Competition is expected to heat up between two regional healthcare providers after Marshfield Clinic Health System (MCHS) announced plans to build a hospital with a projected cost of upwards of $35 million at its Minocqua facility.
Opening volleys came at Tuesday’s Minocqua Plan Commission where officials from both Marshfield Clinic and Ministry Howard Young Medical Center (HYMC) made their case for and against issuing a conditional use permit for the facility. In addition to those officials, there were about 50 people in the audience, the vast majority being Marshfield Clinic employees.
Mindful of Ministry Northern Region Hospitals President Sandra Anderson’s presence at the meeting, Dr. William Melms, regional medical director for Marshfield Clinic, said this: “There will be in this room some distracters, as I would expect. The problem with innovation and competition is that it does go against the status quo. The status quo fears innovation. “There will be people that will call this duplication,” Melms continued. “When you do something and you do it better, then that’s not duplication. That’s innovation.”
MCHS wants to build a 72,000-square-foot hospital adjacent to its current clinic and ambulatory surgery center located at 9601 Townline Road. It would include a surgery center, 12 in-patient private beds, emergency room, imaging and lab. The Marshfield Clinic hospital will compete with nearby Ministry HYMC, which has a 44-bed hospital, emergency room, birthing center and related services.
Anderson laid out her opposition to granting MCHS a conditional use permit to build the hospital, including what she called duplicate services and in a community that is not growing in population. “I want to ask you to respectfully be thoughtful in your consideration about the implications of having a second hospital in Minocqua and what they may do to the overall destabilization of healthcare in our community as we know it,” she said to commissioners. “To have two hospitals, when we already at Howard Young have excess capacity for room – we have, still, a closed fourth floor – doesn’t make a lot of sense. “Simply put, we are duplicating infrastructure, equipment, services, medical professionals. It won’t enhance the continuum of care. It’s going to fragment them and increase costs.”
Ministry-Howard Young attorney Tim Feeley argued that the county zoning ordinance prohibits taking up a CUP application for similar projects within one year of denial. Last year, the county board of adjustment denied the CUP application requested by Marshfield Clinic for a 12-bed skilled nursing facility. He said the county zoning language does not mention allowing hospitals in a District 07 Business B-2 zoning district. The plan commission postponed any action, setting up a special meeting Feb. 14 to receive more detailed plans.
Oneida County Planning and Zoning Administrator Karl Jennrich told commissioners his department just received the plans Jan. 24 and have not had time to study them fully. While zoning language doesn’t directly address a hospital in District 07 Business B-2, he said, there is precedent for that allowance. Nor did he think the previous skilled nursing facility and the hospital CUP requests were similar. He said the helipad should be included in this CUP application. The vehicle parking numbers “look pretty good,” he added. The proposed hospital site is not in a flood plain. The commission wants more details such as the building’s elevation figures, impact on the Lakeland Sanitary District, and the helipad before making a recommendation to the town board, which meets Feb. 21. The town board will send its own recommendation to the county.
A public hearing would be set on the CUP application. Assuming the county approves the conditional use permit fairly quickly, MCHS hopes to begin site preparation this spring with completion in under 10 months, said Melms. The hospital could begin admitting patients by January or February of 2018. As outlined, the hospital would be a steel frame structure attached to its current clinic and ambulatory surgery center. It is being designed to last a minimum of 50 years, said Tim Sessions, chief project architect with the architectural firm BWBR, with offices in Madison and St. Paul, Minn. As with the Clinic building, it would have a “Northwoods feel,” he said. “This building is expandable,” said Melms. A second story can be added when the need for it arises, or it can be expanded horizontally. The adjacent three-story Minocqua Clinic is over 100,000 square feet. The hospital will have a birthing center. The clinic’s ambulatory surgery center would be relocated to the hospital. Melms said helicopter service is essential for rapid transport of patients in remote areas such as Minocqua.
Marshfield Clinic anticipates adding 40 to 50 new staff, mostly in support roles. Melms said there could be some physicians added, depending on their specialty. Their staffing of Howard Young could change, he added. Anderson said later that Howard Young would recruit physicians if the other hospital were built. The proposed hospital and current clinic are both within the Lakeland Sanitary District. In addition to Town of Minocqua and Oneida County reviews, the state Department of Natural Resources would have to sign off on the hospital’s stormwater management plan. The hospital would be open 24 hours a day, 7 days a week. After the meeting, Melms said the $30-$35 million project cost would include all equipment such as for the surgical room and imagining apparatus.
Town Chairman Mark Hartzehim wondered about the tax status of the Marshfield Clinic once the hospital is built, and whether Marshfield Clinic would make payment in lieu of taxes on the hospital, which is exempt from real estate taxes. “That’s an issue we will work through,” replied Dan Kirschnik, Marshfield Clinic’s assistant general counsel. More than 70 physicians providing primary, urgent care and a variety of specialties including medical oncology and hematology services staff Marshfield Clinic’s Minocqua Center.
Marshfield Clinic employs most of the physicians who practice at Howard Young. MCHS also owns Lakeview Medical Center in Rice Lake and is partial owner of Flambeau Hospital in Park Falls, and has 52 of what it calls community care centers. It is also building a 44-bed hospital in Eau Claire and recently acquired a hospital in Marshfield. Ministry operates 14 hospitals across Wisconsin, including the Woodruff hospital, Ministry St. Mary’s Hospital in Rhinelander, Ministry Eagle River Memorial Hospital, and Ministry Sacred Heart Hospital in Tomahawk.
Built in 1977, Howard Young Medical Center joined Ministry Health Care and the Sisters of the Sorrowful Mothers in 2001. St. Louis-based Ascension Health acquired Ministry Health Care last year.
