United Health District Steps Up to Close the Rural Healthcare Gap 

In the heart of southern Minnesota, the United Hospital District (UHD) and Clinics are taking significant strides to provide crucial healthcare services to rural residents. Since 2015, under the leadership of Chief Executive Officer Rick Ash, UHD has remained committed to addressing the healthcare needs of rural communities facing challenges. 

“These communities are shrinking,” he said. “Kids are moving away to larger cities and not as many people are relocating to these small towns. You have to have a certain amount of need to keep the doors open, and we’ve worked extremely hard to keep healthcare local. We’ve been fortunate to grow it, rather than have lost it. That’s what it’s all about.”  

With locations in Blue Earth (including a clinic and a 25-bed hospital), Fairmont, and Wells, UHD provides essential and specialty care to residents in Martin and Faribault counties, as well as northern Iowa. The organization, which consists of more than 25 physicians and advanced practice providers, and more than 240 employees, also offers home health and hospice services.  

UHD’s history dates back to 1886 with the establishment of Smart Hospital. Registered as a district hospital in 1966 and transitioning to a 501(c)3 not-for-profit in 2013, UHD’s journey highlights the community’s commitment to solving healthcare challenges collaboratively. This shift to a not-for-profit structure enabled UHD to access funding sources previously unavailable. 

“Like most things in rural communities, there was a need for healthcare and the community worked together to figure out how to solve the problem,” Ash said of UHD’s history. “Switching to a not-for-profit has allowed us other opportunities in the healthcare environment that we didn’t have access to, like funding sources.” 

UHD’s impact is evident in its impressive annual statistics: nearly 40,000 clinic visits, 5,000 emergency department visits, and a substantial growth in general surgery and obstetric deliveries, with a remarkable 17% increase in childbirth deliveries since 2019. 

“One of the things we’re committed to do, which can be difficult, is keeping baby deliveries in our community,” Ash said. “All across the United States, and even here in Minnesota, we’re seeing rural hospitals close their obstetrics departments. Then, when it comes time for delivery, a mother may be driving an hour or two, if not more.” 

Ash said United Health District is committed to making sure their providers are trained and supported in all areas so the coverage patients need is available. 

“Recruiting providers in the United States is hard, and Minnesota is not immune to it, and it’s getting more difficult,” he said. “At UHD, we focus on creating a culture of family with a focus on patient care.” 

The management team at UHD places strong emphasis on promoting the healthcare system as a place where people want to work, Ash said.  

“There are a lot of amazingly smart and talented healthcare professionals out there and we’ve been very fortunate to have so many here,” he said. “At the end of the day, we want to be a place where our employees can feel good about going to work and having a purpose.” 

In Ash’s eyes, healthcare is about family and taking care of neighbors and loved ones whether it’s in the town you live, the neighboring town or the next county.  

“We build on that model and it’s helped on recruitment and retention,” he said. “At the end of the day, it’s the people that are providing the care that are making this difference. If we don’t have good people, you don’t have good care. I’m most proud of that here. Our healthcare workforce, providers, staff and nurses are all amazing. We are so blessed to have passionate people who care about what they do to make sure the care they provide is a good as it can be.” 

“For us, it’s about being able to serve our communities,” added Chief Nursing Officer, Melissa Storbeck, RN. “Faribault County has one of the lowest income levels in the state and travel can be quite difficult for some people. The ability to get healthcare shouldn’t be limited to having to travel somewhere. We have a significant elderly population and, a lot of times, they don’t want to travel outside of their community because it can be scary and cumbersome for them.” 

A point of focus for UHD is primary and essential care so that residents are able to get their care needs met right in their own backyard. This is a different approach than many metropolitan areas.  

“In specialty clinics, everyone has their own discipline and areas of focus,” he explained. “In a rural area, like we are, family medicine has a much larger scope and our providers see people from birth to their end-of-life journey and everything in between. You’re not going to get that in larger areas.” 

Ash said UHD’s providers are ones that have specific interest in practicing medicine in rural areas because it allows the provider to utilize more of their trainings and expertise.  

“The providers see their neighbors on Main Street, or at a coffee shop or church,” he said. “It’s not like they’re going into an exam room and potentially never seeing this individual again. They are building relationships on a much larger continuum. It improves, I believe, the accountability and passion for wanting to make sure the patient’s experience is the best it can be.” 

The providers at UHD have a strong commitment to rural medicine, echoed Storbeck.  

“When you live in a small town and work in a small town, you have to be comfortable going to the grocery store and running into your patients,” she said. “All of our providers truly have a passion for taking care of the rural community.” 

UHD places value on providing access to appropriate specialty care for patients with services that they can’t offer on-site. Maintaining relationships with larger tertiary care centers has allowed their patients access to services from The Orthopedic and Fracture Clinic and Minneapolis Heart Institute, among others including the Mankato Clinic, Allina Health Systems, Madelia Hospital, Mercy One, and Sanford.  

“We strive to maintain relationships with other facilities so when our patients do need care that we can’t provide, we can send them where they do need to go,” Storbeck said. “We are an in-patient hospital and outpatient clinic with a home health hospital agency in town, so we truly span the lifetime of our patients.”  

Through these partnerships, UHD is able to offer specialist services to patients, including Ear, Nose and Throat, cardiology, mental health, pain management, sleep studies, allergy and asthma and ophthalmology.  

“Several years ago, we started working with ENT (Ear, Nose and Throat) folks out of Mason City, Iowa, who utilize a new sleep apnea technology that is an implantable device under the skin in the upper part of a patient’s chest that will monitor breathing,” Ash explained. “If the device feels breathing is getting restricted, it can provide a wake-up call to those muscles that are collapsing.” 

The device allows for the reduction of a typical CPAP or BIPAP mask that a patient with sleep apnea uses.  

“These are the types of services we can provide onsite that used to not be an option,” he said. “Before, our patients would have to drive 40-100 miles to the next provider. That’s what we’re focusing on; keeping things local.” 

In addition to expanding specialty services, UHD offers general surgery, which provides the community with a service that is uncommon in rural areas. 

“No one wants to be transferred via ambulance if they don’t have to be,” Ash said. “During one of our last remodeling projects, we added a heliport. God forbid if there is a trauma or whatever the case may be, we can get a helicopter here in 20-30 minutes and we can get our patient to Rochester, Minneapolis, Mason City, or Sioux Falls.” 

The Emergency Department in Blue Earth is staffed primarily by board certified emergency room physicians and advanced practice providers, Ash said. Through their relationships with other medical facilities, UHD’s Emergency Department is able to offer telehealth for stroke assessments and psychology services.  

“If someone comes in presenting with a mental health situation, there’s a provider available 24/7 that can do an evaluation and see what we need to do, whether it’s further care, monitoring or out-patient care,” he said. “We’re working hard to bring services like that to United Health District to make them more readily available for the community.” 

UHD has also expanded their resources to offer pain management services, which began a few years ago and has proven to be successful. With the help of a Certified Registered Nurse Anesthetist, UHD works with patients to reduce pain with the use of limited or reduced medications, especially ones with more addictive traits.  

“We’ve seen that our pain management practice has greatly improved quality of life for patients and it helps keep their health care costs down,” Ash said. “It’s been such a need in the community and we didn’t appreciate it until we saw how many people have been able to benefit from it.” 

Results from a Community Health Needs Assessment a few years back identified that mental health was a growing concern to UHD patients, Ash said. UHD used those results to grow their mental health services, and currently has three mental health providers on staff.  

“It gets back to what our community needs and us asking what do we need more of or what gaps exist,” Ash said. “We’re just starting the assessment process again for another three-year cycle and we’ll go back and look at what we’re successful with and what do we need to do differently.”  

Ash said that what UHD is doing isn’t “secret sauce,” rather it’s the old saying that if you provide a great service, people will beat a path to your door.  

“We are providing local care by people that you know and trust, and the rest will help take care of itself,” he said. “If you’re not taking care of your people, nothing else will be effective.” 

UHD, Inc. Foundation  

As a nonprofit, independent organization, much of UHD’s revenue is bookmarked for maintaining operations. To be able to invest in technology, services and facilities, UHD also has the UHD, Inc. Foundation, which Ash said is critical when it comes to the viability of a rural healthcare service.  

“Our foundation is a vehicle for community members to be a part of what’s important for them, and for a lot of individuals, it’s healthcare in their towns,” he said. “People are able to donate for this area or that and it helps us in so many ways. It’s a touch point for the community to directly impact the health care that’s provided for them.” 

Most recently, UHD, Inc. Foundation evaluated the nationwide healthcare shortage and embarked on a plan support future doctors and nurses with aid from the foundation in terms of scholarships, tuition reimbursements and stipends.  

“It’s still in the beginning stages, but we think it will be a great opportunity,” he said. “It’s a great way for people to come back to our community to live, and I think it will help with recruitment and retention. We’re excited that it’s coming together and I think it’s a win-win.” 

To get in front of potential healthcare providers, UHD’s Foundation is also stepping up its game among high school students by providing a High Step Health Science Academy for juniors and seniors.  

“In essence, we’ve been seeing our kids and young children growing up, going to college, going into the workforce and careers in healthcare, leaving the community and not coming back,” he said. “The reality is that many people would like to live or work near the community they grew up in, so our goal is to support that as much as possible.” 

Through the High Step Health Science Academy, students spend one hour per week for two semesters at UHD, learning about a different medical topic each class and taking tours of different areas of the clinic. Topics include safety practices, teamwork and leadership in healthcare, employability skills, healthcare communication and healthcare career exploration. 

“This opens up their eyes and maybe puts a little more sight, taste and smell about what the healthcare industry is like and spikes their interest,” Ash said. “With the foundation, we can work with those individuals who are coming out of their education and want to be in the healthcare field.” 

The growing need of rural healthcare

According to the Centers for Disease Control and Prevention, 15% of all Americans (46 million people) live in rural areas, which puts them at greater risk of death from five leading causes than urban Americans: heart disease, cancer, unintentional injury, chronic lower respiratory disease and stroke. Residents in rural communities also have a higher rate of obesity and diabetes, and are at greater risk of fatal car crashes, suicide and drug overdoses.  

Rural residents can keep themselves healthy by being physically active, eating healthy foods, not smoking, wearing a seatbelt, and seeing their health care provider regularly, which is where UHD aims to make things easier for rural residents.  

“Everybody deserves quality healthcare,” Ash said. “Just because you live in a rural area doesn’t mean you deserve less. Healthcare is a basic human need. Living in a rural area doesn’t mean you should get less care. That’s our mission. Our challenge is to keep as much care close to home as possible. We have to prioritize and we work hard on that, and I think it shows.” 

Services offered at UHD 

• Ambulance Services 
• Allergy and Asthma 

• Anesthesia 
• Cardiology 
• Diagnostic Imaging  
• Diabetes Education 
• Dietician Services 

• Ear, Nose and Throat 
• Emergency Care 
• Home Health and Hospice 
• Inspire Therapy 
• Mental Health 

• Nutrition Counseling 
• Obstetrics 
• Occupational Therapy 
• Ophthalmology 
• Orthopedics 

• Pain Management 
• Pathology 
• Physical Therapy 
• Same Day Appointments 
• Sleep Studies 

• Speech Language Pathology 
• Surgery 
• Urology 

 

Contact Information 

United Hospital District 

515 S. Moore Street 

Blue Earth, MN 56013 

Phone: 507-526-3273 

Web: uhd.org 

Facebook: @uhd.org