FOSSTON — Essentia Health recently broke ground on an emergency room expansion in Fosston.
“We're actually building it out on the front of the building, so it'll be near the highway,” said Mike Curtis, Essentia Fosston administrator, in an interview Monday, April 20.
Curtis explained that after years of additions and renovations at the hospital, the current Fosston ER wound up in the middle of the building. The ER expansion — which officially broke ground on April 8 — will have an adjoining ambulance bay and six private patient rooms. It will also be roughly five times larger than the current ER.
“We're able to update it at the same time with some behavioral health-oriented rooms that are safer and just really better match the existing medical needs of our community and the way health care is moving,” Curtis said.
Systemwide, changes to federal health insurance programs like Medicaid have already led to a slight drop in patients seeking primary care, he said.
“Usually what that means is, maybe not at exactly the same time, but at least shortly thereafter, ERs start going up. If there aren't urgent cares, then it's ERs, and that is the community safety net,” Curtis said. “We were anticipating higher volume in general, which is one reason we are kind of adding space to it.”
Essentia Health is financing the $12 million ER project at Fosston, Curtis said, which has been part of Essentia’s long-term plan for the critical access hospital. Its service range includes a large swath of northwest Minnesota, including Thief River Falls, Crookston, Bemidji and Mahnomen.
Essentia Health announced last spring it would move ahead with two ER expansions: one in Fosston and a $13 million project in Virginia.
“We've all wanted it,” Curtis said of the ER project. “I'm just happy that we're able to do it now.”
Construction is anticipated to begin in earnest later this spring and slated to end by next summer.
In an April 3 news release, the city of Fosston stated that 17 years ago, as part of its agreement with Essentia Health, an ER expansion was discussed with a $5 million price tag.
"Had these commitments been fulfilled as originally agreed, the project could have been completed at a significantly lower cost,” the release stated.
Essentia Health and the city of Fosston have been at legal odds for years following the end of labor and delivery services at Essentia Fosston in 2022.
While area births are now redirected to Essentia St. Mary’s in Detroit Lakes, the city of Fosston has maintained that labor and delivery were core services as part of the 2009 agreement between Essentia and the nonprofit owner of Fosston’s hospital.
The parties are presently engaged in an arbitration demand petitioned by Fosston in late 2025 for a judge to compel more talks, after arbitrators in 2024 ruled that there was no breach of contract.
Essentia Health has posted a lengthy news release outlining its commitments to Fosston, in which it pushes back on some statements made by the city and highlights various projects the provider has undertaken at that site beyond the ER expansion.
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