‘We want to save what we have’

County residents emphasize need to retain basic and emergency care

By Anna Jauhola
A common theme spawned from community meetings regarding healthcare last week throughout Kittson County — we need to maintain what we have.
To begin its strategic planning process, Kittson Healthcare’s board of directors hired Eide Bailly to conduct these meetings. The public resoundingly told Adam Strom the need for primary care, emergency care and ambulance, the nursing home and assisted living, the hospital, diagnostic services, physical and occupational therapies, local practitioners and a pharmacy.
“All ideas are on the table,” said Strom, a senior manager in healthcare strategy for Eide Bailly, to each of six meetings held in Hallock, Kennedy, Karlstad, Humboldt and Lancaster. “I think you have a health system you can be proud of.”
Nearly 150 people attended these meetings where Strom gave an overview of the situation at Kittson Healthcare. The facility currently has a cushion of $3.5 million from COVID funding, but has otherwise lost about $1 million each in 2020 and 2021 – half in depreciation and half in cash. And unaudited numbers show an estimated loss in 2022 of $1.6 million.
While the cushion will keep the facility running for up to four years, it is not a long-term, viable plan. Through initial analysis, Strom explained to the crowds that declining population along with low inpatient numbers in the hospital and less reliance on nursing home services, among other issues, contribute to these losses. Lower nursing home occupancy is a trend across the United States, Strom said, and it’s not because the care is poor or because the facility is bad.
“There is a lower occupancy in the nursing home because more people are staying healthier longer and don’t need care until later in life,” he said. “With lower occupancy, there is lower revenue which leads to less of an ability to maintain the facility, and so on.”
Kittson Healthcare’s medical professional fees constitute 70 percent of the facility’s total expenses. Add onto that the increasing costs of supplies, drugs and contract labor when they can’t fill positions. Traveling CNAs and nurses have been employed in the nursing home and hospital lately due to worker shortages. These people are employed through a third-party company and are paid twice, if not thrice, as much as local employees.
“This is one of the reasons we see such a severe operating loss,” Strom said.
People in every meeting asked why professional fees are so high and whether the administration is top-heavy. Many people asked him to look into the possibility of trimming administration to better support all care providers who bring in revenue. One person flat-out said cutting administrative positions is essential, that the facility used to serve more people and operate on fewer employees — why is it operating so top-heavy now?
“That needs to be a part of the strategy,” Strom answered.
Several people pointed out if the facility paid local employees a little more, they might stay and cut the need for traveling nurses and CNAs. They also commented that morale has been low because of lower fees and a lack of respect or poor treatment of employees. Some said the work environment had reached toxic levels as of late.
“The strategic plan focuses on more than just money,” Strom said.
He noted positive and negative comments equally, assuring the public all comments and concerns are reasonable, as he moved through his presentations. Many asked him to relay the need for better morale and mutual respect within the workplace, between managers and employees.
Community members stressed the importance of the nursing home and assisted living. Being able to keep elderly parents and relatives close when they need that type of care is important. Some asked if it is possible to convert some of the unused nursing home space into more assisted living quarters, considering there is a waiting list for River’s Edge Assisted Living in Hallock.
Everybody agreed the emergency room is important, especially for the farming community and industry sector. Several people mentioned the ER saved their lives, as recently as this month. In line with that, keeping the ambulance services is also at the forefront of people’s minds.
“It would be really scary not to have an ER in a farming community,” said Neil Wiese, a farmer at Humboldt.
Retaining basic, primary care services such as the clinic services in Hallock and Karlstad; diagnostic services like lab, X-ray and CT scans; and a pharmacy are all very important to the community members who spoke up at the meetings. Specifically at the meeting in Karlstad, residents stressed the importance of keeping their local clinic, which is operated by Kittson Healthcare.
“Keeping the clinic open is paramount,” said Brad Thompson, a teacher at Tri-County School in Karlstad. “We want to save what we have.”
When discussing additional services Kittson Healthcare provides, like physical and occupational therapy, a few people said they had no idea those existed. Several people said the facility needs to have better communication with the public across all media.
While nothing has been put in place, nor are they to this point yet, Strom asked if the communities would be willing to financially support Kittson Healthcare. He relayed suggestions of implementing a countywide sales tax or a special hospital taxing district, which adds to property taxes. Some people said they’d be willing to support one or the other, or both. Others said the special taxing district would disproportionately tax farmers. Yet others said a sales tax may not generate enough funding, but would be a fairer tax across the county.
Some suggested the possibility of partnering with a larger facility like Sanford or Altru to operate Kittson Healthcare, as long as it retained local control. Strom reminded them all ideas are currently on the table.
People repeatedly asked Strom to re-evaluate all departments and heavily focus on morale and fairness. If there was one thing everyone agreed on during these meetings, it was the need for primary and emergency care in Kittson County.
Strom also conducted several internal meetings with different groups at Kittson Healthcare such as the board, employees, foundation and hospice.
In the coming weeks, Strom will work on the strategic planning process with the Kittson Healthcare board of directors and leadership team. He said he will present findings to the public when they have a final plan.