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Shriners Hospital for Children in Minneapolis, which provides free orthopedic treatment, is developing plans to move away from hospital care and focus instead on same-day surgeries and outpatient services, according to a statement issued by its board chairman.

The 95-year-old hospital nearly closed in 2003 as part of a systemwide restructuring, but a local spokeswoman said that the facility is in no danger of closing and will continue to provide same-day services, which represents the bulk of its care.

"We are changing with the times and with orthopedic services in general," said Erin Jurkovich, director of professional relations at the Minneapolis Shriners' facility.

In a statement to the Upper Midwest Shriners' community, Roger Robinson, chairman of the board of governors, said more efforts will be made to reach children throughout the region, including the use of telemedicine and affiliating with other health care organizations.

"We are not closing the Twin Cities hospital," Robinson said in the statement. "The only change is for the inpatient procedures, in which case we will shift them to other partnering facilities just as we are currently doing in some cases."

Advances in orthopedic procedures have reduced the need for patients to remain hospitalized for observation and monitoring.

As a result, inpatient admissions at the Minneapolis Shriners 40-bed hospital shrank 65 percent between 2013 and 2016, according to data reported to the Minnesota Health Department, with just 90 patients admitted in 2016.

By comparison, there were 6,000 outpatient registrations, including 390 same-day surgeries.

The care is subsidized by Shriners temples, fundraisers and public donations.

However, financial pressures and overcapacity have put pressure on Shriners since at least 2003, when the national organization considered shrinking the system from 22 to 14 facilities.

The Minneapolis hospital was marked as the first to close because it was among the smallest in the network. Those plans were shelved after an uproar from Shriners groups and the community.

Another downsizing plan emerged in 2009 after the organization's endowment shrank because of the stock market plunge.

A plan to close six hospitals, which did not include the Minneapolis facility, also was rejected. But at the time Shriners said it might eventually convert some hospitals to outpatient care only.

Just this year, Shriners said it was considering consolidating hospitals that specialized in burn care. The burn center consolidation proposal is unrelated to any changes being considered at the Minneapolis hospital, Jurkovich said.

The hospital is not prepared to make a formal announcement about the changes, she added.

"I can assure you we are nowhere near having any decisions near or finalized," said Jurkovich. "Things have to be voted on by the Shriners fraternity because they own the hospital."

Nearly 40 percent of the hospital's patients come from Minnesota, with over half of those living in the Twin Cities metro area.

It also draws from North Dakota, South Dakota, Iowa, Wisconsin, Nebraska and even Canada, according to a report on the Shriners website.

Glenn Howatt • 612-673-7192