“There have been significant changes in how services are being provided. Certainly we have seen a huge shift in hemodialysis compared to peritoneal dialysis and even home dialysis services. That has been kind of a trend in the market place across the country,” said Carris Health Co-CEO Mike Schramm.
Mike Schramm, Carris Health-Rice Memorial Hospital Co-CEO
As those conversations and planning meetings have been conducted, concerns have been raised in the public — and have reached the Willmar City Council — that dialysis treatment might no longer be available at Carris Health — Rice Memorial Hospital.
“I am very concerned about what is happening there, simply because of the conversations happening in the community, the phone calls I am receiving,” said Willmar Mayor Marv Calvin at the Nov. 2 council meeting.
While there is the chance that how those services are provided and delivered might change in the future, there is no intention to pull dialysis services out of the community, Schramm said.
“We are continually looking at how we can enhance and strengthen services, not pull back services,” Schramm said.
Schramm said there are three probable outcomes to these discussions. The first is CentraCare and Carris Health will continue providing dialysis and other kidney health services themselves, as they do now. CentraCare could also decide to either partner with a national provider in kidney care, or sell its dialysis program to one of those providers, such as DaVita, outright. CentraCare has sent out requests for proposals to other dialysis providers as part of the planning.
Schramm said no decisions have been made and he does not expect a decision until sometime next year. He does believe patients in and around the Willmar area will still be able to get the dialysis and kidney care they need.
“It is all about high-quality, reliable and accessible service for our patients moving forward,” Schramm said. “Quality of care will not be sacrificed.”
Schramm also said he understands staff concerns and said staff impacts will be front and center when making decisions regarding the kidney care department.
“Our staff are a very important part of this equation as well,” Schramm said. “Our employees are a key asset to our health systems in all areas.”
Communication with the city of Willmar also remains crucial. The lease signed between CentraCare and Willmar in late 2017, to lease Rice Hospital and ACMC to CentraCare and create Carris Health, lays out some communication guidelines.
The Rice Hospital Board, which includes a City Council liaison, meets at least four times a year, to make sure Carris Health is following the terms of the lease, including commitments to services. The minutes of those meetings are shared, and approved by the Willmar City Council. Carris Health also reports at least annually to the Willmar City Council’s Finance Committee.
“We are compliant with all the things we said we would be doing,” Schramm said.
At the Nov. 2 council meeting, several councilors had concerns about whether the lease allows Carris Health to make significant changes to its available services, including kidney care. Calvin said he has requested that the city’s legal representation look into the lease.
“I don’t want to wait a whole lot longer and allow this ship to go unchecked,” Calvin said.
The lease, approved in November 2017, in Section 5.12, covers service commitments Carris Health agrees to follow. It includes the language “Carris shall work collaboratively with the Rice Board to maintain and expand physician specialty services at the hospital” including kidney care.
Councilor Audrey Nelsen, who serves as the council liaison on the Rice Board, said she wants the council and hospital to have an open dialogue.
“We need to clarify as council members what that lease is,” Nelsen said, pointing out that the Rice Board minutes from Sept. 2 mention the discussion about kidney care, and that the City Council approved those minutes. “I do believe they (Carris Health) are meeting the terms of the lease.”
Schramm said he has had conversations with City Administrator Brian Gramentz and Calvin and has provided the information that was requested by the council.
“I am open to communicating with them as they feel there is a need to do that,” Schramm said. “If they have questions and concerns, they can talk to me.”
Over the almost three years Carris Health has been in operation, Schramm said he believes it has been a positive for the communities it serves.
“We haven’t scaled back or decreased any of the services we historically provided. If anything, we have enhanced services,” Schramm said. “We did it (the lease) for all the right reasons; making sure we were well-positioned for the future and everything coming our way in health care.”