North Memorial takes over Nashwauk ambulance 4 months before county contract starts

NASHWAUK — North Memorial Health took over the Nashwauk ambulance on Wednesday, Sept. 3.

North Memorial, which is owned by the Brooklyn Center-based nonprofit North Memorial Medical Center, signed a three-year contract with Itasca County earlier this year. The County Board of Commissioners voted in February to take over the long-struggling ambulance service from the city of Nashwauk, creating a special taxing district to pay for it.

The contract and taxing district don't begin until Jan. 1, 2026, but North Memorial wanted to take over sooner “to just get their operations up and running,” said Eric Villeneuve, Itasca County health and human services director, in an interview.

So, the city of Nashwauk transferred the license for the ambulance service area to North Memorial, who will then transfer it to Itasca County in the new year.

How will ambulance services change under North Memorial?

In an interview, North Memorial Manager Rob Almendinger said residents can continue to expect timely and reliable service. Almendinger also manages North Memorial’s operations in Brainerd, Park Rapids, Grand Rapids and smaller communities in between.
He said he will manage Nashwauk along with the Grand Rapids supervisor, who is Matt Vangrinsven, according to North Memorial’s website.

North Memorial began operating in Grand Rapids in 2024 after buying Meds-1, which was dealing with its own financial issues as a result of the state of emergency medical services.

The Nashwauk ambulance service area covers much of eastern Itasca County, stretching north to Bearville Township and south to Goodland. It also includes parts of Taconite and Balsam Township and Marble, Calumet and Keewatin.

Nashwauk area residents can expect to see many of the same faces.

Almendinger said they hired all staff who wanted to continue with North Memorial. The service will now have eight full-time staff, rather than six full-time and some part-time. He said the staff also have a higher hourly wage and some will work shorter shifts to ensure safety.

The staff may be familiar, but their ambulance may not be. Type 2 van ambulances will be stationed in Nashwauk that are either brand new or close to new. Almendinger said the van ambulances are smaller and easier to maneuver.

Nashwauk’s two current ambulances will be stationed elsewhere, with at least one likely kept in Grand Rapids as a backup.

“There’s only ever been one ambulance on duty at a time in Nashwauk, and we’re not changing that. The other one is just a spare in case there's a mechanical breakdown,” he said. “So, the way North manages our fleet, we always have spares strategically located across our entire area.”

Who’s paying for all this?

In February, Itasca County created a subordinate service district, which will spread the cost of the ambulance service across the entire Nashwauk service area. Previously, just the city of Nashwauk shouldered the cost.

But the taxing district doesn’t start until the new year. Villeneuve said North Memorial will pay for the cost of running the ambulance service until then.

Here’s how it works once the North Memorial’s contract with Itasca County starts Jan. 1, 2026:

North Memorial will charge for services directly or through insurance, just like any other ambulance service. They won’t be allowed to change their rates more than once a year.
Additionally, Itasca County will pay an annual subsidy with the taxes collected in the service district. The amount of that subsidy was calculated based off how much money Nashwauk was losing when it owned the service and North Memorial’s cost projections.
The subsidy for 2026 is $652,519. It increases to $685,144 in 2027 and $719,401 in 2028.

"After we’ve done the three-year contract, I think we’ll have a better idea of revenues and expenses,” Villeneuve said, noting legislative fixes to ongoing emergency medical services challenges could change things further.

A $650,000 levy would have meant about an extra $100 a year in property taxes for a $250,000 house, the county estimated in February.

The city’s equipment will go to North Memorial, which will be responsible for maintenance.

Nashwauk also agreed to let North Memorial use parts of the Nashwauk Public Safety Building at no charge during this first contract.

Why did the city of Nashwauk stop running the ambulance service?

The city of Nashwauk has owned and operated an ambulance service since the early 2000s. Before that, the local service was privately owned, like Meds-1 before its sale.
But the city has been operating at a loss and was trying to find another someone to take over the service area for a few years.

April Kurtock, Nashwauk city administrator-clerk-treasurer, told the County Board in February that the challenges they’ve faced are no different than other rural ambulance services.

“We have staffing shortages, expensive equipment replacement costs, Medicare’s dismal reimbursement rates and growing deficits,” she said.

Because the service was municipally owned, only the city — and its taxpayers — were paying for the ambulance service. But it was still required to respond to calls for service throughout its larger service area.

“The citizens and taxpayers of Nashwauk shouldn’t have to pay for the service that is utilized by this vast geographical area,” Nashwauk City Councilor Sheila Jensen told the Board in February. “And I’m just glad that this solution came to our attention so that we could start to pursue this process. I think it is the most fair.”

That financial inequity isn’t unique; Cass and Hubbard counties jointly took over the Walker ambulance district in January after similar challenges.

Karen Calaguire was with the Nashwauk ambulance service for nearly 30 years, first as an emergency medical technician when it was privately owned before becoming the coordinator when the city took over.

“I was honored to be part of a wonderful organization for all those decades, and I did stay with it because I truly — and still do — miss that need just to be a caregiver and help others in their time of need,” she said.

She said when she retired about five years ago, the service was doing fine. Calaguire was the only full-time employee.

“And then they went to a full-time model for their employees, so that I think really affected the budget,” she said.

It’s bittersweet to see North Memorial take over after so many years of local ownership, Calaguire said, but she’s not concerned.

“We did a lot of community events and involvement to kind of put ourselves out there, so I hope that North Memorial continues to invest within the community.”