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Plans for COVID-19 tri-county hospital on hold

By Reed Anfinson
Swift County Monitor-News
Plans for opening the Tri-County COVID Medical Center at the Prairie Correctional Facility are temporarily on hold while the State Health Care Coordination Center decides whether or not it will license the facility.

The state agency is asking all hospitals in Minnesota to send it their plans for handling a surge of COVID-19 patients at their own facilities first, Co-CEO of Swift County-Benson Health Service told its governing board at a special meeting Thursday night.

Thursday afternoon the CEOs of the five hospitals working to set up the Tri-County COVID Medical Center (TCMC) had a conference call with representatives of the Office of the State Health Care Coordination Center.

TCMC is a partnership between SCBHS, Appleton Area Health, Madison Health Care Services, Johnson Memorial Health Services of Dawson and Chippewa County Montevideo Hospital.

On the call with them was Dr. John L. Hick who serves as the Minnesota Department of Health’s medical director for the Office of Emergency Preparedness. He is also deputy chief medical director for Hennepin EMS and medical director for Emergency Preparedness at the Hennepin County Medical Center. Joining them as well was Minnesota National Guard Brigadier General Joseph P. Kelly who oversees state emergency response operations and strategic planning.

When the call started, area CEOs were still hopeful that they would get licensure and be ready to accept the first COVID-19 patients by Monday, March 30, McGinty said. Based on Thursday’s call, that is not going to happen, she told the governing board.

“The project will be somewhat on hold from our perspective and they will be looking at surge capacity within each of our own facilities. Once we have met that capacity we would look to our neighboring facilities and regional partners. The state is then going to look at putting up alternate care facilities throughout the state,” McGinty-Thompson said.

During that process, the Prairie Correctional Facility will be considered.

The SCBHS governing board agreed that if it had to act on a joint operating agreement with the other hospitals involved with the TCMC, it would call a special meeting. Potential liability for each facility involved with TCMC is also being studied.

By the end of the day Friday, each care coordination region was to have submitted what areas it had available for handling a surge of COVID-19 patients. Such a facility might be a nursing home that was no longer being used or another facility that could house a medical operation.

“We don’t really have anywhere else we could house it,” McGinty-Thompson, who is also SCBHS’ chief nursing officer, said of Benson. “So, we won’t be submitting. On behalf of TCMC, CEO Lori Andreas is going to submit the Prairie Correctional Facility through CoreCivic to for our region’s site.”

Because the state is now involved in choosing region COVID-19 care <img src="/sites, she said she did not know if the decision would be coming back to the area hospitals. Rather, the state plans to take the top three <img src="/sites in each coalition area and vet them at the state level.

The Minnesota Corp of Engineers will then come and look at each of the facilities and it will select which <img src="/sites are to be used and when, McGinty-Thompson said.

“We can’t do anything until the state gives us licensure,” she said. However, the group will continue to do what it takes to make sure the facility is ready if licensure comes through.

If the state does come through and take over management, McGinty-Thompson said she did know what that would mean for who supplies the facility with equipment and medical supplies. It would make sense that the local medical facilities would be asked to take their supplies back if they were expected to initially meet a surge at their facilities, she said.

That decision could come as soon as this week.

Each hospital will now start over with its planning on handling a surge of COVID-19 patients. SCBHS will continue to work in coordination with CentraCare/Carris with their incident command. It was going to start Friday morning on what its surge plan would be for the area.

“Wow,” was SCBHS Governing Board Chair Patty Schreck’s response to the McGinty-Thompson’s news about the change in plans. She complimented her and Enderson for the countless hours they have spent on working on the COVID-19 medical center preparation in the past couple weeks.

The CEOs of the five hospitals will continue to conduct a daily conference call on the joint medical center and prepare their own facilities, McGinty-Thompson said they are hopeful that it could still be used.

“The groundwork is laid for out there and we feel that we can be operational within 24 hours,” she said. “We are going to continue the work that was planned for this week. We will then likely be touching base a little less frequently.”

In a letter to all five hospital staffs, the Benson City Council and the Swift County Board of Commissioners, McGinty-Thompson and Co-CEO Dan Enderson outlined the status of the COVID-19 medical center effort.

“March 21 was the first day we started converting the Appleton Correctional Facility into a Medical Center that can house our Covid-19 patients. All our organizations have been working diligently on-site and behind-the-scenes to prepare for the opening of TCMC on March 30.

“We have done remarkable things and TCMC will be structurally ready to see patients March 30. Unfortunately, our opening will be delayed due to the state requiring our own hospitals to surge prior to utilizing this resource. We now must go through additional channels to become an approved site,” the letter states.

“We will now wait until further notice for when we would open the doors to take care of our communities. We will use this time to prepare for this pandemic.  We have a lot to be proud of and we are ahead of every organization in the state- - We will have built a hospital in nine days.”
The letter is signed by the CEOs of the five hospitals.

“You have made your case at the highest level and it is impressive,” Joe Hellie, speaking in his position with the liaison Office of the State Health Care Coordination Center, told the group in a letter. “You are ahead of the state and as you heard, each region will have one site designated next week with the expectation of becoming operational within a few days of designation,”

“The state plans are for hospitals to surge within hospitals and then utilize Alternate Care <img src="/sites,” he wrote. “Amazing work and amazing facility.”

Hellie also is the vice president of Strategy and Network Development for CentraCare Health, the firm providing management services for SCBHS. He has worked closely with SCBHS as CentraCare has considered full affiliation with the local facility over the past two years. With the center, he is working more with the state’s emergency operations response to COVID-19.

At a special meeting Tuesday, March 24, the Swift County’s Board of Commissioners had approved a credit line of $333,794 to be drawn as needed by the TCMC. It made $50,000 available immediately.

Commissioners in Chippewa County approved $425,977 for the medical center last week and the Lac qui Parle County board approved $240,228. The financial commitments were based on county population.

TCMC would serve Chippewa, Lac qui Parle and Swift counties. The group has also contacted the Stevens County Medical Center in Morris and Ortonville Area Health Services to gauge their interest in joining their consortium.

While the delay may be a little step back, Enderson said the work that has gone into planning to use the Prairie Correctional Facility has been a very good thing for the region and the state. Because it is ready to go, he said he expected it to be looked at pretty heavily as an alternative care site. “It looks good and it is ready to go,” he said.

While the five hospitals are all competitors for patients in the region, they came together to work for the common purpose of establishing the medical center at PCF, McGinty-Thompson said.

Be prepared for a financial shock

Eight days ago, SCBHS postponed all elective surgeries and started reducing all other outpatient services, Enderson, who is also the hospital’s chief financial officer, said.

He is working on the financial projections of what it means to SCBHS to lose 80 percent of its total revenue over several months. “It is going to have a significant impact on our revenue,” he said.

There could be financial relief coming for hospitals from the state and federal governments, but no one know what that is or when it would come, he said.

Enderson said he would be working on a projected financial statement for what SCBHS would look like to start June if the services continue to be severally reduced.

“This is going to devastate rural health care,” Brian Lydick added. He is Carris Health’s Executive Director for Ambulatory Care and provides oversight of SCBHS for CentraCare.
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