By Gerry Gilmour, Published November 17 2001
In the spirit of the pastFargo's oldest hospital has a new name with a familiar ring.
Prairie Psychiatric Center this past week became Prairie at St. John's, a Catholic hospital.
Nestled against the dike south of downtown Fargo, the hospital daily serves more than 100 adolescent and adult patients needing chemical dependency and psychiatric treatment.
"We wanted to be a faith-based hospital," said Dr. Stephen Setterberg, who founded the hospital five years ago with Dr. Jack Lind, his partner in Psychiatric Medicine Associates.
Setterberg and Lind opened their hospital, first known as Childrens' Psychiatric Hospital, when Paracelsus (now Clarent Hospital Corp.) moved its traditional hospital practices out of the old St. John's building and into the Dakota Hospital (now Heartland Hospital) building on south University.
"We felt psychiatric care was not a high priority in their plan," Setterberg said.
"It dawned on us then that we should open our own psychiatric hospital. We also wanted a patient-centered approach, and wanted to move away from the managed-care approach Paracelsus had brought. We wanted to get back to the heart of medicine."
Soon after opening, the new hospital added adult inpatient psychiatric services, and the name was changed to Prairie Psychiatric Center.
The hospital today is owned by Setterberg and Dr. Emmitt Kenney Jr. as a limited liability corporation. What opened as a 29-bed facility today is licensed by the state of North Dakota as a 53-bed facility. The hospital leases approximately half of the 170,000-square-foot building from Clarent. Psychiatric Medicine Associates moves into two floors of the hospital next month, relocating from the Professional Building just north of the hospital.
The hospital's board of directors in July of 2000 contacted the Fargo Diocese's bishop's office about the possibility of making Prairie a Catholic hospital.
"We wanted to make sure the spiritual needs of the patients were being met," said Marshall Korman, chief executive officer for Prairie at St. John's.
Setterberg said the decision came down to values. "We felt that, ultimately, the values that drive health care should be spiritually based, based on a belief that life has meaning. Values just don't appear out of a vacuum."
They decided to return the institution to its roots: and the name Prairie at St. John's was chosen.
St. John's was founded in Fargo in 1900, at the urging of Catholic Bishop John Shanley, by St. Paul province's Sisters of St. Joseph of Carondelet. Bishop Shanley's residence served as the first hospital. The sisters built a hospital on the current St. John's site in 1904. It was added to in 1935 and 1940, then protected by a permanent dike, and the rerouting of the Red River, in 1960. A new wing was added to the facility in 1965.
"Everybody who talks about the old St. John's has similar things to say," Korman said. "Everybody has positive feelings about St. John's. It was clear to us that St. John's had an image we were aspiring toward."
After getting approval from the Fargo Diocese to make Prairie at St. John's a Catholic hospital, the diocese assigned the Rev. J.L. Evans to the hospital. The 48-year-old Fargo native, who had served as an associate pastor at Holy Spirit of Fargo, was assigned to Prairie at St. John's as a hospital employee.
The St. John that the hospital is named for is St. John the Evangelist, a fisherman who was the youngest of the 12 apostles. "He was at the foot of the cross when Jesus was at his most intense suffering," Evans said. "Jesus entrusted his mother to the care of John. The parallel to us is that people entrust their family members to our care, for days and sometimes weeks."
Evans serves on the hospital's faith committee, composed of representatives of a cross-section of religions. Last year, the committee commissioned local artist Janeen Kobrinsky to create a work capturing the hospital's spiritual mission.
Kobrinsky's oil painting, "Prayer of the Heart," hangs in the hospital's tiny fourth-floor chapel.
The rust-colored work, ringed in gold, is a collage of inspirational lines criss-crossing the canvass in multiple type faces.
"It speaks to the miracle of self-discovery," Evans said.
The discovery for many of the depressed and chemically dependent in treatment is that their life matters.
"People need respect and dignity," Evans says. "When they arrive here, they often feel maligned and left out by their communities. They feel abandoned spiritually -- either they feel abandoned by their church or they have abandoned their church.
"They think that 'Nobody cares about me -- not even God.' For the chemically dependent, they've put alcohol or another chemical before their God."
Evans is conducting a study at Prairie at St. John's to look at how prayer changes in the lives of patients at the hospital. "My gut feeling is that two-thirds of the people, when they arrive here, either don't pray daily or don't pray at all," Evans says. "My guess is that 85 percent of adults, when they leave here, are doing some sort of daily prayer or meditation."
Daily morning reflection and several weekly masses are incorporated into the programming at the hospital. Evans is assisted in his spiritual duties at Prairie at St. John's by the Rev. Sonja Kjar, a Lutheran pastor.
"When I began working here, I could visit with everyone in a day. Now, with more than 100 patients a day, I don't have the time," Evans says. "I have a lot of admiration for the courage of patients as they address their issues. It's hard work. And they face the stigma against mental illness and chemical dependency."
Most of the psychiatric hospital's growth has been in the care and treatment of adults, many facing chemical dependency issues or a dual diagnosis of chemical dependency and mental illness, such as severe depression.
"We expanded because we kept seeing more and more need for treatment of adults," said Korman. "The majority of our patients here have dual diagnoses."
The hospital draws from a geographical area ranging east to west from Alexandria, Minn., to Jamestown, N.D., and north to south from Grand Forks, N.D. to Sisseton, S.D.
Korman said Prairie at St. John's also receives referrals from other states. About 45 percent of the hospital's budget is funded by primary care insurance payments, while 35 percent comes from Medicare and Medicaid, he said. The remaining 20 percent comes from patient co-payments and other insurance payments.
Much of the care at Prairie at St. John's is provided on an outpatient basis.
Many adult chemical dependency patients, for example, are in treatment from 8 a.m. to 4 p.m., then return to their homes and families in the evenings.
"Discharge thinking begins at the moment they are admitted," Korman said.
Setterberg said the length of stay and level of care is determined in a thorough assessment made almost immediately after patients are admitted.
"In the 1980s, the average length of stay for an adolescent was 60 to 90 days," Setterberg said. "Now, with an immediate assessment of the patient, the average length of stay is 10 days. It's almost a function of the post-managed care system. We still manage the care, but we have a system that addresses the economic viability of the care up front."
Readers can reach Forum Business Editor
Gerry Gilmour at (701) 241-5560