Mayo Clinic officials do not plan to immediately appear again before the Freeborn County Board of Commissioners.

In a letter Monday signed by Mayo Clinic President and CEO John Noseworthy, Mayo Clinic Vice President Bobbie Gostout, Mayo Clinic Health System in Albert Lea and Austin CEO Mark Ciota and Annie Sadosty, southeast Minnesota regional vice president for Mayo Clinic Health System, the officials opted to provide written replies to questions commissioners posed in a letter to top hospital officials last month regarding the transition of most inpatient services from Albert Lea to Austin.

Commissioners sent the letter after Mayo Clinic Health System in Albert Lea and Austin Medical Director Sumit Bhagra told commissioners during a Sept. 4 meeting he was not qualified to answer some of the questions they were asking and approximately one week after the county notified the hospital system and the city it would no longer participate in facilitated dialogue sessions to discuss the transition, as commissioners took issue with what they said is lack of communication from Mayo.

In the return letter, Mayo officials invited commissioners to attend an open house for the new inpatient psychiatric services unit in Albert Lea Oct. 25.

According to Mayo Clinic, patients being taken by ambulance from Albert Lea to Austin will not be charged, which is allowed by Medicare because Albert Lea and Austin hospitals are legally considered one entity.

Hospital officials wrote that doctor visits, immunizations, emergency care, same-day surgeries, pharmacy, lab, radiology, dialysis and other services will still be available in Albert Lea.

 

Overnight observation beds

Officials wrote they “are committed to providing observation beds on the Albert Lea campus as part of the Emergency Department.”

“We anticipate having observation beds available prior to the transition of inpatient admissions to Austin,” they said. “We are currently evaluating the Albert Lea campus master facilities plan to identify short- and long-term locations for these beds.”

Mayo officials said they comply with Medicare regulations, and due to the complexity of the program and insurance coverage, “billing questions must be addressed by on a case-by-case basis.”

 

Returning inpatient beds to Albert Lea

Mayo officials again said they have no plans to stop the transition.

“There are no plans to have general medical/surgical inpatient beds on the Albert Lea campus after mid-2019,” they wrote.

The officials wrote that the transition of the inpatient psychiatric unit from Austin to Albert Lea at the end of October will bring “much-needed inpatient psychiatric care and dozens of nursing positions and other staff members as well as a steady stream of patients and their friends and family who visit regularly during extended hospitalizations.”

 

Why was Austin chosen for most of the expansion instead of the more centrally-located Albert Lea hospital?

Officials wrote that locating hospital admissions, intensive care unit, major surgeries requiring hospitalization and child birth centrally “allows us to better use our staff and other resources to provide safe, high-quality care for all patients in the Albert Lea/Austin service area.”

“The Austin campus was selected to house all inpatient services, including labor and delivery, because the facility has a footprint that is more conducive to meeting future space needs for all transitioned services,” they wrote.

 

Facilitated dialogue sessions

“The facilitated dialogues moderated by Judge David Minge over the past year have provided a good forum to discuss concerns and share information; we are disappointed the county has chosen to withdraw from these ongoing discussions,” Mayo officials said in the letter.

According to Mayo Clinic, dialogue has resulted in increased community engagement, “more in-depth collaboration on behavioral health and ongoing efforts to understand transportation challenges in Albert Lea and Austin.”

“We are invested in Albert Lea and are working hard to ensure that we can meet the needs of our patients now and into the future,” officials said. “We know that you share our goal of keeping great care available for area residents, and we appreciate your interest in Mayo Clinic Health System’s work in the area.”

They shared information previously provided on the lack of health care workers they said is putting local patients at risk. Officials said a majority of physicians in their last year of residency have 50 to 100 job offers before they finish training. Since Jan. 1, the hospital has hired 22 new providers in Austin and Albert Lea, including 17 physicians and five nurse practitioners. Six are in practice in Albert Lea, while five are in Austin. Eleven practice in both locations, something officials described as “typical for our practice.”

In Albert Lea and Austin, the hospital system has added three pediatricians to improve access to children and adolescents, as well as hospitalists, emergency physicians and radiologists. Staff for urgent care and express care services has been added.

They also included information on nearly $10 million in investments in the Albert Lea campus.

Mayo Clinic Health System has added staff dedicated to community engagement outreach and programming.

During a commissioner study session Tuesday, county board Chairman Chris Shoff questioned the accuracy of Mayo Clinic’s stated timeline for the transition. District 2 Commissioner Dan Belshan said as a Community Health Board, commissioners can facilitate the entrance of health care entities and discuss the matter with the Legislature.

Belshan spoke of possible steps to help increase the number of physicians locally, including helping them cut down on debt. 

“That can be done with nurses and doctors, I believe,” he said.

Freeborn County Administrator Thomas Jensen said discussions with health care providers have taken place and called bringing in health care providers an “economic development” issue. Taxpayers in Albert Lea have expressed willingness to undergo a tax increase for such development, he said.

“If you want to do it locally, I think it’s something that you should explore,” he said.

Belshan said taxes do not need to be raised for such projects.

Shoff said he did not want to see another community solve a similar issue 10 to 15 years from now and realize it could have been done in Albert Lea.

After the meeting, he said Mayo has not answered questions surrounding patient accounts of being taken to Owatonna, Mankato and Rochester hospitals because of Mayo Clinic Health System in Austin being full and said he did not think the written response from officials was adequate.

“They need to address their recruitment and retention,” he said. “We’ve had a lot of doctors here leave here recently.”

Shoff noted the distance patients will need to travel to Austin from west of Albert Lea.