For 56 years, Rainy Lake Medical Center has kept a simple promise to the Borderland: our doors are open to everyone, no matter what. We’re nonprofit and community owned. We have no shareholders — just patients. Every dollar we earn goes back into care here.
That promise is under strain across Minnesota, and patients are feeling it. This month, hospital and health system leaders released A Statewide Crisis of Care, a report that puts the pressures in one place. Emergency departments had 2,111,832 visits in 2024 — the most ever. Only 48 of Minnesota’s 98 rural hospitals still deliver babies. Minnesotans are traveling farther, getting less and paying more for care that used to be close to home.
Here in International Falls, we’ve worked hard to bring as many healthcare services as possible to our community so patients and their families don’t have to travel 100 miles or more to receive care. Whether it’s expanding surgical services, bringing specialists into our community, or maintaining access to emergency care around the clock, our goal has always been to keep care close to home. For rural families, traveling for healthcare isn’t just an inconvenience. It means time away from work, additional expenses, difficult winter driving conditions, and the added stress of being far from home when someone is sick. Every service we can provide locally makes a meaningful difference in the lives of the people we serve.
The reasons behind this crisis are not difficult to understand, but the challenges are especially significant for rural hospitals like ours. As a Critical Access Hospital, Rainy Lake Medical Center receives cost-based reimbursement from Medicare for many of our hospital services. That provides an important level of financial protection, but it doesn’t mean Medicare covers every expense or that our organization is insulated from rising costs. Medicaid reimbursement remains a challenge, and the cost of medications, medical supplies, staffing, and maintaining our facilities continues to climb.
Across Minnesota, the cost of delivering hospital care increased 30 percent between 2019 and 2024. In 2024, more than one in four Minnesota hospitals lost money providing care. For a rural hospital, the challenge is compounded by the need to maintain essential services around the clock, even when patient volumes are low. We still need qualified nurses, physicians, emergency services, laboratory and imaging capabilities, and the equipment necessary to care for our patients, whether we see five patients or fifty. Those expenses don’t disappear simply because we serve a smaller population. And with federal changes to Medicaid financing beginning in 2027, the financial pressures facing rural healthcare are likely to become even more difficult to manage.
We’re doing our part. At Rainy Lake Medical Center, we’ve worked hard to operate responsibly while continuing to invest in the services our community needs. We’ve maintained positive
operating margins year after year, expanded surgical capabilities, brought additional specialty care closer to home, strengthened physician recruitment, and made changes to how we deliver care to improve both efficiency and patient access. We’ve accomplished this while facing many of the same financial and workforce challenges affecting rural hospitals across Minnesota.
But financial responsibility alone cannot solve the larger problems facing rural healthcare. We can manage our expenses, improve operations, and find creative ways to deliver services, but we cannot control the cost of medications and supplies, eliminate the expense of maintaining 24-hour emergency services, or change how government programs reimburse us. We’ve demonstrated that a rural hospital can be well-managed and financially responsible, but survival and long-term sustainability are two very different things. No hospital, regardless of how efficiently it operates, can solve these challenges entirely on its own.
This isn’t about politics. Our emergency room doesn’t see Republicans and Democrats. It sees neighbors. Keeping care close to home in International Falls will take patients, caregivers, community leaders and lawmakers working together, with common purpose.
I invite you to learn more at protectmnpatients.org — and to ask everyone who wants to represent us how they’ll help keep care close to home.
Robert Pastor is CEO of Rainy Lake Medical Center in International Falls, MN.
Rainy Lake Medical Center in International Falls, MN