ONTONAGON — Despite searches for a last-minute solution, there is no outcome that will prevent closure of the Aspirus Ontonagon Hospital emergency room and hospital after its planned closure on April 20, Ontonagon County officials said Monday.

Three Ontonagon County representatives met last week with Top Upper Peninsula administrators from Aspirus to discuss the impending closure of the Aspirus Ontonagon Hospital and see if there was any chance to keep the facility open.

On April 20, Aspirus will close the hospital and emergency room, reducing operations to an outpatient-only rural health clinic.

“The bottom line is now, there are no solutions,” said Ontonagon County Emergency Manager Mike Kocher, who attended the meeting along with Ontonagon County Sheriff Dale Rantala and a member of the county board.

An Aspirus representative could not be reached for comment Monday.

Kocher thanked Rep. Jack Bergman and his office for their help, without which a sitdown with Aspirus would not have happened, Kocher said.

A member of Bergman’s staff had been on the line during the meeting, and made some suggestions. However, it does not appear there can be any remedy before the hospital closes on April 20, Kocher said.

“It wouldn’t matter now if the states threw $10 million on the table, or the feds threw $10 million the table,” Kocher said. “That ship has sailed. Aspirus is not going to maintain a hospital in the county.”

One possibility had been a Rural Emergency Hospital designation, created in 2022 as a way to retain care in rural facilities that would have otherwise closed. Though barred from offering most inpatient care, REHs would be able to provide emergency department services, observation care and additional outpatient services that would not require a stay of more than 24 hours.

However, Kocher said, Aspirus officials said Ontonagon’s hospital did not meet the criteria.

Aspirus also rejected the possibility of expanding its clinical services to seven days a week, saying there were not enough doctors or physician assistants to make that arrangement work, Kocher said.

While some states have requirements in place that hospitals provide notice of six months to a year before closing, Michigan has no such provisions, Kocher said.

Aspirus remained open to the idea of selling the facility to another party, Kocher said. Aspirus has owned the hospital since buying it from the Village of Ontonagon for $1 in 2007.

Asked about selling it back to the village or county, Aspirus officials said they did not believe they would be able to afford to operate it, Kocher said. If they had bought it, it would need to be operated similarly to Baraga County Memorial Hospital, Kocher said. That facility is operated as a health facility corporation.

No offers are on the table, but Aspirus is willing to entertain offers, administrator told Kocher.

“It was not a no,” Kocher said. “It wasn’t a super-yes, but they would be open to a proposal.”

In its release announcing the closure of the emergency room and hospital, Aspirus had noted the declining patient numbers, which averaged only one inpatient. The emergency room averages five patients per day, Kocher said. Aspirus did not provide numbers regarding financial losses to the Ontonagon County officials, but said it had operated at “a definite loss” for the past five years, Kocher said.

One of the biggest expenses is contracted emergency room doctors, which Aspirus uses at all four of its Upper Peninsula hospitals, Kocher said.

“Aspirus does not have enough doctors, staffing in general, so all four hospitals are contracted ER doctors,” he said. “That’s one of their higher fixed costs.”

One positive is the number of employees who have been able to find other work, Kocher said. Out of about 50 employees, 70% have been able to find jobs, many of them within Aspirus. Another 15% have retired, while the remaining 15% are still looking for employment.

In the meantime, Ontonagon County is trying to firm up arrangements with ambulance services in other counties to ensure emergency service remains intact. With no hospital in Ontonagon, the next-closest options would be in Baraga, Hancock and Iron River.

SONCO Ambulance is Ontonagon County’s main ambulance service. It has two ambulances stationed at the north end of the county at the sheriff’s department, and one on the south end at the Ewen Fire Hall. Rantala said they are also working on keeping an ambulance in Mass City or Rockland.

“We’re trying to provide so that when people dial 911 in the county, an ambulance will arrive,” Kocher said. “We really have no idea other than that it’s going to be a drastic change from within a five-minute ride from Ontonagon, to the hospital in Baraga being the closest.”

Kocher praised the state’s Emergency Medical Systems office, who has worked with the county to make sure the ambulances don’t cause any regulatory issues when they cross county lines.

Ontonagon County is also looking to beef up its first responder training. Sheriff’s department staff, corrections staff and volunteer fire department members will undergo medical responder training. The 60-hour class — 40 hours of online lessons, 20 hours of hands-on training — will have instructors from Aspirus Medivac, Kocher said.

“My deputies are out on the road, so there’s a good chance they’ll be on scene before the ambulance is,” Rantala said. “I want to get my corrections officers trained .. the more training you have, the better off you’ll be.”

Kocher said the CEOs of Baraga County Memorial Hospital and Upper Great Lakes Family Health Clinic have also provided helpful advice. Kocher said they hope to have future talks with UGL, which operates a clinic near the Ontonagon hospital.

Kocher and Rantala planned to meet Monday night with a subcommittee of Village of Ontonagon officials bringing them up to date to prepare for the 20th.

“We tried our best to keep the hospital open, but we were unsuccessful,” Rantala said. “Now we’re working to our best ability to get emergency services for medical reasons, everything possible that we can do.”