ST. PETER — Major changes are on the horizon for River's Edge Hospital and Clinic, one of the few city-run medical facilities left in the state.
CEO George Rohrich said River's Edge's clinic model will change significantly in the upcoming months. Though no decisions have been made, it is possible the clinic will either merge with another clinic or move to providing urgent care only.
The move is the direct result of continued financial losses, which average around $50,000 a month, Rohrich said. Despite marketing efforts, the clinic still draws fewer patients than can sustain it financially.
"We are experiencing growth, but it's not enough," Rohrich said. "Not enough to bring the financials to breaking even or better."
Hospital model to stay the same
The hospital, which operates separately from the clinic, will continue to operate as it has in the past. Revenues there are much higher, Rohrich said. In fact, the hospital is about to wrap up the best year it's had since 2008, which has the potential to get the facility out of the red and operating at a profit.
The uptick in revenue is due mainly to a new partnership with the Orthopaedic and Fracture Clinic in Mankato. For a little more than a year now, River's Edge has been doing knee, hip and shoulder replacements, as well as other procedures, as part of a program called OrthoEdge.
"We had anticipated doing 28 procedures per month," Rohrich said. "... We're doing more than 40 a month now."
Despite the hospital's success, the clinic continues to flounder, however, partially because of strong competition out of both St. Peter and Mankato.
Not only does Mankato Clinic have a presence in St. Peter in the Daniels Health Center, but Mayo Clinic Health Systems operates a clinic out of the same building as River's Edge.
Rohrich said River's Edge has the newest of the three clinics, and as such has had a hard time establishing a presence in St. Peter.
(Though the Mayo Clinic Health System facility and Daniels Health Center are also relatively new to St. Peter, their parent systems are much older and well-known throughout southern Minnesota. In comparison, the River's Edge Clinic was opened in 2009 as a department of the hospital.)
River's Edge also has had a hard time retaining clinical staff, due mainly to a lack of patients and job competitiveness. The River's Edge Clinic in Le Center closed in July 2014 because the physician there left and then reopened in February staffed by a nurse practitioner. It closed again in August after it failed to bring in enough profit to justify its operation.
Dr. Jay Bauder is leaving River's Edge later this month, which leaves only one physician and three nurse practitioners in St. Peter.
"We are losing a physician later this month — it kind of made it obvious we need to take another look at the clinic and the opportunities there," Rohrich said.
River's Edge is in talks with both Mayo Clinic Health Systems and Mankato Clinic about some of those new opportunities, he said. That could mean anything from merging with one of the clinics to offering services more collaboratively.
"We're not looking at selling anything," Rohrich said. "We're not look at closing anything. What we're looking at is changing River's Edge (Clinic).
River's Edge is also investigating any legal hurdles to such a partnership — River's Edge is at its heart a government entity versus your run-of-the-mill nonprofit, which could make things difficult.
And, of course, "There is a possibility that as a result of these discussions, none of the partners involved want to make a change," Rohrich said. "We realize that."
In that case, River's Edge is likely to start providing expanded urgent care services instead, transitioning the clinic to fit that model.
Currently urgent care is offered on a limited basis out of the River's Edge emergency room. But the hospital has chosen not to promote that service in fear of clogging up the department during actual emergencies.
If the clinic starts offering urgent care exclusively, hours could be expanded.
"In some communities, it's open all day," Rohrich said. "That would seem logical, but we can't say."
He did say the River's Edge Hospital Commission hopes to make a decision about the clinic within the next two months. There could be upsides to a merger, he added.
"I believe there is a benefit when patients can move from primary care to specialist within a group, and both groups we're talking to have that depth," he said.
Part of all discussions is the future of River's Edge Hospital and how to ensure that if the clinic merges, lab work, surgery and other hospital procedures are still performed locally.
In the future, the hospital could merge or close itself, Rohrich said. But not for some time, at least.
"We're kind of a dying breed," Rohrich said of city-owned hospitals. "We're becoming more and more rare, and that's probably because a lot of hospitals have chosen to — or had to — join systems ... It could come one day here, but not today. Your board continually indicates they're committed to staying independent. This isn't the beginning to a change to that. This doesn't change that."