By Lori Ehde
Depending on action by the Adrian City Council, Arnold Memorial Hospital could close as soon as this spring.
A combination of declining patient admissions and reduced Medicare reimbursement have put the hospital nearly $300,000 in the red.
As a result, Sioux Valley Hospitals and Health System, which leases the facility, met with Adrian Hospital Board members Monday and proposed the hospital be closed.
The hospital board, which met prior to the Adrian City Council meeting, accepted Sioux Valley's proposal and recommended hospital closure to the city at the following council meeting.
The city won't act on the recommendation until Hospital Board minutes from Monday's meeting are formally approved - possibly a month from now.
'Writing's been on the wall'
Adrian City Councilman Steve Lynn is a former Hospital Board member and currently serves as a liaison between the city and hospital. He wasnÕt surprised by the Hospital Board's action.
"If it's approved, I'll be as sad as anyone to see it go," Lynn said. "But the writings been on the wall a long time."
He remembers a declining bottom line when he first got involved with the Hospital Board in the 1980s.
"Since then we've closed the emergency room, stopped offering OB services, stopped doing surgeries," Lynn said. "It's been kind of an ongoing decline, so I do understand Sioux Valley's position. They have sustained some losses."
The city of Adrian owns the hospital building but signed a 20-year hospital lease agreement with Sioux Valley for hospital operations.
Lynn said closing a hospital is an emotional issue for any community, but he describes himself as a realist.
"I put out the question at Monday's meeting, 'If the city still operated the hospital, would we expect our taxpayers to subsidize it at these losses?' Nobody said anything," Lynn said.
"To me, the people have spoken to a certain degree. They chose to have their health care done somewhere else."
Practically speaking, he said the Sioux Valley plan makes sense.
"You can't expect a town of 1,200 people to support a hospital that provides an emergency room, does surgeries and delivers babies," Lynn said. "In 2001 that's not realistic."
Strains on the budget
Since the federal Balanced Budget Act of 1997 Medicare reimbursements to Arnold Memorial Hospital decreased by $560,000, according to Stan Knobloch, Rock Rapids.
Knobloch serves as Sioux Valley's chief financial officer for Adrian and Rock Rapids hospitals.
He projects expenses will outpace revenues by nearly $300,000 by April 30, the end of Sioux Valley's fiscal year.
Since Sioux Valley signed the lease, hospital inpatient days have dropped from 4,000 to less than 1,000 per year. Of those, acute care hospital admissions have dropped to an average of one-half patient per day.
By comparison, Luverne Community Hospital currently operates with more than 3,000 patient days per year.
Staff reduction
Regardless of Adrian City Council's action on Sioux Valley's proposal, staff cuts are imminent. A hiring freeze has already been implemented, and staff cuts are planned.
Arnold Memorial Hospital currently employs 55 full-time equivalents, many of which have overlapping jobs with Arnold Memorial Nursing Home or the clinic.
Sioux Valley plans to reduce that number to 49.
"We are going to look at productivity standards...what the industry requires to provide certain services," Knobloch said.
"It's really an emotional issue, but we have only one patient every other day. Staff needs to take care of that patient, but how many do you need?"
Employees affected by the staff reduction and possible hospital closure have been given the opportunity to apply for other positions within the Sioux Valley system without losing accrued benefits.
'Community Health Care Center'
Along with cutting acute care hospital services in Adrian, Sioux Valley also proposes discontinuing detoxification services Adrian currently provides for area sheriff's departments and quitting Evergreen chemical dependency program.
At the same time, Sioux Valley has plans to develop the vacated hospital space between the clinic and nursing home into a "Community Health Care Center."
Gerald Carl, chief executive officer of both Luverne and Adrian hospitals, said much of the hospital space could be utilized by the community health care center services.
These may include wellness services such as weight loss, aerobics and health screenings. Acute care hospital services will cease, but the center would continue offering therapy, lab work and mobile services such as mammograms and radiology.
"The idea of the community health care center could include all these things," Carl said.
Public meetings
Until Adrian City Council acts on the Sioux Valley proposal, public meetings have been scheduled to explain the proposal.
They are tentatively set for 7 p.m. Wednesday, March 13, and 7 p.m. Thursday, March 14, both in the Adrian elementary school commons area.