Regional Care Transformation Plan
Frequently Asked Questions

Why are these changes happening?

Our patients are asking for and expecting change.

• We’re listening to patients who said they need faster access to primary and specialty care appointments.
• Our patients also want new ways to access care, including home-based and virtual care options.
• Patients have also said they don’t want to go to a hospital for things like blood draws or minor procedures.

Munson needs to adapt to the financial challenges facing our industry.

• The COVID-19 pandemic has made finding the right workers harder for all industries but especially for healthcare.
• There have been incredible advancements in technology, new medications and specialized treatments. But it all comes at a cost, and reimbursements aren’t keeping up.
• Lower patient volumes in rural communities and scarce staffing resources are hurting rural healthcare systems nationwide.

If we don’t change, we won’t be around to care for Northern Michigan for the next 100 years.

• We are a non-profit healthcare system, but to be able to support our employees and provide the quality care our patients deserve, we can’t operate at a loss.
• Many rural community hospitals and healthcare systems across the country are closing — more than 150 in the past 10 years.
• We want to keep quality healthcare local for our patients in Northern Michigan for years to come.

How will this impact jobs?

The reality is we have 700 job openings right now at Munson Healthcare with staffing shortages hitting the whole healthcare industry post-Covid. So, while some jobs and job locations may look different due to the nature of our regional plans, it is our goal to retain our talented team members and engage them fully in the future talent and work plans.

How will we execute this plan with our recruitment barriers?

We have redoubled our efforts on Recruitment. We have had some big recruitment wins since January 2023, adding more than 2000 new hires across the Munson Healthcare System. Our HR and Marketing teams have been working hard to get creative. On the provider recruitment side, we’ve also had some recent wins, including in primary care.

Why is Munson regionalizing inpatient care to grow outpatient care?

We are focused on what our communities need. We are listening to their feedback and we looked at the numbers, including inpatient daily admissions (i.e. someone who is admitted and needs a bed at a hospital) at of all our hospitals. The data shows that we don’t need as much inpatient care as we may have historically provided. At the same time, we know our patients are looking for more outpatient and primary care services. To ensure we have the right staffing and resources to meet patient demands, we need to regionalize inpatient services and grow outpatient care.

For example, in Manistee, in-patient admissions have declined 40 percent. In Charlevoix, our average daily in-patient admissions are less than five people. At the same time, we recognize that patients struggle to get an appointment with a primary care doctor or receive a timely MRI. The current model isn’t sustainable for our communities. They are seeking more and better outpatient care, and this transformation will help meet that demand.

Is this MMC taking away inpatient care from community hospitals?

This plan will elevate MMC’s ability to provide even more high-level specialty care, but emergency care will still be available at every single hospital. Inpatient care will still be provided in every region. Moving to a system approach ensures we have the right care, at the right time, in the right place. This plan keeps our community hospitals open at a time when many rural community hospitals across the country are closing — more than 150 in the past decade.

Are services going to be taken away from some hospitals?

This plan expands heath care access and strengthens the services we provide across Northern Michigan. The transformation plan is focused on ensuring every community has the right services, staff and resources they need, when they need it. People will see more of Munson in their communities, but with a new front door – more primary care, urgent care and outpatient options.

Are any hospitals going to close?

No. All hospitals in the Munson Healthcare system will remain open. Some services may shift to a regional model; however, all of our hospitals will remain open with 24/7 emergency care, observation care and limited inpatient care.

Is Munson going to be sold?

No. We are not in discussions with anyone about a sale or merger. We are focused on our short-term and long-term plans of sustainability and growth as a system.

What are the Regional Care Transformation Plan changes?

All Regions

• Expanding primary care, improving access and expanding virtual care.
• Patients have a consistent, quality experience no matter what Munson Healthcare System front door you go through.
• Full emergency services remain at all hospitals.

East

• Otsego Memorial becomes a Regional Hospital.
• Charlevoix and Grayling become Community Hospitals; with observation and limited inpatient care, focused on more outpatient services.

South

• Cadillac becomes a Regional Hospital.
• Manistee and Paul Oliver become Community Hospitals; with observation and limited inpatient care, focused on more outpatient services.

Central

• MMC functions as High-Level Specialty Care Center, Available 24/7 to treat complex conditions. (i.e. NICU; Oncology; Critical Care, Stroke, Cardiology)

What is the timeline for these changes?

This is a three-year plan. Right now, we are announcing the vision and the foundation of the plan, but you will hear more in the months ahead. There will be many different milestones and checkpoints throughout the 3-year timeline.

What does it mean to become a “regional hospital” vs. a “community” hospital?

• We will be regionalizing some inpatient services to ensure we have the right services and staffing levels at the right time and location for the right patient care need.
• Community hospitals (Manistee, Paul Oliver, Grayling and Charlevoix) will still have emergency room care, observation care and limited inpatient care, outpatient services and outpatient surgery.
• Regional hospitals (Otsego Memorial/Gaylord and Cadillac) will have emergency room care, observation care, outpatient and inpatient services. Those needing higher levels of care may be required to go to either a regional hospital or Munson Medical Center in Traverse City depending on their condition or need.

Is OB closing in Grayling?

What we are discussing is an upgraded, redesigned regional birthing center that may change where you deliver your baby, but not where you receive all your care in the nine months leading up to delivering your baby. Local OB and Gynecology services will remain available to our patients in Grayling.

So you won’t be delivering babies in Grayling?

We expect to continue having deliveries in Grayling for at least two more years while we finalize redesign of the new birthing center in Gaylord.

Why Gaylord for the Regional Hospital Location and the Regional Birthing Center?

Gaylord has a larger population, has close access to a major highway, and it’s a growing community where long-term demand is anticipated to be strong.

Will there be job loss from this move to a regional birth center?

Where our team works and how they work might change. However, we already have scarce staffing resources which means we will need all of our teammates to make this vision a reality.

Why are some areas getting services and not others?

To truly function as a system, Munson Healthcare must look at things like in-patient volume, birth rates, population density, proximity to major roads and ability to recruit and retain the necessary staff to match patient needs in each community. All of these factors go into decisions around where and when to expand services. The changes we are making as part of this plan will help us provide the right care at the right time and in the right location.

Why are you investing in Gaylord’s birth center and pausing Munson Medical Center’s proposed Family Birth and Children’s Center?

Munson Medical Center’s Family Birth and Children’s Center is still in our 5-year plan. The proposed birthing center in Gaylord would be a redesign of an existing space rather than a new build like what’s being proposed in Traverse City. The costs are vastly different. Because of this and the fact these are different communities with different variables, the timelines may look different for these investments. In Traverse City, we are investing $3.5M in improvements to the current labor and delivery space, the inpatient pediatrics unit and the NICU given the pause of our full birth center project.

What is happening in the South Region with regionalizing in-patient services?

Right now, in Manistee, there are teammates on call for after-hours surgery at our Manistee Hospital to perform surgery and administer anesthesia. Due to low patient volume after 7 p.m. on weekdays and on weekends as well as staffing shortages, we will continue to do outpatient, scheduled surgeries during business hours when we have our surgical team on site. However, after 7 p.m. and on weekends, patients in Manistee needing emergent surgeries will be transported regionally to the appropriate hospital for care (i.e. Cadillac Regional Hospital or Munson Medical Center in Traverse City.)

Is any other hospital not doing after-hours surgery?

The transition in Manistee actually aligns with the services Paul Oliver Memorial Hospital currently offers. Surgeries are only performed at Paul Oliver during business hours. We have limited surgeries in Frankfort currently – and regionalizing after-hours surgery in Manistee aligns with what is already happening in Frankfort.

What is the date of this transition in Manistee?

Our target date for this transition is: by December 1, 2023.

Will Munson have inpatient services in the community hospitals?

We will still have emergency services, observation care and limited inpatient care in all hospitals. Additionally, we are looking to expand outpatient services and primary care in all communities. However, long term, we would look to significantly reduce inpatient load in our community hospitals (Charlevoix, Grayling, Manistee & Paul Oliver/Frankfort) and look to better utilize regional hospitals (Cadillac and Otsego Memorial/Gaylord) and MMC in Traverse City for our in-patient volume.

Will Munson have inpatient services in the regional hospitals?

Yes, we will have inpatient care in regional hospitals and at Munson Medical Center in Traverse City.

What’s going on with outpatient surgeries at my hospital under the new plan?

A major misconception following the rollout of the new plan is that all surgeries would be moved out of community hospitals into regional hospitals. Outpatient surgeries that are currently taking place at Manistee, POMH, Charlevoix and Grayling will continue under the RCTP.  

What are the next steps for the Petoskey Community Health Hub?

We are currently working to close on the purchase of the building, and we are working with the local government to rezone the property for medical use. That zoning process is public, which is why you saw the announcement go out when it did. We hope to have that process complete by the end of the 2023 calendar year. Following that, we’ll move on to the design and renovation process to build out the space.  

Is there an estimated opening date or expected hours of operation for the Petoskey Community Health Hub?

It's currently too early in the process to announce an estimated opening date or hours of operation, but construction is expected to start in the spring.

Is Kalkaska part of the Regional Care Transformation plan?

While Kalkaska isn’t an owned entity, and not subject to the transformation plan, it is an important affiliate. They are a great example of what we envision our community hospitals to look like in the future. They provide broad based outpatient services and robust emergency services. Inpatient services at KMHC are available for appropriate level of care, keeping those patients in the community closer to home.