Transcripts

LEIF ENGER: The light gray-blue carpeting of the Helgeson Funeral Chapel in Baudette is under siege this morning a woman dressed in hospital blues pushes a heavy industrial strength carpet cleaner around the floor, moving caskets aside to make room.

CAROL SCHARF VANCAMP: We washed the walls down and vacuum and clean the windows and do the carpets, and it takes sometimes three days to complete this job.

Carol Scharf VanCamp is head of the housekeeping department for Trinity Hospital, a few blocks down from the funeral parlor. About six years ago with patient counts down and the hospital floundering financially, the administration asked each department to come up with ideas for keeping staff busy and bringing in more money. The housekeeping department says, Scharf VanCamp, looked around town, saw no one else offering business and home cleaning services and gave it a try themselves.

CAROL SCHARF VANCAMP: If the hospital administration had not done the brainstorming when they did do it, that I would have been out of a job. I would have been laid off. It isn't going to be a big moneymaker. It's more or less to keep the housekeepers on. When the patient count is below six patients, then with our outside jobs, I don't have to call the housekeepers off.

LEIF ENGER: Taking on non-traditional duties has become a trademark of Trinity Hospital. The dietary department now fixes meals not only for the patients upstairs but for inmates of the jail across town. The hospital has also contracted with Lake of the Woods County to provide the county's public health services, a one of a kind partnership in Minnesota all of this, says Hospital Administrator David Nelson, has helped turn around a facility that was down to one full time physician and an average of just two patients a day.

DAVID NELSON: Trinity was well ahead of its time, and when you can finally come to grips that you are just not a hospital anymore, and a hospital being a definition of providing acute care, inpatient care, you have the chance, I believe, to start thinking differently. We've added a lot of amenities out there that people, obviously needed, or they wouldn't be using them.

LEIF ENGER: The concept of rural hospitals staying afloat by doing more than just taking care of people is one some experts think we'll soon see more of. Fueled by private foundation and government grants, a number of small hospitals have hired consultants to help them work with local leaders, looking at New ways to serve their communities. Executive Director Terry Hill of the Northern Lakes Health Care Consortium in Duluth says, such transition planning could help some hospitals buy back their futures.

TERRY HILL: Too many communities out there are really not tuned in to the circumstances when there are local health care system. To some degree, that's the fault of the hospitals and the health care system itself, and we do not have a strong history of close interaction between the community itself and the health care system. That definitely has got to be remedied. The community needs to know what's at stake.

LEIF ENGER: Hill forecasts, though, that no matter how careful or creative the planning, many small town hospitals will still be forced to close in the next several years. When that happens, he says, those communities must be ready with a backup, either a regional hospital in a nearby town or some emergency health care system that will get to them quickly and take them to help.

[SIREN WAILING]

Judy McCourt is test driving a new ambulance being rented by the town of Littlefork, a community of 900 northern Minnesota. McCourt is Chief of Ambulance Services here, supervising a staff of 11 volunteer drivers.

JUDY MCCOURT: The people here want and need the ambulance because we cover an area of about 1,400 people, and 42% of those people are senior citizens, and they want that ambulance out there for their convenience, and we want to be here for them.

LEIF ENGER: The ambulance crew was organized in August of 1987, six months after the town's hospital closed for lack of a doctor. The closing prompted a group of concerned residents to take a class in emergency medical training. Since then, they've averaged about one ambulance run per week to International Falls or sometimes Duluth. Littlefork residents like David Staples say they still miss their hospital. But the ambulance, with its crew of friends and neighbors, is a comfort.

DAVID STAPLES: Well I broke a hip, and then a hurry to get to the hospital. So my daughter was on the ambulance driving, and she come and pick me up right away, and it wasn't long till I was up in the Falls hospital.

LEIF ENGER: With its own second hand shop to raise revenues, a series of raffles and bake sales, even a dunk tank at the County Fair, the littlefork ambulance seems to have become the most popular cause in town. Terry Hill of the northern lakes consortium says, that sort of community involvement is going to be increasingly important as more small town hospitals, short of doctors and patients close their doors for good.

TERRY HILL: Communities that are facing the loss of a hospital need to be deciding what they want as an alternative and what they will support because, again, a hospital can make a transition into some other entity. But if the community is not willing to support it, then it's beside the point.

LEIF ENGER: Northern Lakes Health Care Consortium Executive Director Terry Hill. This is Leif Enger.