Minnesota
A first in Minnesota, Mahnomen hospital shutters inpatient beds to survive
One of Minnesota’s smallest hospitals is eliminating inpatient care and converting to a rural emergency center, a move designed to keep its doors open amid financial struggles.
Mahnomen Health Center’s administrator notified the state earlier this month of plans to close the hospital’s inpatient unit and only operate an emergency room to stabilize and observe patients. State leaders said the northwest Minnesota hospital could be the first of many to be forced by financial shortfalls into this transition, which will be discussed at a state public hearing on April 30 and then take effect the next day.
“The struggles of not-for-profit hospitals in Minnesota are real, they are escalating, and now we are headed toward closures of service lines and closures of things that communities need,” said Dr. Rahul Koranne, chief executive of the Minnesota Hospital Association. The trade group is lobbying Minnesota lawmakers for an increase in hospital payment rates by the state’s Medical Assistance program, which haven’t been adjusted for inflation since 2019.
Minnesota has maintained a broad rural network of inpatient medical care far longer than most states. But about a quarter of its 127 hospitals have been in financial distress and were struggling before the challenges of the COVID-19 pandemic. Mayo Clinic’s hospital in Springfield closed in 2020 while several other rural facilities cut high-cost inpatient services such as baby deliveries.
Mahnomen will be the first in the state to contract into a rural emergency hospital — a federally designated level that was offered as a lifeline for struggling hospitals last year. Such facilities must treat patients within 24 hours on average, but can keep patients for longer periods of observation and care as long as that average is maintained by year’s end, said Mahnomen administrator Dale Kruger.
“At hour 25, (the federal rule) isn’t that you have to push them out onto the street,” he said.
The change nonetheless creates a gap of inpatient care that will extend beyond Mahnomen, a community of 1,200 within the White Earth Reservation. The nearest full-service hospitals are 28 miles away in Ada and Fosston, where the mayor and community leaders have been fighting plans by Essentia Health to stop scheduling baby deliveries. The nearest regional hospital is 36 miles south in Detroit Lakes.
Mahnomen is managed by Sanford Health, but owned by Mahnomen County and the city government. The hospital posted an operating loss of 26% in 2022, when it staffed 10 of 18 licensed inpatient beds, according to the most recent public financial data. It was one of the poorest performing hospitals in Minnesota that year, though another 41 lost money and four in Granite Falls, Onamia, Hallock and Lake City lost more than 15% on hospital operations.
Like most small hospitals, Mahnomen buoyed some losses with operating gains from outpatient clinics and elder-care facilities. Kruger said it faces unique challenges serving Minnesota’s poorest county. More than 5% of its charges to patients were written off as unpaid debts, by far the highest rate in Minnesota.
The new designation should have a $1 million impact and cover the hospital’s shortfalls, Kruger said, while minimally affecting patient care. The hospital in 2022 only admitted 52 patients, who stayed on average for three days.
“It was a way to assure health care into the future for our community,” he said.
Nationally, 23 hospitals have switched to rural emergency hospitals, according to the NC Rural Health Research Project. Only eight had been critical access hospitals, a special designation that qualified the nation’s smallest medical facilities such as Mahnomen for increased federal payments. Koranne said other Minnesota hospitals are weighing the switch.
Critics have called rural emergency hospitals “Band-Aid Stations” because of their limited scopes, but Kruger said that was the same label used in the late 1990s when Mahnomen became the state’s first critical-access hospital. He remained confident that local patients would rely on Mahnomen for outpatient and emergency care. The hospital’s 24-hour ER has five bays, including two trauma bays that rapidly resuscitate and stabilize patients.
The Minnesota Department of Health on Wednesday announced the informational hearing — the eighth since the state started requiring them before substantial changes in hospital operations.
Earlier hearings covered the closures of baby delivery units in Fosston and New Prague, a mental health unit in Fergus Falls and an addiction unit in New Ulm. Doctors and nurses spoke in opposition at a hearing last month to Allina Health’s plan to close inpatient pediatric beds at Mercy Hospital, and relocate intensive care and surgical services from Mercy’s Fridley campus to its Coon Rapids campus.
Minnesota
Minnesota sues to block Trump administration’s withholding of Medicaid funds
Minnesota on Monday sued President Donald Trump’s administration in an attempt to stop it from withholding $243 million in Medicaid spending, warning it may have to cut health care for low-income families if the funding is held back.
The lawsuit asked a U.S. court in Minneapolis to issue a temporary restraining order to block the withholding for Medicaid, which is the health care safety net for low-income Americans.
The move came after Vice President JD Vance said last week the administration would “temporarily halt” some Medicaid funding to Minnesota over fraud concerns, as part of what he described as an aggressive crackdown on misuse of public funds.
Minnesota Attorney General Keith Ellison said his office has a strong track record of fighting Medicaid fraud and has won more than 300 convictions and $80 million in judgments and restitutions during his time in office.
“Trump’s attempts to look like he’s fighting fraud only punish the people and families who most need the high-quality, affordable healthcare that all Minnesotans deserve,” Ellison said in a statement. “As long as I am attorney general, I will do everything in my power to defend our tax dollars, both from fraudsters and from the Trump administration’s cruelty.”
The lawsuit names the Department of Health and Human Services and the Centers for Medicare and Medicaid Services as well as Dr. Mehmet Oz, in his official capacity as CMS administrator, and Robert F. Kennedy Jr. in his official capacity as HHS secretary.
The Department of Health and Human Services, which includes CMS, didn’t immediately return messages seeking comment late Monday.
The threatened cuts amount to roughly 7% of Minnesota’s quarterly Medicaid funding, Ellison’s office said in a news release. Minnesota could be required to significantly cut health care services for low-income families or other government services if the cuts take effect, it said.
Medicaid, which is known as Medical Assistance in Minnesota, provides health insurance to 1.2 million Minnesotans who would otherwise be unable to afford it. A family of four may qualify for Medical Assistance with an income at or under $42,759, the attorney general’s office said.
The lawsuit said the administration violated due process procedures because it was taking hundreds of millions of dollars without proving Minnesota’s noncompliance with Medicaid regulations through discovery and an evidentiary hearing.
It alleged the administration failed to provide Minnesota with details about its decision, in violation of federal law. It cited legal precedents, including one that said Congress may impose conditions on states’ acceptance of federal funds, but “’the conditions must be set out unambiguously.’”
Minnesota’s complaint further charged the administration violated the Constitution because the withholding imposed retroactive conditions on Minnesota’s Medicaid funding.
It said withholding the funds was arbitrary, capricious and part of a pattern of political punishment of Minnesota.
The administration said it would hold off on paying $259.5 million to Minnesota for Medicaid spending in the fourth quarter of 2025. Minnesota’s lawsuit challenges the withholding of $243 million of this money.
Minnesota
Iran conflict: 250 Minnesota National Guard member serving in Middle East
(FOX 9) – The Minnesota National Guard tells FOX 9 there are currently 250 guard members on regularly scheduled deployment at the United States Central Command areas of responsibility as the United States leads strikes in Iran.
Guardsman in Middle East
What we know:
The Minnesota National Guard says the deployed airmen and soldiers are serving from Duluth’s 148th Fighter Wing, the Marshall-based 1-151 Artillery, and the Stillwater-based 34th Military Police Company.
What they’re saying:
“While their missions and duty locations vary, all are grateful for the strong support of those back home,” writes Army Maj. Andrea Tsuchiya, State Public Affairs Officer for the Minnesota National Guard.
What we don’t know:
The guard did not disclose the exact bases or countries where the soldiers and airmen are serving.
CENTCOM covers 21 countries including: Afghanistan, Bahrain, Egypt, Iran, Iraq, Israel, Jordan, Kazakhstan, Kuwait, Kyrgyzstan, Lebanon, Oman, Pakistan, Qatar, Saudi Arabia, Syria, Tajikistan, Turkmenistan, the United Arab Emirates, Uzbekistan and Yemen.
Pres. Trump says Iran operations likely to last 4 to 5 weeks
Big picture view:
In his first public remarks since the launch of the attack on Iran, President Trump said he expected operations to last four to five weeks, but he was prepared “to go far longer than that.”
The president also laid out his objective for the mission: to destroy Iran’s missile capabilities, to “annihilate” their navy, to ensure the country doesn’t obtain a nuclear weapon and that the regime “cannot continue to arm, fund and direct terrorist armies outside of their borders.”
Minnesota
U.S.-Israeli strikes spark dueling rallies in Twin Cities
Iranians in Minnesota react to Khamenei death
Iranians in the Twin Cities gathered in downtown Minneapolis on Sunday to celebrate major developments in the Middle East following the death of Supreme Leader Khamenei. While many Iranian-Americans expressed hope for regime change, anti-war protesters also took to the streets to condemn the military strikes, with some members of Minnesota’s DFL delegation calling the operation “unlawful” and “illegal.”
MINNEAPOLIS (FOX 9) – Iranians in the Twin Cities gathered in downtown Minneapolis Sunday to celebrate major developments in the Middle East. Anti-war protesters also took the streets of Minneapolis Saturday.
Plus, Jewish communities say they are on high alert over concerns of potential retaliatory acts in major cities across the U.S.
‘Massive moment’
What we know:
Following a joint U.S. and Israeli military operation in Iran, Khamenei was killed in an attack, Iranian state media confirmed early Sunday.
What they’re saying:
Iranian community groups rallied at Nicollet Mall and 11th Street on Sunday to express hope for regime change.
Dozens of Iranian-Americans said they are celebrating the news.
“We are here to support Iranian people. Today, everybody is happy, very happy,” said Beheshteh Zargaran, an Iranian-American.
“Killed Khamenei, which was the supreme leader, and hopefully they will continue this action and help Iranians finally topple the Islamic regime,” said Faraz Samavat, an Iranian-American.
“That means a lot. We are fighting for almost half a century to destroy this cruel regime against people of Iran,” said Ali Mohammad, an Iranian-American.
Iranians in MN celebrate strikes by Pres. Trump
Iranians in the Twin Cities are gathering in downtown Minneapolis to celebrate major developments in the Middle East following a joint U.S. and Israeli military operation. Community groups rallied at Nicollet Mall and 11th Street to express hope for regime change after news that Iran’s Supreme Leader, Ayatollah Khamenei, was killed in Saturday’s airstrikes.
The other side:
Protesters also took to the streets in the Twin Cities over the weekend condemning the strikes.
Some people are criticizing the military operation including members of Minnesota’s DFL delegation. Congresswoman Betty McCollum called the strikes “unlawful” and Congresswoman Ilhan Omar called the war “illegal and unjustified.”
Heightened security:
Jewish communities in Minnesota say they are also on high alert following security guidance across the country to prevent potential retaliatory violence.
“A heightened sense of vigilance making sure that everybody is aware of their surroundings and that all of the protective measures are in place,” said Steve Hunegs, executive director of the Jewish Community Relations Council of Minnesota and the Dakotas.
There are currently no known specific threats against local Jewish communities.
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