Fosston, Essentia Health to Enter into Mediation After 15-Month OB Care Pause

A central hub for medical services in northwest Minnesota could take possible legal action against Essentia Health if a core service is not restored.

The city of Fosston is working with the healthcare provider to find solutions to the over 400-day pause in obstetric care. On Sept. 19, the community gathered in an informal meeting requested by Essentia Health to review the possible solutions.

In the room of over 100 people, Essentia aimed to reach a solution with Fosston regarding the current pause in OB care for the city.

“We heard too many comments about needing to restore the service in Fosston and that’s absolutely what we’re going to do,” said Fosston City Administrator Cassie Heide. “We’re going to work to that end.”

“Essentia actually asked for this public meeting so they could bring the challenges to light,” explained First Care Foundation Member Evan Fonder. “The city basically said, ‘okay,’ and then we’ll bring some of the risks that come with closing an OB, and labor and delivery services, and some of the challenges and, really, frustrations that we’ve seen over the last 400 days in trying to be a unified force with a health center.”

Since 2009, Essentia Health has served the Fosston area, including surrounding communities. Among other services in a contractual agreement with the city is obstetric care. Essentia put a pause on OB care in June 2022, and since that time, Fosston has worked to meet the requirements from Essentia to return this care, despite some changes along the way.

The city was originally given a goal of hiring full-time OB nurses before being told to also hire OB nurse leadership. Along the way, Essentia Health then reportedly changed the requirements from hiring personnel to meeting a volume of babies delivered to maintain competency.

“We wanted to come alongside [Essentia Health] to really help them meet the goal they had set, which was Oct. 1,” said Heide. “That goal changed along the way in terms of the barriers that were included and also the timing in which it could be done by.”

For solutions to offering OB care to Fosston, Essentia Health is leaning toward a shared model of healthcare. Fosston, however, is advocating for keeping the patients and the practice in the area. If OB care is not resumed in Fosston, patients could continue to go to further locations, including Detroit Lakes or Fargo. This change could affect more than just the town.

“It’s the 15 other communities around us that are in the market of Essentia Health-Fosston,” said Heide. “We have to think about this area. We are rural. There are barriers for people.”

“This is non-negotiable,” said Fonder. “[Essentia Health’s] been this really good partner. But this is a line we can’t cross because it really becomes, if we bend in a contractual agreement for this core service, what’s next?”

The Fosston City Council voted to enter into mediation with Essentia Health at the meeting. They also authorized an investigation into any other possible breaches of their agreement with the healthcare provider. The mediation process can take place over the next 30 days. If no agreement can be reached between Essentia Health and the city, the next step would be arbitration.

If Fosston were to withdraw from their contract with Essentia Health, the provider would have 12 more months of service before no longer operating the hospital and returning it to being an independent hospital.