Ludeman: It’s ‘survival time’ for health care
By Rae KrugerArticle Photos
MARSHALL - Hospitals and nursing homes might not be able to do what Minnesota Commissioner of Human Services Cal Ludeman has asked, Avera Marshall hospital board member Art Olson said Monday.
Ludeman spoke at Monday's Avera Marshall Regional Medical Center's hospital board meeting. The state's human services department is one of the largest insurance payers in the state because it handles Medicaid, General Assistance and MinnesotaCare patients. Payments are paid to hospitals and nursing homes like Avera Marshall.
"You are asking us to take less and then asking us to improve quality," Olson said to Ludeman. "That's not gonna happen."
Ludeman acknowledged that weak Medicaid reimbursements to hospitals from the state and other costs will be difficult for hospitals in the future.
"How about nursing homes?" Olson asked.
"That's even tougher," Ludeman said.
Avera Marshall operates a nursing home in Marshall.
"It is survival time, no doubt about it," Ludeman said.
"As miserable as the payment from Medicaid is (we don't want to lose it)," Ludeman said. "I'm embarrassed by it."
One thing Avera Marshall may have in its favor is a relationship with a larger entity in Avera Health of Sioux Falls, S.D.
Ludeman said the health care market is becoming more integrated as health systems grow. The market is applying pressure for health care facilities to integrate, Ludeman said.
"You have a relationship and you are contemplating a different ownership," Ludeman said.
Ludeman also fielded questions about the mental illness care facilities being operated and built by the state.
The 16-bed units, including one to be completed in Willmar, are replacing the large, warehouse style facilities, Ludeman said.
Marshall has a mental health unit with 10 beds, but local officials said there is a need for the state community based mental health facilities.
Avera Marshall Behavioral Health Unit manager Paula Tofte said those community-based smaller facilities were to have been available for seriously aggressive patients with mental health issues.
Now, units such as Marshall's are being told by the state facilities that they won't accept those aggressive patients, Tofte said.
Ludeman said it was his department's belief the state facilities would take the more aggressive patients when they had available beds.
"I'll check into that," Ludeman said.
Gloria Sabin of Western Mental Health Center in Marshall said more beds may be needed for patients with mental health issues, especially the more aggressive patients.
Ludeman said a network of facilities in Minnesota, Iowa, South Dakota and Wisconsin will be developed to make it easier to locate beds. It may take time to find the right number of beds, at the right time for the right number of patients, Ludeman said.
Meanwhile, no one wants to return to the prior conditions where patients could be transported in shackles to a large mental health hospital and left there for six months to a year.
"That is not gonna happen again," Ludeman said.
The state will continue to work on improvements in the health care system in Minnesota, Ludeman said. The state wants to make sure that small businesses are able to provide health care, and that children continue to get health care, as well as adults, Ludeman said. The state also needs to improve how residents of different cultures and ethnic groups access health care programs in the state, Ludeman said.
Care needs to have a consumer focus where consumers tell the state and providers what they need to do about their health before they get sick, Ludeman said.
The state also needs strong involvement from the private sector, Ludeman said.
