Mayo explains decision rationale; Drop in inpatient needs a key issue
Published 7:50 am Friday, September 1, 2017
Albert Lea Tribune
In a letter to the Attorney General’s office, Mayo Clinic officials said patients requiring inpatient services — including the medical/surgical, labor and delivery, and intensive care units — have decreased at both Austin and Albert Lea campuses, with the two campuses utilizing just over one-third of available inpatient beds and less than 25 percent of the total licensed beds.
In the letter, Mayo expanded on its review
and rationale for its decision to consolidate most inpatient services to Austin, citing a provider shortage, a “sharp decrease” in the demand for inpatient services and a reduction in reimbursement levels.
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In 2013, there were an average of 18 patients daily in Albert Lea, while that number decreased to fewer than 16 patients daily in 2016.
In Austin, that number has decreased from about 33 patients daily in 2013 to about 19 daily in 2016.
Currently an average of one to two surgeries is done each day at each campus. Each campus also averages one birth a day.
“To address these challenges and ensure MCHSAA remains strong and able to continue to provide high-quality care to patients, now and in the future, the decision was made to consolidate certain services across the two campuses of the hospital,” it said.
Mayo officials in the letter were responding to a series of questions posed in mid-August regarding the June announcement about the consolidation. The intensive care unit will be transferred to the Austin campus in October. In early 2018, major surgeries requiring hospitalization are slated to move to Austin, and in mid-2018, the behavioral health inpatient unit is slated to transfer to Albert Lea. The inpatient medical/surgical unit will transition to the Austin campus in early 2019, and childbirth services will transfer to Austin at some point in 2020, following the construction of a new building for those services. Location on the Austin campus has yet to be announced.
The health system also said its review showed the Austin campus provided the most optimal layout for the expansion of hospital inpatient rooms, a larger intensive care unit and room for additional growth to the facility, making it the best location for housing these services.
Mayo, who made the announcement in June, said the inpatient services being consolidated on the Austin campus amount to less than 5 percent of the overall care provided by Mayo Clinic Health System in Albert Lea and Austin. The remaining 95 percent of services will be offered on both campuses, including services such as the emergency room, outpatient surgeries, primary care, specialty care, laboratory services, radiology services and others.
Manpower remains an issue. In the fourth quarter of 2016, Mayo Clinic Health System in Albert Lea and Austin had 102 hospitalist shifts that were unable to be staffed internally at both locations that had to be staffed through locum tenens coverage, or coverage where a provider fills in for another provider on a temporary basis.
Both campuses have reportedly had numerous physician positions across several departments that they have been unable to fill — in some cases for years. Dr. Annie Sadosty, the new regional vice president for Mayo Clinic Health System in Southeast Minnesota, said the Austin campus will be short four physicians at the end of 2017.
These issues, combined with declining reimbursement from all payers led the health system to look at new models of care, it stated.
Mayo Clinic Health System and Mayo Clinic Health System in Albert Lea and Austin assessed over an 18-month period how services are being used by patients, what the current and projected need for services is, along with patient and staff satisfaction data, financial performance and future potential remodeling needs.
The health system weighed patient satisfaction scores, quality and outcomes data, access to appointments and health care consumer data to evaluate how to optimize services between the two campuses and preserve access as close to home as feasible. It said guidelines were put in place so that any recommendations to consolidate would maintain or improve patient outcomes and improve access for primary and specialty care for patients.
It looked at both campuses for size, function, equipment and potential for future growth, according to the letter.
The health system said it did not need the vote of the local Board of Trustees because it was not discontinuing or terminating services across the two campuses, which together are classified as a single corporation. Because it was consolidating services — and the services would be on one of the campuses — the vote was not required or sought. However, Mayo said the board was “fully informed and supportive of the decision to consolidate certain services across the two campuses of the hospital.”
The response came one day before Lt. Gov. Tina Smith was slated to come to Albert Lea to meet with city and county officials and leaders of the Save Our Hospital organization.
Save Our Hospital Co-Chairwoman Mariah Lynne issued the following statement after reviewing the summary released by Mayo.
“It’s evident from our initial review of the summary document that Mayo Clinic feels it can continue to be vague — even with the AG’s office. As we do not have access to attachments and supplements, we can only make assumptions based on the summation. We are confident in Attorney General Swanson and her staff, that they will request any additional information and detail necessary to thoroughly review these points of concern for the safety of rural health patients in our area.”
She said she will continue to rely on elected and appointed officials to hold the health system accountable for its actions.