MACHIAS, Maine — About a year ago, a small group of concerned residents banded together to draw attention to problems at their local health care facility.

Sadly, the group said, little has changed at Down East Community Hospital during that time.

“Things are worse now,” Annie Dickinson, one of the founding members of the Committee to Save Our Hospital, said Saturday. “The community is fed up.”

Dona Emerson, acting president of the hospital’s auxiliary board and member of a different community group — the Friends of DECH — has a different view.

“We feel like the Save Our Hospital Committee has done some real damage and has created a divide in the community,” Emerson said Saturday. “They are not the only voice. We want people to know there are some who support the hospital.”

Friction between the two sides has increased in recent months, particularly as DECH continues to find itself in the news for the wrong reasons.

Just last week, state and federal licensing agencies released a report indicating the Machias hospital had failed in numerous emergency room procedures during an incident last fall. It was the third federal survey in about 15 months that found DECH out of compliance and required drastic changes in various procedures at the hos-pital.

Additionally, the federal Centers for Medicare and Medicaid Services has informed the hospital that it is prepared to terminate DECH’s participation in the Medicare program after April 15. Robin Popp, a spokeswoman for the hospital, said in a statement released over the weekend that DECH staff are working diligently to en-sure that Medicare termination will not occur.

Even if the hospital comes into compliance, though, the divide between those who want to see the current hospital administration accept blame and those who stand unwaveringly behind DECH leaders is growing.

Florence Wood, a member of the Committee to Save Our Hospital, said the only resolution acceptable to her is for hospital CEO Wayne Dodwell to step down. She also said DECH should sever ties with Quorum Health Resources, the national company that provides Dodwell’s management services to the Machias hospital.

Susan Hassell, a spokesman for Tennessee-based Quorum, said in a recent interview that the hospital’s board of trustees makes all decisions related to personnel. So far, she said, they have backed Dodwell.

Emerson, who took over the auxiliary board after the previous president, Janet O’Neal, was forced out for her involvement with the Save Our Hospital Committee, said the hospital is facing significant public pressure.

“Can any hospital meet the level of standards we’re forced to meet?” Emerson asked. “For every tragedy people read about, there are so many good stories.”

A handful of community members who were interviewed Saturday in Machias were reluctant to speak on the record about the issues facing Down East Community Hospital. Some seemed genuinely concerned, others not as much, but all admitted they have been paying close attention.

DECH’s public image problems date back several years. At the beginning of this decade, the hospital faced serious financial turmoil, which precipitated the arrival of Quorum Health Resources and a new CEO. Dodwell did what he was asked, turning around DECH’s finances within two years.

In the process, though, some people feel Dodwell’s approach has alienated staff. Since his tenure began in 2002, a number of longtime physicians have left the hospital, while others have been forced out. At least two doctors have taken DECH to court over what they feel was unfair treatment and termination.

“If the hospital thought it had a hard time recruiting doctors before, what about now?” Wood said.

The revolving door of doctors is an issue at most rural hospitals, not just DECH. Up until January 2008, most of the concerns at the hospital involved internal politics.

That all changed when Reid Emery, a hospital patient who checked himself out the evening of Jan. 1, 2008, was found dead in a snowbank near the hospital the next day.

Emery’s death — caused by a combination of hypothermia and an accidental overdose of drugs he was given at DECH — prompted the first federal investigation. It also created the first hint of uneasiness in the community about care at their hospital.

Since then, a host of complaints have been filed with the state Department of Health and Human Services about DECH, many of which have turned up unfounded.

Others, however, have resulted in additional investigations by the state and CMS, which in turn have resulted in required changes at the hospital.

Last November, police discovered numerous hospital files washed up on the bank of a nearby river. The files, which contained confidential patient information, had been stolen from the hospital in what most agreed was an inside job. So far, the person or people responsible have not been found.

Earlier this year, a full federal survey of the hospital prompted the state to put DECH on a conditional license based on concerns in four areas: pharmacy records, clinical records, standards of care and patient safety.

The hospital came into compliance with those concerns a short time later but remains on a conditional license.

The latest investigation completed late last month uncovered improper procedures in emergency room care. A patient who was taken to DECH for treatment of a possible head injury reportedly was not seen promptly or stabilized properly for transfer to another facility. The man later died at a Bangor hospital, although DECH has not been held responsible for his death.

While the state and federal agencies continue to closely monitor progress at the hospital, the two competing community groups struggle to find common ground.

“They don’t want anyone that disagrees or debates with them,” Dickinson said, referring to the board of trustees and hospital administration. “Our job is to tell the truth, however painful that is for them.”

Emerson said she’s willing to work together to soften hard feelings in the community, but she’s not sure how to do it.

“There has to be a compromise somewhere in the middle,” Emerson said. “Until that happens, there is a black cloud over the community.”