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KARE 11 Investigates: Rural hospitals facing COVID-19 ICU bed shortage

Small hospitals were already financially stretched. The outbreak will make that worse

SLEEPY EYE, Minn. — The largest coronavirus outbreaks have been in cities. But new cases are popping up in rural Minnesota every day – adding to the strain on rural hospitals.

At Sleepy Eye Medical Center, in Brown County, Dr. John Pelzel is one of just 3 doctors and 2 nurse practitioners bracing for an influx of COVID-19 patients. There are no ICU beds in the hospital, no isolation rooms and a shortage of nurses, Pelzel said.

“We’re working with five providers who staff our hospital 24/7,” he said. “We have three ventilators, none of which is setup for long term use.”

The ICU bed shortage is widespread in many counties across rural Minnesota.

What’s more, many of Minnesota’s rural hospitals are confronting a financial crisis if the coronavirus crisis worsens.

The state’s smaller hospitals were already facing a budget crunch, said Rahul Koranne, president of the Minnesota Hospital Association. But now they need to buy new equipment and retrofit rooms, all while dealing with the financial loss of postponing all elective surgeries.

“I would definitely call this particularly unprecedented epidemic also a financial perfect storm,” Koranne said.

Minnesota isn’t the only state where smaller hospitals are facing a crisis. The Washington Post reported over the weekend that hospitals across the country say they are so short on funding that without emergency aid they’ll run out of money within weeks and be forced to close.

Koranne said the situation in Minnesota is not that dire, but warned that if residents don’t practice social distancing, “it could be pretty overwhelming.”

Even without being overwhelmed, many rural residents who do get sick and need hospitalization may have to go hundreds of miles away for care.

Data from Kaiser Health News shows that large swaths of the state are without a single intensive care bed. Of the state’s 87 hospitals, only 33 have ICU beds. The entire southwestern part of Minnesota has no ICU beds, for example. Northwestern Minnesota has 10.

If someone needs ICU care, many have emergency rooms which could serve that role, but only for a short time, said Dr. George Morris, the medical incident commander for CentraCare, which operates six hospitals – most in rural counties.

"But that lack of resources for our rural counties will become a problem as this wave hits harder,” he said.

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Rural hospitals face another challenge, said Morris. If even a few doctors or nurses at the smaller facilities get sick and the hospital faces an onslaught of patients, “we will not be able to respond to this crisis.”

Koranne said Minnesotans can potentially avoid the crisis by practicing social distancing and not going to hospitals unless they are sick.

“Please help us. We need you to be our full partner right now,” he said. 

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