ALBERT LEA — The debate about impending changes at Mayo Clinic Health System's hospital in Albert Lea could soon enter the legal realm.

Freeborn County Attorney David Walker told First District Congressman Tim Walz, D-Mankato, Monday that he's been in contact with Minnesota Attorney General Lori Swanson's office about potential anti-trust concerns related to Mayo's plans to consolidate hospital services at its combined Albert Lea and Austin campuses.

Walker sent his initial letter to Swanson's office July 25 and said he's since shared various documents with Swanson's staff. The Post Bulletin received a copy of Walker's letter, which asks Swanson's office to consider "the possibility that this situation may involve anti-competitive practices" in order to stop the "hospital from down-sizing and ultimately closing."

At issue is whether Mayo made any contractual promises to maintain services since acquiring Albert Lea's hospital in 1995. Mayo has acquired numerous rural hospitals across the state since the 1990s and has reduced services at several in recent years, including Saint Peter, Fairmont, Lake City, Wabasha and Madelia.

"I sent a letter and have spoken with the assistant attorney general," Walker said prior to Monday's meeting with Walz. "They are considering and researching it. I wouldn't call it an investigation, but looking into it is the right way to put it.

"I'm certainly not in the position to say Mayo is doing anything improper, but I think it's very important for us to find out."

Mayo declined comment on Walker's inquiry to the AG, though spokeswoman Joan Gordon noted Mayo had provided all of the requested data to Walker as of Monday morning; Walker confirmed receipt of the documents.

In a crowded event at Albert Lea City Hall on Monday, where many speakers and spectators were sporting the "Save Our Hospital" slogan, Walz pledged federal support of Walker's inquiry by way of the U.S. General Accountability Office. His announcement prompted cheers.

'A punch to the gut'

Walz, who is also running for Minnesota governor, repeated his criticism of Mayo's lack of communication, noting infrastructure budgets are often set decades in advance and often revolve around the needs of local hospitals. He and state Rep. Peggy Bennett, R-Albert Lea, said they were not made aware of Mayo's plans before the June 12 press release, a statement previously made by members of the Albert Lea School Board, Albert Lea City Council and Freeborn County Board, and citizens.

All three local governments have approved unanimous resolutions opposing Mayo's plans. On Monday morning, the county boards in Worth and Winnebago counties, just across the Iowa border, approved similar resolutions.

Albert Lea City Manager Chad Adams told Walz that Mayo's decision "blindsided" local residents due to lack of public dialogue and disclosure. Mayo has since explained that financial losses, staffing concerns and a desire to create efficiencies played a role in its decision.

Mayo was not invited to attend or participate in Monday's discussion, though Walz met with MCHS-Albert Lea and Austin CEO Mark Ciota shortly after telling the crowd that "trust is strained." The Albert Lea Tribune reports that Walz suggested that Ciota and Mayo "really rethink" moving forward on the current timetable.

Following the two meetings, Walz published a letter that he says will be sent directly to Mayo Clinic President and CEO John Noseworthy.

"Mayo's failure to fully and proactively engage the Albert Lea community on this decision is disappointing," Walz wrote. "Hospitals — like our schools and small businesses on Main Street — are the lifeblood of rural America and small towns. A partial closure of a hospital, regardless of the logic used to justify it, feels like a punch to the gut."

Mayo provided this statement responding to Walz late in the day Tuesday:

"We value open communication with Congressman Walz on a wide range of issues. We appreciate his visit to our Albert Lea campus on Monday to see firsthand the challenges Mayo Clinic Health System in Albert Lea and Austin — like all rural hospitals across Minnesota and the nation — are facing regarding recruitment and retention of physicians and the dramatic impact of the change in health care from inpatient care to outpatient care delivery.

"Mayo Clinic received a letter from Congressman Walz regarding upcoming transitions of inpatient services between Albert Lea and Austin following his visit. The congressman reaffirmed his appreciation of the work of Mayo Clinic and our dedicated employees, and reinforced his 'long and frank working relationship' with Mayo. We respect and value Congressman Walz’s service to all his constituents, and his engagement in the work ahead to strengthen rural health care.

"These are not easy issues. We are confident that, as we work together with the people of Albert Lea, these changes will strengthen the Albert Lea campus and protect jobs. We are committed to work more closely with the community in facing the challenges of rural health care now and in the future. We are confident that patients will continue to have access to high quality patient care that in both Albert Lea and Austin and that Mayo Clinic Health System will remain an integral contributor to the health and economic vitality in both communities."

Plans proceeding unchanged

While it remains to be seen if Walker's inquiry will warrant a full investigation or Walz's criticism will gain traction, criticism abounds. Minnesota Nurses Association President Mary Turner, who represents 125 nurses in Albert Lea, and SEIU Executive Vice President Lisa Weed, who represents 85 more, both criticized Mayo's lack of transparency.

However, it appears unlikely that the public pushback will impact Mayo's plans — barring legal action.

MCHS Vice President Dr. Bobbie Gostout declined multiple requests to alter plans last month and three employees in Albert Lea were informed last week of their impending layoff due to transition plans. According to the Tribune, Ciota also told Walz there are "clear indications" that Mayo's plans remain unchanged.

Mayo's Gordon said Monday that rumors of an altered timeline — pushing transition plans forward in response to criticism — are untrue. Mayo officials have previously refuted estimates of 500 lost jobs from MNA, but multiple speakers said concerns persist.

"Of course we're worried about job loss," said Angie Obermeyer, Albert Lea's MNA rep. "Everyone on campus is (scared). With the hospital slated to become a skeleton of what it currently is … Albert Lea will be the only community of our size (in Minnesota) without a full-service, acute care hospital."

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