Ely Bloomenson Hospital

Read the linked Power Point presentation (see attachment) prepared by Mr. Fossum, the Administrator for the hospital and nursing home in Ely, MN.
Ely, MN is a small community located on the Canadian border in northeastern, MN. It is home to the famed Boundary Waters Canoe Area (BWCA) attracting tourists from around the world to the rugged camping and canoeing offered by the BWCA and the adjacent Canadian Quetico Park. Ely was settled by loggers and miners. Many of the families trace their lineage back five to 6 generations.
The once prosperous town has fallen on hard times. With changes in mining and manufacturing, the local mines closed or severely restricted ore production in the 1980s to current. The timber industry is highly regulated, employing few. The tourist industry is the fledgling promise to the community. Local outfitters have been limited as well due to regulations on how many canoeists and campers may enter the park every day. Further, the winters are rugged and cold leaving few tourists to visit from October through April.
The Ely Bloomenson Hospital opened in 1958 replacing the Shipman Hospital. The hospital is community owned. In addition, there is an attached skilled nursing facility. Further, there are many levels of apartments for older adults on the campus setting and the addition of assisted living in 2008. Skilled nursing facilities are very expensive to operate. The power point presentation provides some real statistics to consider.
As Medicare legislation changed, the hospital became a Critical Access Hospital (CAH). CAH designation is very profitable to these hospitals. However, while CAH legislation is beneficial to the hospital side of business, it does cause the nursing home to become a losing proposition.
The community is growing older with each day. The SNF is full with a waiting list. However, the SNF is losing money everyday with a sense of dread by hospital officials. However, like the hospital, it is community owned. This SNF serves the community well and has for the last 50 years.
Some issues: the organization did reduce the number of SNF beds in 2008 to make room for an onsite medical office practice and to try to reduce the losses. However, the losses continue while the community is angered by the lack of needed SNF space for a loved one.
The SNF staff is unionized. It is difficult to negotiate wages, etc with this staff. The organization feels labor costs are out of control. The union is unwilling to negotiate. Even when SNF beds were closing, the union stood firm. The assisted living, however is not unionized and is able to staff.
The adminstrator is advocating to close the SNF.
The community is in an uproar! It is a community owned and operated facility. The beds are full. Where will the patients go? (The nearest SNF is 65 miles away and is also full).
What do you recommend?

Feel free to complete your own research into this issue. There are two local newspapers; the Ely Echo and The Timberjay. Each has covered this issue.