2 St. Paul hospitals to close, psychiatric beds reduced in Fairview's shakeup

Two St. Paul hospitals are shutting down in the face of major financial losses. Fairview Health is closing St. Joseph’s downtown along with Bethesda Hospital near the state Capitol. Bethesda will be repurposed as a homeless shelter, and St. Joseph’s is becoming a community wellness center.

The system is expanding emergency outpatient mental health care, but is not guaranteeing that its 105 inpatient psychiatric beds will remain at St. Joseph’s past 2021. That concerns Sue Abderholden, executive director of NAMI Minnesota.

“People have high anxiety, depression, increased use of alcohol. And what everyone else in the world is recognizing is that we’re going to have an increased need for mental health treatments in the future,” she said.

Abderholden said the inpatient psychiatric beds at St. Joseph’s alone represent about 17 percent of the Twin Cities metro area total. Fairview Southdale is losing its 18-bed psychiatric unit.

Fairview Health said the COVID-19 pandemic has exacerbated losses that were already mounting. The system was $163 million in the red for the first half of the year, and is on track to close out 2020 an estimated $250 million in the hole.

St. Joseph’s Hospital is slated to become a “hub of health and wellness,” according to a Fairview Health statement. Rather than acute care, Fairview spokesperson Joe Campbell said the facility will focus on primary care, housing and other support services. He says 72 percent of cases at the St. Joseph’s emergency department are considered potentially preventable.

“Which means that they could have been better dealt with a social worker, at home, with a care provider over the phone, or in one of our specialty or primary care settings before going to the hospital,” Campbell said.

Bethesda, the area’s main COVID-19 hospital, will transfer its patients to rooms at St. Joseph’s before the end of the year. Campbell says COVID-19 treatment will continue there as long as necessary.

Fairview plans to lease Bethesda to Ramsey County for use as a homeless shelter. St. Paul Deputy Mayor Jaime Tincher said they’re still working out key details including the budget and staffing.

“We’re hoping it’s pretty turnkey for what we would need and that we wouldn’t need to make a lot of investments in the building to have it be something that is really beneficial to the folks we need to serve.”

Tincher said the building could house around 100 people, or about a third of those sleeping outside in the city.

The Ramsey County board is expected to discuss details of the lease agreement for Bethesda at its meeting Tuesday.

The Fairview Health overhaul goes beyond the two hospital closures. Fourteen primary care clinics in Minnesota and two in Wisconsin will shut down by Dec. 4.

The restructuring at Fairview also means the elimination of 900 positions. Officials point out that’s just under 3 percent of the total workforce, and the health system has 1,200 open jobs. Employees are being encouraged to transition wherever possible.

About a third of the positions being cut are union jobs, most of which are nursing positions. Minnesota Nurses Association President Mary Turner says this is the worst possible time to eliminate the jobs of experienced care providers, with COVID-19 case numbers at a high level and potentially more hospitalizations to come.

“To even think about nurses being laid off or furloughed, it's the 'you gotta be kidding me'  kind of reaction," Turner said.

More than 19 months remain in the nurses’ contract with Fairview, and Turner said the union will enforce the agreement’s layoff provisions to the letter.

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