Mayo Clinic is closing its hospital and emergency department in the southwest Minnesota town of Springfield, citing troubles with recruiting patients and physicians to the medical center.

The hospital and ER, as well as clinics in the towns of Springfield and Lamberton, will close effective March 1, the clinic announced this week.

The closure in Springfield, which is about 125 miles southwest of the Twin Cities, is the latest example of how the Rochester-based health system has been consolidating health care operations across its network of hospitals and clinics in and around southern Minnesota. It fits with a national trend, as well, where more rural health care facilities are facing financial challenges.

"For the past several years, Mayo Clinic Health System in Springfield has experienced several challenges, including an inability to recruit and retain physicians, declining hospital admissions and extremely low use of the emergency department," the clinic said in a statement. "Despite robust efforts to implement a new care model in October 2018, many of those challenges remain, and the hospital and emergency department now face new concerns regarding future accreditation."

Minnesota has a proportionately larger number than other states of small critical-access hospitals in rural areas, but the latest financial data shows that many are struggling and that more than 30 meet the state Department of Health's definition of financially distressed. The most recent 2018 data for Mayo Springfield showed that it lost nearly $1.5 million that year and had a negative operating margin of 10.8%.

Mayo Clinic is Minnesota's largest private employer with a five-state network of hospitals and clinics. Mayo announced in August that it would close a clinic in La Crescent, Minn., and it moved labor and delivery this year from its hospital in Albert Lea to its Austin facility. In October, Mayo said it would close its clinic in the northeast Iowa town of Waukon this month.

In Springfield, the hospital thus far in 2019 has admitted nine inpatients plus another 28 patients for overnight observation, clinic officials say. They add that the ER has been seeing a daily average of three to four patients.

Part of the problem was staffing, as the Mayo Clinic hospital in Springfield had hired three search firms in the past five years to address physician shortages and financial losses. An attempt to transfer management to the Avera McKennan system in South Dakota fell through, so the hospital proceeded last year with a plan for all care to be provided by nurse practitioners and physician assistants with videoconferencing guidance as needed from Mayo doctors in Rochester and Mankato.

But the plan didn't stem the loss of patients, who have access to eight hospitals in a 38-mile radius around Springfield, said Dr. James Hebl, regional vice president of Mayo Clinic Health System, in a statement this week on the Springfield closure.

"There's only so many patients to go around," said Hebl, adding that the experimental care model and low patient numbers could have made it hard for the hospital to receive critical reaccreditation from the Joint Commission next year.

The closure will affect about 60 employees, the clinic says. Mayo says another health care group in Minnesota has expressed interest in working with Springfield to establish outpatient clinic services.

Hebl said he was proud that Mayo served Springfield for 22 years and that it would work with patients to find new sources of medical care. While closures aren't planned for other Mayo hospitals in southwest Minnesota, some of which also are posting negative operating margins, he said that rural hospitals throughout the state are facing a looming financial crisis that could result in more such actions.

"I think it may be a tipping point," he said.

Minnesota had seen the closure of only two rural general hospitals, in Pine City and Albany, in the past decade, though technically Mayo Albert Lea stopped being a stand-alone hospital because of its recent merger with Mayo Austin.

In a statement, the Minnesota Hospital Association said the Mayo closure is emblematic of statewide financial struggles for rural hospitals and of the need to reform rural hospitals in ways that attract doctors and maintain high-quality medical care.

"These concerns raise broader policy questions," said spokeswoman Wendy Burt, "about building, financing and staffing more sustainable models of care for all residents."

Christopher Snowbeck • 612-673-4744

Jeremy Olson • 612-673-7744