Gail Millette has visited United Hospital’s infusion center since it opened in 1999, relying on regular infusions of calcium and magnesium — and sometimes lengthy blood transfusions — to stay alive. Those visits, at least twice a week, have made all the difference for Millette, 66, of St. Paul, who had her overactive thyroid removed as a teen.
After this week, she and other United Hospital patients who receive regularly-scheduled transfusions, long-acting injections for mental health disorders or other infusion-based therapies will have to look elsewhere for care.
On Friday, United will close the doors to its primary infusion center outside downtown St. Paul, shuttering the metro area’s only infusion center dedicated to non-chemotherapy patients. The decision comes two years after a similar closure at Abbott Northwestern Hospital in Minneapolis, which also is run by Minneapolis-based Allina Health.
Given “bumping rights” under organized labor contracts, the five nurses dropped from the infusion center will be relocated to other departments within the hospital, forcing lay-offs of nurses with less seniority.
For United, it will mark the second departmental closure and the second round of nursing lay-offs in recent months. On July 25, the St. Paul hospital closed its pain center in a move blamed on “provider shortages,” dropping seven nurses while forcing patients to seek out alternative sites for critical pain management.
The St. Paul-based infusion center serves some 20 patients per day, with appointments booked at least two or three weeks in advance, according to impacted employees, who say Allina — which oversees 12 hospital campuses in Minnesota and western Wisconsin — just recently issued widespread notice to patients this August that the department is shutting down in a few days time.
A cost-driven consolidation
Allina Health has sought to reassure patients needing intravenous medicines and fluids that they can still receive services at two more specialized clinical sites on the United campus, or at Allina’s rural clinics and hospitals. Nurses employed at the infusion center point out, however, that those sites are already overloaded by patient demand or lack the full range of services available at United.
“Most of the infusion centers don’t have a pharmacist on staff, so they couldn’t take me,” said Millette, who needs a pharmacist to mix the cocktail of calcium and magnesium that’s pumped into her body. Her blood transfusion appointments can take up to five hours, making travel time an added concern.
“When they so cavalierly suggested ‘you can just go to Minneapolis, or to Crystal, or Coon Rapids,’ well no, I live in downtown St. Paul,” Millette said. “The mental health patients who aren’t always medically compliant with their meds, what are they going to do? Some of them will probably end up being less compliant. And that’s really sad.”
Hospital management has described the infusion center’s closure as a cost-driven consolidation, noting that the United Hospital campus will continue to offer infusion care at both the Allina Health Cancer Institute and the Allina Health United Medical Specialties Clinic Infusion Center, which is located within the Nasseff Specialty Center on Smith Avenue.
The hospital system suffered significant operating losses in 2022 and 2023, but made a $344 million turnaround last year, according to Becker’s Hospital Review.
“As part of this consolidation … Allina Health will help patients transition their care to two remaining infusion centers at our United Hospital campus … or another Allina Health infusion center in the metro area,” said a spokesperson for the health system, in an email last week.
“We are grateful for the excellent care our compassionate care team members have provided for our patients,” the email went on to say. “We will work with impacted care team members to find other positions within the Allina Health system.”
Nursing staff have said United’s Cancer Institute and Specialties Clinic infusion centers are both short-staffed. Both sites have referred patients to the hospital’s primary infusion center on a daily basis, especially for rheumatology infusion services and other non-chemotherapy treatments, according to staff.
“United Medical Specialties was sending their patients to us because they didn’t have the staff,” said a nurse at the infusion center, who asked not to be identified as they are not authorized to speak on behalf of their employer. “We were taking patients for both those sites and were booked out for weeks.”
Abbott Northwestern dropped its infusion center in 2023
In a previous consolidation, Allina shut down the infusion department at Abbott Northwestern Hospital in Minneapolis in October 2023, giving patients less than a month to locate alternative sites. At the time, United Hospital was the closest option available outside of the Abbott Northwestern campus, but that will no longer be the case Friday.
Erin Moriarty, a spokesperson for the Minnesota Nurses Association, released a written statement on Tuesday calling the latest closure a threat to patient care. She noted that Allina has cut staffing level in hospitals and outsourced some services while taking in hefty revenue from a laboratory services venture with New Jersey-based Quest Diagnostics, as well as other partnerships with for-profit companies such as UnitedHealth Group.
“The closure of the Abbott Infusion Center left patients scrambling to find care, with less than a month’s notice,” Moriarty wrote. “Many of those patients transferred to United’s infusion center and will now be forced to make yet another transition. This closure also leaves the metro area without an infusion center dedicated to non-chemo patients.”
Nurses also fear that Allina infusion centers based in rural locations such as Hastings, Lakeville and Faribault may not be well positioned to absorb such a wide range of referrals and patient demands, or be ready to balance treatment for patients with complex chemotherapy regimens alongside non-chemotherapy patients. While United Hospital has its own mother-baby center, most Allina locations do not.
From blood transfusions to antibiotics, chemotherapy
Infusions can range from blood transfusions to the administration of intravenous or intramuscular antibiotics, chemotherapy, immunotherapy, hydration and additional therapies for chronic conditions like chronic pain, autoimmune disorders and cancer.
The centers also inject long-acting drugs for schizophrenia and other mental health disorders.
The Minnesota Nurses Association noted that some infusion centers do not currently service patients needing high-risk medications, or who are pregnant, or do not offer blood transfusions because they’re not attached to a hospital, or do not have a pharmacist. Some currently only take Allina patients.
In addition to serving Allina patients, infusion center staff said the United Hospital site receives referrals from outside neurology clinics facing their own staffing shortages, as well as oncology clinics that lack the capacity to administer blood transfusions. Even OB-GYN clinics and mental health clinics use the center for patient injections.
“Excluding Allina providers, we have worked with over 35 different facilities,” said an infusion center nurse.
“It seems to me that there’s a pattern of taking patients who are not on commercial insurance and tossing them to the side,” she continued. “If you’re homeless or rely on medical rides, being directed to Lakeville or Faribault is insane. I don’t know that public transition will even get you there. Transportation, especially for the mental health population, is a challenge.”
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