MACHIAS, Maine — After several years of turbulence, which included a court-ordered receivership, the death of a patient, lawsuits and an interim CEO who has been working to turn things around, Down East Community Hospital received its full state license Tuesday.
The hospital had been operating under a conditional state license since 2008, and interim CEO Doug Jones said Tuesday the hospital staff knew they would be carefully scrutinized.
“This process has been so rewarding,” Jones said. “This community really rallied around the hospital. Whether they were supporters or critics of DECH, people wanted the local hospital to survive.”
The state placed the hospital in receivership in July 2009, with Eastern Maine Healthcare Systems of Brewer taking over operations after a number of investigations into clinical and administrative complaints.
The highest-profile incident at DECH was the death in January 2008 of Reid Emery, 61, of Eastport. Emery checked out of the hospital against doctors’ wishes on a cold, snowy evening and, heavily drugged from his stay at the hospital, was found dead the next day in a nearby snowbank.
An investigation by the federal Centers for Medicare and Medicaid Services into Emery’s death found, among a number of other deficiencies, that hospital staff had failed to meet the safety needs of the patient.
Area residents became so concerned they formed two advocacy groups, the Committee to Save Our Hospital, and Friends of DECH.
Other investigations identified problems in emergency care and surgical protocols, and in November 2008 patient files apparently stolen from the hospital washed up on a nearby riverbank.
Surveyors from the Maine Department of Health and Human Resources made an unscheduled visit to DECH late last month, Jones said Tuesday.
“At the conclusion of that visit, the lead surveyor told us it was an awesome experience,” Jones said.
He said that requalifying for the full license was so meaningful that many staff members were in tears.
Obtaining a full state license, however, does not mean an end to the court-ordered receivership.
Jones said DECH still needs to appoint a new board of trustees and install a new financial plan before DHHS can petition the court to remove the receivership status. Eastern Maine Healthcare Systems has acted as the hospital’s receiver during this transition.
“There are still a number of steps to complete before the court can be petitioned to lift the receivership order linking the hospital with EMHS. In many ways that is very good because even though DECH is capable of providing quality care on its own, we continue to receive an incredible amount of support from EMHS,” Jones said.
Jones said an applicant review panel, charged with creating the new board of trustees, met last week.
“There are 38 candidates,” Jones said. He said a decision will be made soon and the board will govern “with fresh eyes.” He said two previous board members likely will remain on the board to provide continuity.
Jones said nearly 50 people have submitted applications of interest for seats on the board and advisory councils, and those applications will be reviewed by a panel composed of EMHS directors, business and community leaders from Washington County, and DHHS officials.
In addition, lawyers are conducting a review of the hospital’s bylaws and will make recommendations for improvement.
“So there is still a lot of governance work to be done before the receivership is dissolved,” Jones said.
Jones said one of the major changes at DECH under his tenure is the installation of a complex quality improvement structure, which was created from scratch and operates very much as a business mode. “Checks and balances are built right in,” Jones said.
He said the DHHS survey team told him this was the best quality improvement program they had seen in a small hospital in Maine and could easily compete with programs at larger hospitals.
In addition, Jones said many staffing leadership changes have been made and new directors of nursing, emergency services and outpatient services have been hired.
Jaclyn MacIntyre, vice president of professional and support services, said the surveyors focused on whether problems discovered in 2008 that prompted a conditional state operating license had been solved.
“They combed over records in the emergency department, pharmacy department and nursing areas, as well as completed an exhaustive review of hospital policies and found everything to be in order. I am especially proud that the surveyors noted that DECH, as an organization, is displaying increased professionalism and pride in what we do,” MacIntyre said.
Michelle Hood, president and CEO of Eastern Maine Healthcare Systems, said Tuesday the health care system would likely be interested in continuing some type of contractual relationship or strategic affiliation with DECH.
“Preserving access to quality health care is our mission and something we take very seriously,” Hood said. “From clinical and quality oversight to planning and communication, EMHS has been proud to support DECH and the Machias community.”
Jones said that when he was hired to rebuild DECH he knew it was a staggering task.
“But I was never overwhelmed,” he said. “It was energizing. There were surprises and lots of rumors, which was new and different for me. But it has been so rewarding.”
Jones said he is interested in being hired as the permanent CEO, but that decision will be made once the new board of trustees has been installed.