BISMARCK, N.D. — Garrison Memorial Hospital sees 1,400 to 1,500 people in its emergency room annually. That is up about 20 percent over the last three to four years.
Tioga Medical Center patient numbers have increased fourfold, from 6,000 patients in 2010 to more than 24,000 today.
To meet this new demand, investments are being made in rural health care across the state, in areas where those facilities are the only medical care available for miles around.
“We’re the only hospital on (U.S. Highway) 83 between Minot and Bismarck,” Garrison Memorial Hospital Administrator Tod Graeber said. “Because we’re so far away from the larger cities ... with strokes or heart attacks people may not survive.”
The U.S. Department of Agriculture alone has invested more than $178 million in 42 projects since 2009.
“Our medical facilities are the foundation of our communities and critical components to supporting population and industry growth,” said Jasper Schneider North Dakota’s USDA Rural Development state director.
Alan O’Neil, the chief executive officer at Unity Medical Center in Grafton has been involved in three USDA-funded projects during his health care career — for the Jamestown Regional Medical Center, Richardton and Aneta.
“It’s always a challenge because we don’t have the critical mass or volumes,” O’Neil said of finding funding for rural health care projects.
He said without USDA funding, the $46 million loan for the new Jamestown Regional Medical Center would have been difficult.
“I think USDA is a very viable option,” he said
In Garrison, to accommodate the increase in patients, the hospital is using a $300,000 USDA grant it received in 2013 to expand its emergency room from two beds to four and upgrade equipment like defibrillators, cots and CPR devices.
Without the grant, Graeber said, the hospital would have had to use municipal bonds for funding.
Garrison is a big recreation area and Graeber said in the summer the hospital can get really busy. The expansion will reduce wait times.
In addition to better patient flow, O’Neil said the Jamestown project helped the hospital recruit staff as well as patients.
“Health care is a cutting-edge industry. New and improved is what people are looking for,” he said. “It’s a proven fact that new facilities enhance the ability to recruit professionals.”
Since the upgrade, Jamestown has been able to attract a new radiologist and add orthopedic services. It has a state-of-the-art maternity ward that delivers 400 babies a year, O’Neil said.
Graeber agreed, saying he has been able to maintain a full nursing staff because of the upgrades rather than struggling to hire like other facilities. Garrison Memorial Hospital is the largest employer in town with 155 on staff.
“And they’re usually good-paying jobs,” Graeber added.
O’Neil said overall, he thinks rural health care in North Dakota is good and smaller facilities are able to collaborate with larger ones through telemedicine.
In 2010, St. Alexius Medical Center received a $158,000 USDA grant to expand its telemedicine network to connect to 22 rural medical facilities, including those like the Garrison hospital in McLean County.
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Where O’Neil thinks the USDA could offer more improvement is through updating aging facilities in the state. He said many facilities in rural North Dakota are older than the national average.
“That’s an opportunity for USDA to be a partner in funding capital projects, he said.
USDA does that through several funding methods, including loan and loan guarantees for community facilities in towns with populations of 20,000 or less; zero-interest loans and grants given to utility companies, which in turn pass that money on to local projects; loan guarantees for businesses in communities with populations of 50,000 or less; and telemedicine loans and grants for communities with populations less than 20,000.
Other current USDA funded projects in the central and western parts of the state include:
A $15 million loan to build a new Southwest Healthcare Services hospital and clinic in Bowman.
The 60-year-old facility provides care to a population of 3,200 people.
The facility is now too small and is inaccessible due to design, according to a USDA report.
The new facility will be double the size at 59,000 square feet. It will be attached to the existing long-term care facility, combining all services in one central location.
There will be more emergency rooms and new equipment. The nursing home will be remodeled and include a new memory care unit.
Southwest Healthcare Services employs more than 180 people and plans to hire more after construction is complete.
An $8 million loan for the construction of a new Tioga Medical Center clinic.
The current Tioga clinic sits at the bottom of a 100-foot grade from the hospital. The location down the hill has caused water damage and has made it difficult to transfer patients, according to the USDA report.
The new 15,000-square-foot clinic is slated to be finished in 2015 and will be attached to the existing hospital.
The Tioga Medical Center is the fourth largest employer in the area, only coming in behind three oil field companies.
A $39.3 million loan for the construction of a new 79,200-square-foot McKenzie County hospital and clinic, which has experienced increased patient loads from high risk workers in the oil field.
The facility will be on the same campus as the existing long-term care facility. The project also will expand the facility by 25,500 square feet.
A $5.5 million loan for construction of the new Richardton Health Center.
The project includes 19,000 square feet dedicated to a 24-bed nursing home and 3,000 square feet for a new clinic.
The current occupancy rate at the nursing home remains at 95 percent or higher with a waiting list. The new facility will include four extra rooms and will bring the nursing home under the same roof as the clinic.