Health care in Winneshiek County follows an unusual model, one that differs from many community-owned hospitals.
Several readers have asked for an explanation of who owns what, so here goes:
When the hospital was located in the old Smith Building in Decorah, it began running out of space. That's when Winneshiek County stepped in to purchase land on Montgomery Street that could be used for a new hospital.
The county still owns that property to this date and leases it for $1/year to the Board of Trustees of Winneshiek Medical Center. That lease and the property tax levy the county imposes for funds for the hospital are the county's involvement in the hospital.
The hospital then built a building on the county-owned land. The building itself belongs to the hospital.
In 1993 when Mayo Clinic Health Systems moved into a new clinic building connected to the hospital, Mayo signed a lease for the county-owned land. In 2005 when Winneshiek County Memorial Hospital bought out Mayo Clinic, the lease was folded into the overall hospital lease with the county and the building and the clinic became the property of WCMH.
That brings us back to today. Winneshiek County owns the property the hospital and clinic sit on and leases the property to Winneshiek Medical Center. The hospital owns all its buildings. It pays Mayo Clinic Health Systems for the work of Mayo physicians, as well as for the work of Mayo administrators. In that sense, Mayo Clinic Health System is a contractor--it does not own any of the facilities, nor does it have a lease with Winneshiek County, but it provides services to the hospital for which it is paid.
(Clarification: While the hospital owns all the buildings it uses, Northeast Iowa Behavioral Health owns the building it uses and rents the county-owned land.)