismissal is the latest blow in this central Minnesota community on the edge of the prairie. Over the last nine months, the town of 3,400 residents and seat of Todd County has lost its mayor, a city manager, two school board members, and now its superintendent.
Students walked out earlier this month in support of Ludvigson. Signs in support of Ludvigson can be seen across town on the lawns of apparent Democrats and Republicans alike. And last week, hundreds packed the American Legion off Hwy. 71 to eat beef sandwiches and sign support letters for Ludvigson, who only swung by to pick up his child for hockey practice.
In a time of great divide in America, this fight has nothing to do with politics.
“You’ve got Harris buttons and Trump hats side-by-side, arm-in-arm,” said Amanda Hinson, a former local newspaper reporter who is concerned the board is not being upfront about why they placed Ludvigson on special assignment. “We want transparency in our government.”
Lawn signs around Long Prairie, Minn., now include people weighing in on the dismissal of Superintendent Daniel Ludvigson by the school board. (Christopher Vondracek)
School board members say Ludvigson has repeatedly shown he is not ready for the prime time of a school district bigger than the one in central North Dakota he arrived from two years ago. They have twice disciplined Ludvigson, but did not state the reason for placing him on “special assignment,” beyond insinuating that staff are fearful to raise official complaints.
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.
