Audio Merger may strengthen small town hospital (story audio) Photos Weiner Memorial Hospital Mixed feelings about the merger Curt Hohman Resources Avera Health Sioux Valley Regional Health Services Your Voice Join the conversation with other MPR listeners in the News Forum.

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Merger may strengthen small town hospital
by Cara Hetland, Minnesota Public Radio
May 18, 2004

Weiner Memorial Hospital in Marshall, Minnesota, is likely to merge with a larger regional health care system. The hospital board says the facility's future growth depends on the stability that a merger would bring. (MPR Photo/Cara Hetland)

The Weiner Memorial Hospital in Marshall, Minnesota, has decided to merge with Avera Health, a regional health care network based in Sioux Falls. The hospital board of directors decided the independent, city-owned hospital can no longer grow without help from a larger hospital. For the last year, the board has struggled between independence and the desire to grow. Officials have decided the benefits of joining with a larger system outweigh the loss of autonomy.

Marshall, Minn. — For Marshall, a town of about 14,000, Weiner Memorial is the center of all things medical. It holds the lab and high-tech scanning equipment. It houses the clinic and nursing home, as well as the rehab and exercise center. The building is remodeled and modern. It's a welcoming place.

Richard Slieter runs Marshall's hospital. He says thousands of people come through every year. It's been successful, but Slieter confesses health care is starting to suffer.

"Due to retirement and for a variety of other reasons, there were nine physicians who left this community. That's not uncommon. Some of that was predicted and some of those physicians were replaced. But not all of them. As a result of that, our community's access to health care services was compromised," says Slieter.

	Mixed feelings about the merger

There are 17 physicians who practice in Marshall. That includes doctors at the hospital and others at an independent clinic. Slieter says the shortage means they can't offer specialty practices like urology or oncology. Recruiting physicians to a small town is a fulltime job, and no one at the Marshall hospital has time to do it.

"We could recruit all kinds of physicians. If you have enough money you could bring any doc into any community. The question is will he or she be a good fit? Will it be comfortable? will it be rewarding, professionally satisfying, and will they stay?" Slieter asks.

Mitchell, South Dakota, was in the same boat eight years ago. Doctors were leaving and patient care was starting to suffer. Today, the Mitchell hospital has more than 40 physicians and the facility is thriving. The turnaround came in the form of a merger.

The region's other big health care chain, Sioux Valley Regional Health Services, was also competing to merge with Weiner Memorial. Sioux Valley and Avera are in constant competition to merge with smaller hospitals and clinics. Each company employs about 10,000 people.

Avera is a Catholic health ministry. Curt Hohman, senior vice president, says their network consists of four hub hospitals, each with its own network of clinics and smaller hospitals. Hohman says Marshall's hospital will become another regional hub.

"Regional health status is special status within Avera Health. They would be developing their own regional referral network, within a network of specialists, with a network of hospitals and possibly even clinics that extend within a geographic area around Marshall," says Hohman.

Sioux Valley Regional Health System is a much larger operation. It manages 23 hospitals and 16 nursing homes. The facilities are in South Dakota, Minnesota, Iowa and Nebraska.

	Curt Hohman

Richard Slieter, the hospital's CEO, says the board chose Avera Health because doctors already had a relationship with Avera. And he says more people from Marshall go to Avera in Sioux Falls than Sioux Valley Hospital.

Weiner Memorial will remain a city-owned hospital, and the board will continue to set the vision. Avera Health will provide management services like lawyers, supply purchasing and physician recruitment.

Slieter says many in Marshall would prefer the hospital remain independent.

"You give up something (in a merger). You give up some autonomy, you give up some independence. You need to standardize in ways you may not otherwise want to do. You lose some control or you compromise over some control issues. But the community wins. This is all about the community," says Slieter.

A contract should be finalized by July 1.

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