Slow Transfer To Nursing Homes Driving Avoidable, Unpaid Hospital Stays in Minnesota with $487M Price Tag

Bottlenecks at hospitals have mounted over the last year with long wait times for patient transfers to nursing homes – recent facility closures in the sector not helping the situation.

These persistent delays in discharges from emergency departments and inpatient care resulted in unnecessary hospital-level care and deep financial losses for hospitals because these delayed discharges are considered unpaid care. Such unpaid care has strained hospitals financially across the nation, with 12 hospitals entering bankruptcy last year. 

And a new survey released Wednesday – related to delayed hospital stays in Minnesota – reveals that these stays bore a heavy cost for hospital and health systems in the largely rural state. In fact, one in six days of hospital care were deemed unnecessary and unpaid, threatening access to care for patients across Minnesota, the survey showed.


“Minnesota hospitals have gone from being a safety net, to being a catch-all for patient care,” said Minnesota Hospital Association CEO and president Dr. Rahul Koranne. “This is a function they were never intended for, can’t afford, and isn’t good for patients. This gridlock is preventing Minnesotans from getting care that their lives depend on. Policy makers must act.”

Skilled Nursing News has reported that slow transfers to nursing homes and rehabilitation facilities due to an increase in shutdowns of facilities over the last year, have contributed to patients needlessly remaining at hospitals, and not just in rural states, but in New York as well. 

For Minnesota alone, hospitals provided 9,223 days of emergency department stays, with patients waiting for inpatient care, or simply brought to a hospital for lack of any alternative, the survey showed.


The latest survey, involving 101 hospitals, was conducted by the Minnesota Hospital Association, and it backs data collected by the Minnesota Department of Human Services in early 2023, which also pointed to a staggering number of unnecessary hospital stays. Together the two surveys represent an annual total of nearly 195,000 patient days of avoidable and unpaid care, costing Minnesota hospitals and health systems an estimated $487 million in unpaid care. Last year, the state agreed to provide funds to alleviate the situation, but it seems these weren’t enough.

“We are at a critical point,” Koranne said in the press release. “Our hospitals are facing immense financial pressure. We need real and immediate financial assistance from the legislature in the coming weeks to prevent further service or facility closures and to ensure access to quality health care for all Minnesotans.”

In Minnesota, 67% of the hospitals reported operating losses in the first half of 2023.

Meanwhile, the Minnesota DHS has already had three hearings on hospital service closures in January.

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