Mayo Clinic announced Friday that it will shutter its primary care clinic based in La Crescent, Minn., this fall and consolidate its health services with nearby providers.

Starting Nov. 22, the southeastern Minnesota clinic will begin referring patients to Caledonia, Minn., or across the Mississippi River to La Crosse and Onalaska, Wis.

"This was a difficult and well-considered decision. We are exploring ways that we can provide health care services more efficiently and effectively while being good stewards of our resources," Michael Morrey, regional chair of administration for the Mayo Clinic Health System in northwestern Wisconsin, said in a statement.

Morrey insists that centralizing the practice offers patients expanded access to specialty care. Staff members have already been notified of the change and Mayo officials say they hope those employees stay with the company. It's unclear whether the move will result in layoffs.

The announcement comes at a time when rural hospitals across the nation are increasingly under financial distress, resulting in many closing. Many in Minnesota have stayed open because of a wave of mergers with larger health care organizations, along with aggressive use of federal subsidy programs, health officials say. But staying open can mean tough choices, including cuts that can backfire if they upset patients who then go elsewhere for care.

Mayo Clinic faced an uproar when it announced in 2017 that it would halt inpatient care and surgeries in Albert Lea, Minn., as part of a consolidation with its nearby hospital in Austin, Minn. Mayo argued that keeping both facilities as they were resulted in costly redundancies.

Staff writer Jeremy Olson contributed to this report. Liz Sawyer • 612-673-4648